Robinson2016a

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Robinson2016a
BibType ARTICLE
Key Robinson2016a
Author(s) Jeffrey D. Robinson, Alexandra Tate, John Heritage
Title Agenda-setting revisited: When and how do primary-care physicians solicit patients' additional concerns?
Editor(s)
Tag(s) Medical EMCA, EMCA, Agenda setting, Primary care, Conversation Analysis, Physician, Patient, Communication, Question asking
Publisher
Year 2016
Language English
City
Month
Journal Patient Education and Counseling
Volume 99
Number 5
Pages 718–723
URL Link
DOI 10.1016/j.pec.2015.12.009
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Soliciting patients’ complete agendas of concerns (aka. ‘agenda setting’) can improve patients’ health outcomes and satisfaction, and physicians’ time management. We assess the distribution, content, and effectiveness of physicians’ post-chief-complaint, agenda-setting questions. Methods: We coded videotapes/transcripts of 407 primary-, acute-care visits between adults and 85 general-practice physicians operating in 46 community-based clinics in two states representing urban and rural care. Measures are the incidence of physicians’ questions, their linguistic format, position within visits, likelihood of being responded to, and the nature of such responses. Results: Physicians’ questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits (p < .001). Compared to questions whose communication format explicitly solicited ‘questions’ (e.g., “Do you have any questions?”), those that were formatted so as to allow for ‘concerns’ (e.g., “Any other concerns?”) were significantly more likely to generate some type of agenda item (Chi 2 (1, N = 131) = 11.96, p = .001), and to do so more frequently when positioned ‘early’ vs. ‘late’ during visits (Chi 2 (1, N = 73) = 4.99, p = .025). Conclusions: Agenda setting is comparatively infrequent. The communication format and position of physicians’ questions affects patients’ provision of additional concerns/questions. Practice implications: Physicians should increase use of optimized forms of agenda setting

Notes