Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data.
Crystal W Cené, Beth Haymore, Jeffrey P Laux and 8 others
PMID 27609321WHAT IT FOUND
Family presence did not make heart failure visits more centered on the patient.
In accompanied visits, providers gave more medical information, asked fewer questions, and patients spoke less, while visit length was similar.
Key findings
01The main patient-centered communication comparison showed no difference between accompanied and unaccompanied visits.
02Providers made 25% more biomedical information statements and 16% fewer partnership-building statements in accompanied visits.
03Patients' verbal activity was 32% in accompanied visits and 43% in unaccompanied visits, while visit length was similar at 23.1 and 24.7 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show whether companions caused the communication differences or whether patients who bring companions differ in other ways. Patients who chose to be accompanied may differ from those who were not, introducing selection bias. The sample came from one academic cardiology clinic, and most patients had Class II to III symptoms, so results may not apply to other heart failure populations. Patients with significant cognitive or psychiatric impairment, patients unable to perform activities of daily living, and nursing home residents were excluded. Only 6 providers were studied, and all visits were in cardiology outpatient care. The number of communication statements may not reflect the quality of communication.
Declared interests
The supplied publication types indicate NIH extramural research support. The article text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that family presence improves patient-centered communication or makes visits better. The main patient-centered communication measure did not differ, and the study was cross-sectional, so it cannot show that companions caused the observed communication patterns.