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[Influence of the companion in Primary Care consultations on communication skills and interview time]
Alejandro Pérez-Milena1, Natalia Zafra-Ramírez2, Juan Andrés Ramos-Ruiz3
1Centro de Salud El Valle, Distrito Sanitario Jaén-Jaén Sur, Servicio Andaluz de Salud, Jaén, España.
Objetives:
To know the influence of the companion in triadic clinical encounter on the quality of doctor-patient communication and the duration of the interview.
Design:
Cross-sectional descriptive study.
Location:
10 Primary Care Centers.
Participants:
Resident doctors of Family and Community Medicine.
Interventions:
Peer review of video recordings of clinical demand consultations.
Main Measurements:
CICAA-2 questionnaire to assess communication skills (improvable, acceptable or adequate); age and sex, reasons for consultation and duration of the interview. Bivariate and multivariate analyses. Ethical authorization, oral informed consent and custody of the video recordings.
Results:
73 RD (53.8% women, 32.9±7.7 years) participated with 260 interviews (60.3% women and 2.1±1.0 clinical demands). 27.7% of consultations with a companion (female sex 65.3%). The mean duration of the interviews was 8.5±4.0min. Clinical encounters lasted longer when a companion attended (2.7±0.5min more; p<.001 Student t) and with a greater number of clinical demands (40% with ≥3 reasons, p=0.048 X2). The mean value of the total score of the CICAA-2 scale (46.9±16.5; difference 4.6±2.3) and Task 2 (39.3±15.8 with difference 4.4±2.2) were higher when companion was present (p<.05 Student t). The model obtained with logistic regression shows a longer duration of the consultation with a companion (OR 1.2; CI [1.1-1.3]) and possibly a better score in Task 2 communication skills (OR 1.02; CI [0.99-1.1]).
Conclusions:
Triadic communications challenge the clinician's communication skills, improving their abilities to identify and understand patient problems, albeit at the cost of a greater investment of time.
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