Physician–patient dialogue surrounding patients’ expression of concern: applying sequence analysis to RIAS
Social Science & MedicinePublished 24 November 2003
Hilde Eide, Vicenç Quera, Peter Kjær Graugaard, Arnstein Finset
Citations107
SJR quartileQ1
SJR score2.10
SNIP2.01
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
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.
Abstract
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.
Keywords
PsychologyHealth ProfessionsArts and Humanities
Journal of Educational StatisticsObserving Interaction: An Introduction to Sequential Analysis
2,312 Citations1988Victor L. Willson, Roger Bakeman +1 more
Cambridge University Press eBooksHandbook of Research Methods in Social and Personality Psychology
2,128 Citations2024Harry T. Reis, Harry T. Reis +32 more
Cambridge University Press eBooksHandbook of Research Methods in Social and Personality Psychology
1,950 Citations2014Harry T. Reis, Harry T. Reis +23 more
Cambridge University Press eBooksInteraction and Grammar
1,436 Citations1996Elinor Ochs, Elinor Ochs +10 more
This book discusses grammar and graphic representation in the interpretive activity of physicists Elinor Ochs, Patrick Gonzales and Sally Jacoby, and resources and repair in syntactic, intonational, and pragmatic resources for the management of turns.
Cambridge University Press eBooksInteractional units in conversation: syntactic, intonational, and pragmatic resources for the management of turns
927 Citations1996Cecilia E. Ford, Sandra A. Thompson
The LancetEfficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial
864 Citations2002Lesley Fallowfield, Valerie Jenkins +4 more
This trial shows that training courses significantly improve key communication skills and more resources should be allocated to address doctors' training needs in this vital area.
JAMAA Model of Empathic Communication in the Medical Interview
783 Citations1997Anthony L. Suchman
Based on observations, the basic empathic skills seem to be recognizing when emotions may be present but not directly expressed, inviting exploration of these unexpressed feelings, and effectively acknowledging these feelings so the patient feels understood.
British Journal of CancerPsychiatric morbidity and its recognition by doctors in patients with cancer
700 Citations2001Lesley Fallowfield, Dr Madeleine Ratcliffe +2 more
These data show that much of the probable psychiatric morbidity experienced by patients with cancer goes unrecognized and therefore untreated and doctors need communication skills training to elicit problems during consultations.
JAMAA Study of Patient Clues and Physician Responses in Primary Care and Surgical Settings
663 Citations2000Wendy Levinson
It is suggested that physicians in both primary care and surgery can improve their ability to respond to patient clues even in the context of their busy clinical practices.
Health Education MonographsPatient Participation in the Patient-Provider Interaction: The Effects of Patient Question Asking on the Quality of Interaction, Satisfaction and Compliance
640 Citations1977Debra Roter
The experimental group patients demonstrated higher appointment-keeping ratios and were less satisifed with care received in the clinic on the day of their visit than were placebo patients, while the placebo group patient-provider interaction was characterized as mutually sympathetic.
Patient Education and CounselingDoctor–Patient communication and cancer patients’ quality of life and satisfaction
453 Citations2000L.M.L. Ong, Marja Visser +2 more
Surprisingly, oncologists' patient-centredness was negatively related to patients' global satisfaction after 3 months, and the affective quality of the consultation seems to be the most important factor in determining these outcomes.
Medical Entomology and ZoologyAnalyzing Interaction: Sequential Analysis with SDIS and GSEQ
440 Citations1995Roger Bakeman, Vincent Quera
Social Science & MedicineDoctor-patient interactions in oncology
395 Citations1996Sarah Ford, Lesley Fallowfield +1 more
Examination of the structure and content of the bad news cancer consultations of 117 outpatients newly referred to the Medical Oncology Department of a large London teaching hospital showed that clinicians tended to use closed rather than open questions and patients asked few questions and were seldom given space to initiate discussion.
European Journal of CancerHelping cancer patients disclose their concerns
391 Citations1996P.J. Maguire, Alison Faulkner +3 more
Training of health professionals involved in cancer care should ensure they acquire positive skills and relinquish the inhibitory behaviours, which promote patient disclosure and inhibit it.
Medical CareRelations Between Physicians?? Behaviors and Analogue Patients?? Satisfaction, Recall, and Impressions
380 Citations1987Debra Roter, Judith A. Hall +1 more
Investigating associations between physicians' task-oriented and socioemotional behaviors, on the one hand, and analogue patients' satisfaction, recall of information, and global impressions, revealed that role-playing patients clearly distinguished task from socioem emotional behaviors of the physicians, and a consistent pattern of association emerged.
Journal of Clinical OncologyHow Are You Feeling? Who Wants To Know? Patients’ and Oncologists’ Preferences for Discussing Health-Related Quality-of-Life Issues
348 Citations2000Symone Detmar, Neil K. Aaronson +3 more
Although both patients and oncologists seem willing to discuss a wide range of HRQL issues, communication regarding psychosocial issues may be hampered by competing expectations as to who should take the lead in initiating such discussions.
