Examining the context and helpfulness of family companion contributions to older adults' primary care visits.
Jennifer L Wolff, Yue Guan, Cynthia M Boyd and 5 others
PMID 27817986WHAT IT FOUND
Family companions mostly supported older adults' primary care visits by clarifying information for the doctor.
Patients who wanted family to decide rated companions more helpful. A pre-visit checklist made no clear difference to companion speech in these 30 visits.
Key findings
01Companions averaged 35 behaviors that supported patient autonomy per visit, and the most common was clarifying or expanding patient information for the doctor (55% of all companion behaviors).
02Patients who delegated health management spoke less (16.8% of visit statements) than patients who co-managed (42.6%) or self-managed (40.3%), while their companions spoke more (45.2% versus 14.5% and 13.8%).
03Patients who preferred to leave health decisions to family or close friends rated companions as more helpful (mean 6.7) than patients preferring independent decisions (mean 2.5) on a 0-10 scale.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study analyzed only 30 older adult-companion dyads from one academic geriatrics clinic, so it may not apply to other settings. It was exploratory and did not adjust for many patient or companion factors because the sample was small. Patients with significant cognitive deficits were excluded, so it says nothing about older adults with dementia. Patient preferences for family involvement were measured with one question, so the preference may not have matched the companion present or the specific decision. The study measured communication behaviors and patient ratings, not health outcomes or decision quality.
Declared interests
The supplied text does not include a conflicts-of-interest statement. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that the pre-visit agenda-setting checklist improved companion communication. The checklist group averaged 47.2 autonomy-enhancing behaviors per visit versus 43.5 in the control group, but the paper reports no statistically significant difference.