Ishikawa Hirono, Roter Debra L, Yamazaki Yoshihiko, Hashimoto Hideki, Yano Eiji
Department of Hygiene & Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo 173-8605, Japan.
Patient Educ Couns. 2006 Apr;61(1):80-6. doi: 10.1016/j.pec.2005.02.010. Epub 2005 Oct 19.
Elderly patients are often accompanied during medical visits by a companion, usually a family member. This study explores the association between patients' expectations regarding the communication role of their companions, and the role intended and taken by companions during the medical visits, on patient perceptions of companion helpfulness.
Participants included 63 patients aged 65 or over who were under continuous care of nine attending physicians at a university-affiliated geriatric clinic in Tokyo, and their companions during the medical visit. These medical visits were audiotape recorded and coded using a Japanese translation of the Roter Interaction Analysis System (RIAS).
The discrepancy between what patients expected of their companions, and what companions intended and actually did during the visit, predicted patient ratings of companion helpfulness. It was especially noteworthy that the highest ratings of companion helpfulness occurred when patients expected their companion to be actively involved in communication and they were. However, if the patient anticipated only a limited companion role, the companion was not viewed as very helpful regardless of the role they played.
There would be a largely unexploited potential for improving communication effectiveness through the optimal engagement of companions in visit communication.
老年患者就诊时通常会有一名陪同人员，一般是家庭成员。本研究探讨患者对陪同人员沟通角色的期望，与陪同人员在就诊期间预期及实际所扮演的角色之间的关联，以及这种关联对患者对陪同人员帮助程度认知的影响。
研究对象包括63名65岁及以上的患者，他们在东京一所大学附属医院的老年诊所接受9位主治医生的持续治疗，以及他们就诊时的陪同人员。这些就诊过程被录音，并使用罗特互动分析系统（RIAS）的日文译本进行编码。
患者对陪同人员的期望，与陪同人员在就诊期间预期及实际所做之事之间的差异，预示着患者对陪同人员帮助程度的评分。特别值得注意的是，当患者期望陪同人员积极参与沟通且陪同人员确实如此时，对陪同人员帮助程度的评分最高。然而，如果患者预期陪同人员的角色有限，那么无论陪同人员实际扮演何种角色，患者都不会认为其很有帮助。
通过使陪同人员最佳程度地参与就诊沟通来提高沟通效果，在很大程度上仍存在未被发掘的潜力。
