Turn analysis and patient-centredness in paediatric otolaryngology surgical consultations
Funding information
This study was funded by Canadian Institutes of Health Research, Nova Scotia Health Research Foundation, and Dalhousie Department of Surgery. The funding bodies played no role in this study.
Abstract
Objectives
Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision-making (SDM) processes. This study investigated SDM-related outcomes through turn analysis and an assessment of patient-centred dialogue.
Design
Multi-centre prospective cohort study analysing audio- and video-recorded patient/parent-physician interactions.
Setting
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.
Participants
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy.
Main outcome measures
Medical dialogue measures (turn analysis, patient-centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM-Q-9).
Results
Turn density was significantly higher for physicians than patients/parents (P < .001), as were total statements (P < .001), and total time talking (P < .001). The opening statement was completed by the physician in 91.5% of interactions and was significantly longer than family opening statements (P = .003). The mean number of informed consent elements addressed per interaction was 4.5 out of 6. The mean patient-centredness score was 0.2 (range 0-0.56). Significant negative correlations between patient-centredness score and physician turn density (r = −.390, P = .002), physician mean turn time (r = −.406, P = .001), total physician statements (r = −.426, P = .001) and total physician speaking time (r = −.313, P = .016) were noted. There were no correlations in SDM questionnaire scores with turn analysis variables, informed consent elements or patient-centredness scores.
Conclusions
Surgeons dominated the consultation in terms of talking, mostly in a unidirectional manner. Neither patient-centredness nor turn analysis correlated with perceptions of SDM from the parents' perspective.
CONFLICT OF INTEREST
The authors have no conflicts of interest or disclosures.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
