Older Adults' Pain Communication During Medical Visits
Older Adults' Pain Communication During Medical Visits
The purpose of this descriptive secondary analysis was to explore the use of Communication Accommodation Theory as a framework to examine pain communication strategies used by older adults and their primary care practitioners during medical ambulatory care visits. Ambulatory medical visits for 22 older adults with moderate or greater osteoarthritis pain were audiotaped, transcribed verbatim, and coded by two independent raters for six a priori communication strategies derived from the attuning strategies of Communication Accommodation Theory: 1) patient selecting the pain topic; 2) patient taking a turn; 3) patient maintaining focus on the pain topic; 4) practitioner using an open-ended question without social desirability to start the pain discussion; 5) practitioner encouraging the patient to take a turn by asking open-ended questions; and 6) practitioner interruptions. The majority of practitioners did not start the pain discussion with an open-ended question, but did not interrupt the older adults as they discussed their pain. Five (22.7%) of the older adults did not discuss their osteoarthritis pain during the ambulatory medical visit. The majority of patients took their turn during the pain discussion, but did not maintain focus while describing important osteoarthritis pain information to their practitioner. Practitioners might assist older adults to communicate more information about their pain by initiating the pain discussion with an open-ended pain question. Older adults might provide more pain information to their practitioner by staying on the pain topic until they have completed all of the pain information they wish to discuss with the practitioner.
Practitioner-patient communication is the basis for information exchange during ambulatory medical visits and is the vehicle through which therapeutic relationships are formed. If communication is done poorly, then patients may not fully disclose their symptoms and issues and opportunities are lost (Frantsve & Kerns, 2007). The present study explored the use of Communication Accommodation Theory (CAT) as a basis for understanding the communication between practitioners and older adults with osteoarthritis pain during routine ambulatory medical visits. Practitioner communication with older adults is a process that may have layers of preconceived notions on both sides of the communication that can affect the amount and quality of information exchanged. It is also possible that attitudes and expectations of elderly patients and practitioners regarding health care choices are affected by the age of the patient (Frantsve & Kerns, 2007).
Abstract and Introduction
Abstract
The purpose of this descriptive secondary analysis was to explore the use of Communication Accommodation Theory as a framework to examine pain communication strategies used by older adults and their primary care practitioners during medical ambulatory care visits. Ambulatory medical visits for 22 older adults with moderate or greater osteoarthritis pain were audiotaped, transcribed verbatim, and coded by two independent raters for six a priori communication strategies derived from the attuning strategies of Communication Accommodation Theory: 1) patient selecting the pain topic; 2) patient taking a turn; 3) patient maintaining focus on the pain topic; 4) practitioner using an open-ended question without social desirability to start the pain discussion; 5) practitioner encouraging the patient to take a turn by asking open-ended questions; and 6) practitioner interruptions. The majority of practitioners did not start the pain discussion with an open-ended question, but did not interrupt the older adults as they discussed their pain. Five (22.7%) of the older adults did not discuss their osteoarthritis pain during the ambulatory medical visit. The majority of patients took their turn during the pain discussion, but did not maintain focus while describing important osteoarthritis pain information to their practitioner. Practitioners might assist older adults to communicate more information about their pain by initiating the pain discussion with an open-ended pain question. Older adults might provide more pain information to their practitioner by staying on the pain topic until they have completed all of the pain information they wish to discuss with the practitioner.
Introduction
Practitioner-patient communication is the basis for information exchange during ambulatory medical visits and is the vehicle through which therapeutic relationships are formed. If communication is done poorly, then patients may not fully disclose their symptoms and issues and opportunities are lost (Frantsve & Kerns, 2007). The present study explored the use of Communication Accommodation Theory (CAT) as a basis for understanding the communication between practitioners and older adults with osteoarthritis pain during routine ambulatory medical visits. Practitioner communication with older adults is a process that may have layers of preconceived notions on both sides of the communication that can affect the amount and quality of information exchanged. It is also possible that attitudes and expectations of elderly patients and practitioners regarding health care choices are affected by the age of the patient (Frantsve & Kerns, 2007).
