Differences in Physicians' Verbal and Nonverbal Communication With Black and White Patients at the End of Life.
Context: Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient- and/or surrogate-provider communication may contribute to this phenomenon.Objectives: To test whether hospital-based physicians use different verbal...
| Publicado en: | Journal of Pain & Symptom Management Vol. 51; no. 1; pp. 1 - 9 |
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| Autores principales: | , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Elsevier B.V.
Jan2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=112041008&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 112041008 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08853924 4CB jtl: Journal of Pain & Symptom Management issn: 08853924 maglogo: N pubinfo: dt: Jan2016 vid: 51 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 112041008 112041008 NLM26297851 112041008 10.1016/j.jpainsymman.2015.07.008 NLM26297851 PMC4698224 [Available on 01/01/17] 112041008 ppf: 1 ppct: 8 formats: tig: atl: Differences in Physicians' Verbal and Nonverbal Communication With Black and White Patients at the End of Life. aug: au: Elliott, Andrea M. Alexander, Stewart C. Mescher, Craig A. Mohan, Deepika Barnato, Amber E. affil: Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania sug: subj: Black Persons Psychosocial Factors Physicians Psychosocial Factors Terminal Care Psychosocial Factors Nonverbal Communication White Persons Psychosocial Factors Psycholinguistics Posture Emotions Adult Healthcare Disparities Human Videorecording Physician-Patient Relations Female Speech Decision Making Hospitals Time Factors Pennsylvania Male Validation Studies Comparative Studies Evaluation Research Multicenter Studies Funding Source Randomized Controlled Trials Adult: 19-44 years Female Male ab: Context: Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient- and/or surrogate-provider communication may contribute to this phenomenon.Objectives: To test whether hospital-based physicians use different verbal and/or nonverbal communication with black and white simulated patients and their surrogates.Methods: We conducted a randomized factorial trial of the relationship between patient race and physician communication using high-fidelity simulation. Using a combination of probabilistic and convenience sampling, we recruited 33 hospital-based physicians in western Pennsylvania who completed two encounters with prognostically similar, critically and terminally ill black and white elders with identical treatment preferences. We then conducted detailed content analysis of audio and video recordings of the encounters, coding verbal emotion-handling and shared decision-making behaviors, and nonverbal behaviors (time interacting with the patient and/or surrogate, with open vs. closed posture, and touching the patient and physical proximity). We used a paired t-test to compare each subjects' summed verbal and nonverbal communication scores with the black patient compared to the white patient.Results: Subject physicians' verbal communication scores did not differ by patient race (black vs. white: 8.4 vs. 8.4, P-value = 0.958). However, their nonverbal communication scores were significantly lower with the black patient than with the white patient (black vs. white: 2.7 vs. 2.9, P-value 0.014).Conclusion: In this small regional sample, hospital-based physicians have similar verbal communication behaviors when discussing end-of-life care for otherwise similar black and white patients but exhibit significantly fewer positive, rapport-building nonverbal cues with black patients. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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