Biomedical subjects

Hilde Eide

Publications and source records attributed to Hilde Eide.

9 recordsLinked to original sources

PubMed2005

Changes in physician-patient communication from initial to return visits: a prospective study in a haematology outpatient clinic.

Limited research has investigated how physician-patient interaction changes over time. We have therefore examined physician-patient communication during the two initial, as well as the seventh (on average) patient visit to a haematology outpatient clinic. Consultations were audio taped and analyzed using the Roter interaction analysis system (RIAS). Patients completed the Impact of Events Scale (IES) before and a satisfaction questionnaire after each consultation. Consultations were generally physician dominated and task-focused. While the amount of task-focused communication was significantly reduced between the initial and the return visits, the amount of socio-emotional communication remained quite stable. In return visits (but not in the two initial visits), patients with more severe diagnoses were given longer consultations and they provided more task-focused information to a less verbally dominant physician. Patients were more satisfied in the second and return visits (but not in the first), if consultations contained greater levels of socio-emotional communication.

Adult↗

PubMed2004

Listening for feelings: identifying and coding empathic and potential empathic opportunities in medical dialogues.

The objective of the study was to validate the model of empathic opportunity (EO) and potential empathic opportunity (PEO) using the Roter Interaction Analysis System (RIAS) in a sample of cancer patients. Thirty-nine audio taped consultations at an outpatient oncology clinic performed by four oncologists were previously coded with the Roter Interaction Analysis System for another purpose. These consultations were also coded by two raters with the empathic and potential empathic opportunity method (E-PE-O method). The reliability of EO and PEO coding was satisfactory. Most of the EOs were found within the RIAS category "showing concern". The PEOs were found in both the socio-emotional and the instrumental categories of the RIAS. We conclude that the E-PE-O method is a good starting point for studying the empathy process in oncology consultations.

Empathy↗

PubMed2004

Physician-patient dialogue surrounding patients' expression of concern: applying sequence analysis to RIAS.

The aim of this study was to analyse with sequence analysis physician-patient dialogue surrounding patients' expression of emotional cues. Two samples, sample 1 consisting of 36 cancer patient consultations conducted by four oncologists, and sample 2 consisting 79 consultations of haematology patients conducted by nine specialists, were audiotaped and coded with the Roter Interaction Analysis System (RIAS). Sequence analysis by means of a generalized sequential querier (GSEQ) was applied to the coded data. Lag sequential analysis (analysed using RIAS categories) showed that certain behaviours of physicians corresponded with patients' expressions of concern. Physicians in both samples used silence and minimal encouragers before patient concern. The oncologists also used optimistic and affirming responses. The most common physician responses to patients' concern were minimal encouragers or affirming and optimistic responses. Sequence analysis based on RIAS coding appears to be a promising method for the study of doctor-patient dialogue and should be utilized more in studies of the communication process in medical consultations.

Adult↗

PubMed2004

Nursing home residents' dependence and independence.

BACKGROUND: Entering an institution constitutes one of the most difficult developmental challenges for older people, and may lead to increased dependency because of reinforcing environmental events such as the interaction pattern of the staff. AIMS AND OBJECTIVE: The aim of this paper was to describe the pattern of social interaction between nursing home residents and the nursing staff during mealtimes. DESIGN AND METHODS: Six residents of a nursing home in a suburb of Oslo were observed. Data were collected during 120 systematic observations. Different types of behaviour relating to the residents' level of independence when interacting with the staff were examined using a structured observational scheme developed by Baltes. RESULTS: Data showed that the residents' maintenance of independent self-care was the most predominant behaviour. Residents were rarely socially active. The behaviour of one resident varied among meals. Observations of independent self-care maintenance during interactions between the residents and the staff were sometimes consistent and sometimes inconsistent. The response of the nursing staff to the residents' social engagement was variable. Generally, however, they did not respond at all and seldom displayed engagement-supportive behaviour. CONCLUSIONS: The results represent a challenge to the nursing staff to increase social interaction during mealtimes, and also to examine their inconsistent behaviour towards the residents. RELEVANCE TO CLINICAL PRACTICE: Mealtime appears to be a good opportunity to foster the independence of the residents as well as to enhance social activity in the form of informal conversation. Greater consistency of staff behaviour is required, based on ethical values such as consideration of the residents' self-esteem and autonomy, thereby stimulating independent self-care at mealtimes. Inconsistent behaviour, often based on values that are not clarified, may, on the contrary, lead to increased dependence of the residents.

Aged↗

PubMed2003

Interaction analysis of physician-patient communication: the influence of trait anxiety on communication and outcome.

