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RIA Medical. Call Us: Our Services. Primary Care; Geriatric Care RIA Medical has been wonderful in We trust our physicians and know. communication and roles of companions in Japanese geriatric encounters. using the Roter Interaction Analysis System (RIAS) with additional categories. The consultation was audiotape recorded and analyzed using the Roter Interaction Analysis System (RIAS) with additional categories.
|Author:||Lue Smitham DVM|
|Published:||15 July 2014|
|PDF File Size:||10.9 Mb|
|ePub File Size:||29.4 Mb|
|Uploader:||Lue Smitham DVM|
We posit that previously described aspects of the patient-provider relationship 11 and medical communication processes 12 may be extended to the older patient and their companion, when present.
Prior studies find older patients are often unable or unwilling to articulate their desired preferences for communicating with medical providers 1314 and that patient, family, and provider assessments of patient symptoms 1516 and treatment priorities 1718 commonly diverge.
Medical communication that is aligned with rias geriatric information sharing and decision-making preferences is associated with varied end-points such as patient satisfaction, emotional well-being, treatment adherence, and physiologic measures such as lower symptom burden.
We sought to develop a checklist that was brief and appropriate for self-administration in a clinic waiting room. Careful attention was paid to considerations of the busy physician practice and the diverse older adult population. We reviewed a wide range of existing health-related quality of life, rias geriatric status, and needs assessment instruments to construct an item pool of common older patient concerns that were appropriate for discussion in primary care visits.
To establish face and content validity, a panel of 3 geriatricians and 1 geriatric psychiatrist then reviewed and nominated candidate items for inclusion. We generated a final list of 23 common patient concerns that was balanced across physical, mental, and social role function domains.
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The checklist see Appendix involves two activities that are completed by a patient and their companion before a scheduled appointment. The first activity involves completing the checklist of common geriatric health concerns using three steps. Instructions to the patient state: Clinic staff mailed recruitment letters to established patients of 4 participating geriatricians with upcoming scheduled visits.
As this study was designed as a proof of concept pilot study, we sought to recruit rias geriatric more homogeneous clinical study sample that would be able to complete the checklist.
Therefore, older adults with significant cognitive deficits on the basis of more than two incorrect answers on a 6-item cognitive screen 21 were excluded. Comparable sensory and cognition exclusion criteria applied to companions rias geriatric also completed screening calls.
After providing informed consent using an institutional review board approved form, each dyad was randomized to the checklist or to usual care rias geriatric stratified, blocked randomization with alternating block sizes of 4 and 6 for each physician.
Dyads assigned to the intervention received a clipboard, pen, and a copy of the checklist that they completed together in the clinic waiting room without research or office staff assistance. Dyads assigned to usual care waited for their visit as usual. All medical encounters were audio-recorded but otherwise proceeded as usual, without research or office staff rias geriatric.
Physicians, patients, and companions completed surveys rias geriatric after the visit in the office suite. Patients and companions were contacted by telephone two weeks following the visit and were asked additional questions about the medical visit, as well as socio-demographic factors and health status.
The consultation was audiotape recorded and analyzed using the Roter Interaction Rias geriatric System RIAS with additional categories developed to code aspects of companion communication.
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Rias geriatric made a significant contribution to the communication during the visit by providing information and asking the rias geriatric questions, as well as facilitating patient's talk.
The companion's communication may influence not only the patient's but also the physician's communication.
The patient's expectation of the companion's role during the visit and the companion's intention regarding their role were generally related to one another, and had positive associations with the companion's actual behavior during the visit.
Nevertheless, companions rias geriatric anticipated playing a more direct communication role during the visit, including the provision of information and asking of questions, than patients expected of them.