Behavior Research Methods, Instruments, & ComputersThe Observer Video-Pro: New software for the collection, management, and presentation of time-structured data from videotapes and digital media files
339 Citations2000L.P.J.J. Noldus, Rudie J. H. Trienes +3 more
The design and operation of the The Observer Video-Pro system is described, illustrated with a case study from research on Repetitive Strain Injury (RSI).
Medical CareSatisfaction, Gender, and Communication in Medical Visits
315 Citations1994Judith A. Hall, Julie T. Irish +3 more
Investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender suggested that gender-related values and expectations influence patients' reactions to physicians' behavior.
Psycho-OncologyOncologists' reactions to cancer patients' verbal cues
309 Citations2002Phyllis Butow, Rhonda Brown +3 more
Overall, results showed that doctors effectively identify and respond to the majority of informational cues; however, they are less observant of and able to address cues for emotional support.
Patient Education and CounselingEmpathic communication and gender in the physician–patient encounter
265 Citations2002Carma L. Bylund, Gregory Makoul
The ECCS appears to be a viable and sensitive tool for better understanding empathy in medical encounters, and for detecting modest gender differences in patients' creation of empathic opportunities and in physicians' empathic communication.
The Medical Interview: Clinical Care, Education, and Research
263 Citations2011Mack Lipkin, Samuel M. Putnam +1 more
Higher cognitive functioning is associated with better memory, attention and concentration, and the quality of associations in a larger group of people is improved.
Medical CareOutcome-Based Doctor-Patient Interaction Analysis
190 Citations1982Thomas S. Inui, William B. Carter +2 more
It is concluded that choice of IA system for research or teaching purposes should be based on behaviors and outcomes of particular interest and importance to the user.
JAMAPatient-Physician Communication During Outpatient Palliative Treatment Visits
184 Citations2001Symone Detmar, Martin J. Muller +3 more
The amount of patient-physician communication devoted to such issues remains limited and appears to make only a modest contribution, at least in an explicit sense, to the evaluation of treatment efficacy in daily clinical practice.
Medical CareTask Versus Socioemotional Behaviors in Physicians
152 Citations1987Judith A. Hall, Debra Roter +1 more
Although the more medically informative physicians spent less time making socioemotional utterances, they had a voice quality that may compensate for that neglect, and most aspects of physician style were reliable across visits.
Social Science & MedicineImproving the detection of psychiatric problems in cancer patients
146 Citations1985Peter Maguire
The dynamics of dialogue
134 Citations1990Ivana Marková, Klaus Foppa
Psycho-OncologyCancer patients’ coping styles and doctor-patient communication
125 Citations1999Lucille M.L. Ong, Mechteld R.M. Visser +4 more
The relation between cancer patients’ coping styles and doctor–patient communication and global affect and the relation between monitoring and blunting and patients' age, sex, education, quality of life and prognosis was investigated.
Psycho-OncologyThe Roter Interaction Analysis System (RIAS) in oncological consultations:: psychometric properties
116 Citations1998L.M.L. Ong, Marja Visser +6 more
Two studies are presented in which the psychometric properties of the RIAS are investigated in an oncological setting.
Mutualities in Dialogue
95 Citations1996Ivana Marková, Carl F. Graumann +1 more
Patient Education and CounselingAnalyzing medical dialogues: strength and weakness of Roter’s interaction analysis system (RIAS)
84 Citations2002Margareth Sandvik, Hilde Eide +4 more
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.
Psycho-OncologyThe relationship between patients' concerns and psychological distress in a hospice setting
75 Citations1998Cathy Heaven, Peter Maguire
A total of 87 patients admitted to two hospices during a 9 month period were assessed by trained nurses to determine their current concerns and a semi structured concerns interview was administered using the Concerns Checklist, Hospital Anxiety and Depression Scale and the Spielberger State Anxiety Inventory.
Patient Education and CounselingPhysician communication in different phases of a consultation at an oncology outpatient clinic related to patient satisfaction
72 Citations2003Hilde Eide, Peter Kjær Graugaard +2 more
The study suggests that the physician should not initiate discussion of psychosocial topics during physical exam, and there was a positive correlation between physician informal talk (IT) and patient satisfaction in the history-taking phase.
Patient Education and CounselingChanges in physician–patient communication from initial to return visits: a prospective study in a haematology outpatient clinic
42 Citations2004Peter Kjær Graugaard, Kjersti Holgersen +2 more
The amount of task-focused communication was significantly reduced between the initial and the return visits, and the amount of socio-emotional communication remained quite stable.
PubMedPatients' predispositions to discuss health issues affecting quality of life.
24 Citations1996Street Rl, Don B. Cauthen +2 more
Patients were more satisfied with care when there was more discussion of the patient's overall well-being and physical health and discussions about psychosocial issues were not related to patient satisfaction.
Epidemiologia e Psichiatria SocialeExploring rare patient behaviour with sequential analysis: an illustration
21 Citations2003Hilde Eide, Viceng Quera +1 more
Behavior Research Methods, Instruments, & ComputersOTS: A program for converting Noldus Observer data files to SDIS files
14 Citations2000Roger Bakeman, Vicenç Quera
Observer users who convert their data files to sequential data interchange standard files can then take advantage of various flexible and powerful data modification and computational procedures available in the Generalized Sequential Querier, a program that assumes SDIS-formatted files.