A linguistic study of patient-centered interviewing: emergent interactional effects

Area of Science:

• Medical Communication
• Sociolinguistics
• Health Services Research

Background:

• Patient-centered interviewing (PCI) is linked to improved patient outcomes.
• Understanding the interactional mechanisms of PCI is crucial for its effective implementation.
• Clinician-centered interviewing (CCI) remains a common communication style.

Purpose of the Study:

• To compare the interactional effects of patient-centered interviewing (PCI) against clinician-centered interviewing (CCI).
• To identify specific communication behaviors that differentiate PCI from CCI.
• To explore the sociolinguistic underpinnings of physician-patient interactions.

Main Methods:

• A pilot study involving simulated new-patient visits comparing PCI (N=4) and CCI (N=4).
• Independent rating of interviews and patient satisfaction measurement using a validated questionnaire.
• Interactional sociolinguistic analysis at turn, topic, and interaction levels.

Main Results:

• Significant differences observed in physician responses to psychosocial cues between PCI and CCI.
• Distinct variations in the number and types of physician questions across PCI and CCI.
• Qualitative evidence of physician-patient attunement and interactional accommodation in PCI interviews.

Conclusions:

• PCI demonstrates distinct interactional advantages over CCI, potentially explaining its positive effects on relationships and outcomes.
• Unexplored variables like question form, phonological accommodation, and stylistic markers warrant further investigation.
• This study provides a foundation for larger research on patient-centeredness in clinical practice.