Respecting patients is associated with more patient-centered communication behaviors in clinical encounters

Abstract

Objective Attitudes towards patients may influence how clinicians interact. We investigated whether clinician-reported respect for patients was associated with communication behaviors during HIV care encounters. Methods We analyzed audio-recordings of visits between 413 adult HIV-infected patients and 45 primary HIV care providers. The independent variable was clinician-reported respect for the patient and outcomes were clinician and patient communication behaviors assessed by the Roter Interaction Analysis System (RIAS). We performed negative binomial regressions for counts outcomes and linear regressions for global outcomes. Results Clinicians with higher respect When clinicians had higher respect for a patient, they engaged in more rapport-building, social chitchat, and positive talk. Patients of clinicians with higher respect for them engaged in more rapport-building, social chitchat, positive talk, and gave more psychosocial information. Encounters between patients and clinicians with higher respect for them had more positive clinician emotional tone [regression coefficient 2.97 (1.92-4.59)], more positive patient emotional tone [2.71 (1.75-4.21)], less clinician verbal dominance [0.81 (0.68-0.96)] and more patient-centeredness [1.28 (1.09-1.51)]. Conclusions Respect is associated with positive and patient-centered communication behaviors during medical encounters by clinicians and patients. Practice Implications Clinicians should be mindful of their respectful attitudes of respect and work to foster positive regard for patients to promote more patient-centered communication and higher quality of care. Educators should consider methods to enhance trainees’ respect in communication skills training.

Communication predictors and consequences of Complementary and Alternative Medicine (CAM) discussions in oncology visits

“…These communication elements have been associated with facilitation of patient engagement in care [17, 21], patient ratings of feeling respected [18, 19], medication adherence [20], perceived shared decision making [27], therapeutic alliance [17, 32] and improved mental health outcomes [33, 34]. …”

Twenty‐five years of diabetes distress research

“…In addition, patients who perceive more positive relationships with providers, generally report higher levels of self-care and have higher confidence in their ability to follow recommendations [37]. Professional attitudes can shape these positive relationships, with higher respect for patients resulting in more rapport building, social exchange and positive talk [38], as well as increasing confidence [17] and supporting patients' ability to complete daily activities [39]. Being more autonomy-supportive, by using person-centred approaches such as motivational interviewing [40], is associated with increased perceived competence and reduced diabetes distress [41].…”

Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences*

“…A RIAS-based patient-centeredness score with established predictive validity for a variety of outcomes is increasingly used as a summary measure in these studies to investigate racial and ethnic disparities in communication (15, 16), in evaluation of communication training programs (17–20) and in establishing patient-centered correlates of respect (21); non-verbal sensitivity (22); and mindfulness (23). …”