No abstract

Physician training focuses on an encounter between two people: the patient and the physician. In practice, a third person (companion) frequently accompanies a patient during medical encounter, but nevertheless reviews about the presence of a companion of the patient in consultation are rather scarce in our environment. The subjective experience of disease is built by patient in the family context and is expressed in the medical consultation, often, with the presence of a companion of the patient. The presence of the companion of the patient in consultation is a metaphor from the patient. We show a very brief update, through a short fable, about the subject of companion of the patient in the consulting room. There is a high prevalence of the presence of companion (25% of the interviews are with companions), predominating a middle-aged adult, usually the couple and is a worker, housewife or retired. The patients with companion are older women, with more chronic diseases, with poly-pharmacy, they generate hospital referrals, and they have lower levels of social class. The presence of a companion is an indicator of potential problems in the context of the patient (in 45% of the cases the patients with companion vs. 30% in unaccompanied patient). The 55% of companions are "non-collaborators", that are they predominantly housewives and unemployed persons. There is a high frequency of the companions who attended the family medicine consultation without the presence of the patient (9% of all consultations), which has ethical and legal implications. The companion shapes the experience obtained by the patient's physician. A second adult accompanying the patient in the consultation is always significant and deserves the attention of the doctor. It is needed achieve communication skills during the interview with the different companions of the patients in family medicine consultation.

A ll over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver (1). So, spouses often serve as the primary caregivers to their ill or disabled partners (2).The domain of health includes the entire range of issues which touch on illness, sickness, disease, wellness, as well as those activities of preventing, diagnosing, healing, caring and curing. Thus, questions about women's participation in this domain profound and immediate concern to women, and involve roles and selves. Women have domestic activities which sustain, literally and symbolically, the way of life. As the providers of health, women are responsible for securing the domestic conditions necessary for the maintenance of health and for recovery from sickness. Women also serve as mediators of outside services. Their responsibilities with the domestic health service unavoidably bring them into contact with professional health service, among them the family doctor (3).In practice, a third person (companion) frequently accompanies a patient during medical encounter. There is a high prevalence of the presence of a companion, who is in almost one of every 4 visits served in Family Medicine. Companions of the patients in the medical office are usually family members in near 100% of cases (4-9).The major results of existing studies suggest that the regular presences of companions of the patients in consultations are often perceived as helpful. Accompaniment to medical visits is associated with better self-care maintenance and management, and this effect may be mediated through satisfaction with provider communication (10). Also, companions provide company, emotional support, and they have a role in mobility and decision making of the patients (11,12). However, their participation often poses challenges (13).Despite all the above, the reports, reviews or investigations about the gender OBJECTIVES:The purpose of this study is to describe gender differences in patient's companion, and their characteristics, in family medicine consultations. METHODS:A descriptive and prospective study in a family medicine office (Toledo, Spain) was carried out. For each patient and companion, the following variables were collected: age, gender, chronic illness, chief complaint, medications taken, social class, request for additional tests, kinship, social status and availability of companion. The bivariate comparisons were performed using the test of Chi squared, the Student t test, and the MannWhitney test.RESULTS: 104 companions to the patient in the family medicine office were obtained. Of these, 65 (62.5%) were female, and 39 (37.5%) male.In the female companions with regard to the male companions: there were 69% in the group of 40-64 years old vs. 49% (p = 0.02); were wife (34%) vs. husband (56%) (P=0.001); were unskilled...

Objective: To describe differences in verbal behaviour style in interviews of patients females with patient's companion (triadic consultations) and patient's females without patient's companion (dyadic consultations) in family medicine. Participants and Methods:Secondary analysis of existing dataset coded to explore patient-clinician verbal communication during ambulatory visits in a family medicine office in a health Centre in Toledo (Spain) was carried out. A qualitative study was performed by audio recording of the consultations and verbal content analysis of the interviews, based on the identification of 6 categories of classification of behaviours of the interaction process (Proposing, Supporting/Agreeing, Disagreeing, Giving Information, Seeking Information, and Building). A convenience sample was carried out. A suitable sample number was considered when saturation occurred. Quantitative methodology was used as a technique to control the reliability and biases.Results: 5 unaccompanied consultations and 7 consultations with companion were included in the analysis. The female patients with a companion show 2/3 more verbal behaviours (165 vs. 101) with slightly more behaviours of "Supporting or Agreeing" (42% vs. 34%), but less of "Giving Information" (43% vs. 53%) than when the female patients go unaccompanied, predominating these two types of behaviours in both modalities. Consultation with female patients with a companion shows almost twice as many verbal behaviours of the doctor vs. the consultation with unaccompanied women (186 vs. 100), and is longer (6.4 ' vs. 7.7'). Conclusions:This study shows that consultations of female patients with a companion are longer and more verbal behaviours are performed. In patients female the triadic consultations have more agreements, but less information is obtained than in the dyadic, and in general there is mixed results. Female patients show a clear predominance of verbal behaviours of "Giving information" and "Supporting or Agreeing", both with or without companion in the consultation.