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Exploring rare patient behaviour with sequential analysis: an illustration

Published online by Cambridge University Press:  11 October 2011

Hilde Eide ,
Viceng Quera  and
Arnstein Finset
Hilde Eide*
Affiliation:
1Faculty of Nursing, Oslo University College, Oslo, Norway Department of Behavioural Sciences in Medicine, University of Oslo, Olso, Norway
Viceng Quera
Affiliation:
Department of Psychology, University of Barcelona, Barcelona, Spain
Arnstein Finset
Affiliation:
Department of Behavioural Sciences in Medicine, University of Oslo, Olso, Norway
*
Address for correspondence: Dr. H. Eide, Faculty of Nursing, Oslo University College, Pilestredet 52, N-0167 Oslo (Norway). E-mail: [email protected]
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Summary

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 rare patient utterances and associated physician behaviour.

Declaration of Interest: none.

Keywords

sequence analysisphysician-patient relationsRIASGSEQ.
Type
Sequence Analysis of Patient-Provider Interaction
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Special Issue 2: Sequence Analysis of Patient-Provider Interaction , June 2003 , pp. 109 - 114
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

Bakeman, R. 2000. Behavioural observation and coding. In Handbook of Research Methods in Social and Personality Psychology (ed. Reis, H.T. and Judd, C.M.). Cambridge University Press: Cambridge.Google Scholar
Bakeman, R. & Gottman, J.M. 1997. Observing Interaction. An Introduction to Sequential Analysis. Cambridge University Press: New York.Google Scholar
Bakeman, R. & Quera, V. 2000. OTS: A program for converting Noldus Observer data files to SDIS files. Beliavior Research Metliods, Instruments, and Computers 32, 207–212.Google Scholar
Bakeman, R. & Quera, V. 1995. Analyzing Interaction. Sequential Analysis with SDIS and GSEQ. Cambridge University Press: New York.Google Scholar
Butow, P.N., Brown, R.F., Cogar, S., Tattersall, M.H.N. & Dunn, S.M. 2002. Oncologists' reactions to cancer patients' verbal cues. Psycho-Oncology 11, 47–58.CrossRefGoogle ScholarPubMed
Eide, H., Graugaard, P.K., Holgersen, K. & Finset, A. (in press). Physician communication in different phases of the consultation related to patient satisfaction at an oncology outpatient clinic, in press. Patient Education and Counseling.Google Scholar
Eide, H., Graugaard, P.K. & Finset, A. (submitted for publication a). The patient's conveyance of concern in an oncology out-patient clinic consultation: Relation to physician communication and patient satisfaction. Journal of Beliavioural Medicine.Google Scholar
Eide, H., Quera, V. & Finset, A. (submitted for publication b). Sequential patterns of physician-patient dialogue surrounding cancer patients' expression of concern and worry: Applying sequence analysis to RIAS. Social Science and Medicine.Google Scholar
Hall, J.A., Epstein, A.M., DeCiantis, M.L. & McNeil, B.J. 1993. Physicians' liking for their patients: more evidence for the role of affect in medical care. Health Psychology 12, 140–146.Google Scholar
Maguire, P. & Faulkner, A. 1988. Improve the counselling skills of doctors and nurses in cancer care. British Medical Journal 297, 847–849.Google Scholar
Maguire, P., Faulkner, A., Booth, K., Elliot, C. & Hillier, V. 1996. Helping cancer patients disclose their concerns. European Journal of Cancer 32A, 78–81.Google Scholar
Noldus Information Technology 1996. The Observer System for Collection and Analysis of Observational Data. Base package for Windows, 3.0. Wageningen.Google Scholar
Noldus Information Technology 1997. The Observer System for Collection and Analysis of Observational Data. Support package for video analysis, 4.0 Wageningen.Google Scholar
Noldus, L.P., Trienes, R.J., Hendriksen, A.H., Jansen, H. & Jansen, R.G. 2000. The Observer Video-Pro: new software for the collection, management, and presentation of time-structured data from videotapes and digital media files. Behavior Research Methods, Instruments & Computers 32, 197–206.CrossRefGoogle ScholarPubMed
Quera, V. & Bakeman, R. 2000. GSEQ for Windows: New software for the sequential analysis of behavioral data, with an interface to The Observer. In Measuring Behavior 2000, 3rd International Conference on Methods and Techniques in Behavioral Research..Google Scholar
Roter, D.L. 1977. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction and compliance. Health Education Monograplis 5, 281–315.CrossRefGoogle ScholarPubMed
Roter, D.L. 1989. Tlie Roter Metliod of Interaction Process Analysis (RIAS Manual). Johns Hopkins University: Baltimore.Google Scholar
Roter, D.L., Hall, J.A. & Aoki, Y. 2002. Physician gender effects in medical communication: a meta-analytic review. Journal of American Medical Association 288, 756–764.CrossRefGoogle ScholarPubMed
Sandvik, M., Eide, H., Lind, M., Graugaard, P.K.Torper, J. & Finset, A. 2002. Analysing medical dialogues: Strengths and weaknesses of Roter's Interaction Analysis System (RIAS). Patient Education and Counseling 46, 235–241.Google Scholar
Stewart, M.A. 1995. Effective physician-patient communication and health outcomes: a review. Journal of Canadian Medical Association 9, 1423–1433.Google Scholar
Suchmann, A.L., Markakis, K., Beckman, H.B. & Frankel, R.M. 1997. A model of empathic communication in the medical interview. Journal of American Medical Association 277, 678–682.CrossRefGoogle Scholar