TY - JOUR
T1 - It takes two to tango
T2 - A dyadic approach to understanding the medication dialogue in patient-provider relationships
AU - Schoenthaler, Antoinette
AU - Basile, Melissa
AU - West, Tessa V.
AU - Kalet, Adina
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/8
Y1 - 2018/8
N2 - Objective: To describe typologies of dyadic communication exchanges between primary care providers and their hypertensive patients about prescribed antihypertensive medications. Methods: Qualitative analysis of 94 audiotaped patient-provider encounters, using grounded theory methodology. Results: Four types of dyadic exchanges were identified: Interactive (53% of interactions), divergent-traditional (24% of interactions), convergent-traditional (17% of interactions) and disconnected (6% of interactions). In the interactive and convergent-traditional types, providers adopted a patient-centered approach and used communication behaviors to engage patients in the relationship. Patients in these interactions adopted either an active role in the visit (interactive), or a passive role (convergent-traditional). The divergent-traditional type was characterized by provider verbal dominance, which inhibited patients’ ability to ask questions, seek information, or check understanding of information. In the disconnected types, providers used mainly closed-ended questions and terse directives to gather and convey information, which was often disregarded by patients who instead diverted the conversation to psychosocial issues. Conclusions: This study identified interdependent patient-provider communication styles that can either facilitate or hinder discussions about prescribed medications. Practice implications: Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors.
AB - Objective: To describe typologies of dyadic communication exchanges between primary care providers and their hypertensive patients about prescribed antihypertensive medications. Methods: Qualitative analysis of 94 audiotaped patient-provider encounters, using grounded theory methodology. Results: Four types of dyadic exchanges were identified: Interactive (53% of interactions), divergent-traditional (24% of interactions), convergent-traditional (17% of interactions) and disconnected (6% of interactions). In the interactive and convergent-traditional types, providers adopted a patient-centered approach and used communication behaviors to engage patients in the relationship. Patients in these interactions adopted either an active role in the visit (interactive), or a passive role (convergent-traditional). The divergent-traditional type was characterized by provider verbal dominance, which inhibited patients’ ability to ask questions, seek information, or check understanding of information. In the disconnected types, providers used mainly closed-ended questions and terse directives to gather and convey information, which was often disregarded by patients who instead diverted the conversation to psychosocial issues. Conclusions: This study identified interdependent patient-provider communication styles that can either facilitate or hinder discussions about prescribed medications. Practice implications: Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors.
KW - Dyadic communication
KW - Patient-provider communication
KW - Qualitative analysis
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U2 - 10.1016/j.pec.2018.02.009
DO - 10.1016/j.pec.2018.02.009
M3 - Article
C2 - 29478882
AN - SCOPUS:85042351059
SN - 0738-3991
VL - 101
SP - 1500
EP - 1505
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 8
ER -