Little attention has been paid to how patients' personality traits interfere with the communication and the outcome of physician-patient interaction. We performed an experimental study with students with high and low trait anxiety as patients. One physician conducted a single consultation with 41 students applying two beforehand-specified consultation styles. Patients completed questionnaires concerning emotional state and satisfaction. The actual content of the consultations was analyzed by Roter interaction analysis system (RIAS). The physician gave more biomedical information to low-anxiety students than high-anxiety students. Students who provided a lot of biomedical information themselves were less tense after the consultation. However, students with high anxiety were more dependent on the physician actively asking biomedical questions for them to be able to deliver that same information. In contrast to low-anxiety students, those with high anxiety were less satisfied after consultations involving many psychosocial questions posed by the physician and a good deal of emotional talk on their own part. Compared to low-anxiety students, students with high anxiety were less satisfied and tenser after consultations with much positive emotional talk on the part of the physician. We conclude that physicians and educators should be aware that psychological and emotional communication may be experienced as intrusive and inappropriate by patients with high trait anxiety when they present minor somatic problems.

Adult↗

PubMed2003

Physician communication in different phases of a consultation at an oncology outpatient clinic related to patient satisfaction.

The aim of this study was to identify the relationship between content during the different phases of the consultation and overall patient satisfaction with regular follow-up consultations at a cancer outpatient clinic. Thirty-six consultations were analysed with Roter Interaction Analysis System (RIAS). In the statistical analysis, timed events of the RIAS categories were used. The regular follow-up consultations were rather short aiming at discussing medical and therapeutic aspects of the illness. There was a positive correlation between physician informal talk (IT) and patient satisfaction in the history-taking phase. Patients were found to be dissatisfied if the physician had focused on a great deal of psychosocial exchange (PE) during physical examination. Our study suggests that the physician should not initiate discussion of psychosocial topics during physical exam. This result should be studied further in other samples and designs.

Adult↗

PubMed2002

Analyzing medical dialogues: strength and weakness of Roter's interaction analysis system (RIAS).

Roter's interaction analysis system (RIAS) is analyzed in this article. Ground rules of linguistic interaction analysis, emphasizing meaning as a product of interaction and turn taking as a basic principle for the understanding of interaction are briefly introduced. Specific aspects of the application of RIAS are discussed and a number of adjustments and/or specifications suggested: (1) utterances should be defined in terms of content and turn taking criteria; (2) the recording system should allow for registering interruptions; (3) pauses or silences should be scored on the basis of functional criteria and not as demarcation in the communication; (4) clear distinctions should be made between the categories of "backchannel" and "agree"; (5) questions should be coded according to function rather than linguistic form; (6) some of the socioemotional categories may appear too narrow, others too wide; (7) crying should be included in the coding scheme as a separate category.

Communication↗

PubMedDate not supplied

Long term benefits of communication skills training for cancer doctors.

OBJECTIVE: To assess satisfaction and learning accomplishments after communication skills training courses for cancer doctors in the Nordic countries. METHOD: 155 physicians from the five Nordic countries participated in a communication skills training course. Questionnaires were completed at baseline, at course completion and at follow-up after 2 to 6 years. RESULTS: 94% of the physicians indicated satisfaction with the course. Physicians who had participated in the whole course (as opposed to those who had participated only in parts of the course) and physicians from Denmark and Sweden were most satisfied with the course. Whereas physicians at baseline most frequently reported a need to learn specific aspects of communication, often with emphasis on psychiatric problems, at follow-up they most typically reported that they had learnt basic communication skills (i.e. to listen and to pose open-ended questions). The majority of the physicians reported at follow-up that they applied the learnt skills to patient-related work, in relation to colleagues and on a personal level. CONCLUSION: Communication skills courses for senior clinicians with no previous formal training in this field should emphasise basic communication skills as well as the handling of difficult situations in doctor-patient interaction.

Adult↗

PubMedDate not supplied

Exploring rare patient behaviour with sequential analysis: an illustration.

AIMS: To illustrate the application of sequence analysis to the study of rare patient behaviour in physician-patient dialogue. The rare behaviour in question here is patients' expression of emotional cues and concerns. We investigate which physician behaviours precede and follow such expressions. METHODS: Thirty-five cancer-patient consultations performed by four oncologists (two male and two female) were analysed. The consultations were coded with the Roter Interaction Analysis System (RIAS). Sequence analysis by means of Sequential Data Interchange Standard (SDIS) and the Generalized Sequential Querier (GSEQ) was applied to the coded data. Lag analysis (using RIAS categories) was applied to associate the given behaviour (patient 'concerns') with target behaviours (physician utterances). RESULTS: For female physicians the significantly associated behaviour before the patient's expression of concern was reassurance, while male physicians also applied facilitation behaviour. After patients' expression of concern both reassurance and facilitating behaviour were shown by physicians of both genders. CONCLUSIONS: Sequence analysis appears to be a clinically meaningful and statistically sound method for analysing are patient utterances and associated physician behaviour.

Communication↗