Communication and outcomes of visits between older patients and nurse practitioners.

BACKGROUND: Effective patient-clinician communication is at the heart of good healthcare and may be even more vital for older patients and their nurse practitioners (NPs). OBJECTIVES: The objectives of this study were to examine 1)contributions of older patients' and NPs' characteristics and the content and relationship components of their communication to patients' proximal outcomes (satisfaction and intention to adhere) and longer term outcomes (changes in presenting problems, physical health, and mental health), and 2) contributions of proximal outcomes to longer term outcomes. METHODS: Visits were video-recorded for a statewide sample of 31 NPs and 155 older patients. Patients' and NPs' communications during visits were measured using the Roter Interaction Analysis System for verbal activities, a check sheet for nonverbal activities, and an inventory of relationship dimension items. Proximal outcomes were measured with single items after visits. At 4 weeks, change in presenting problems was measured with a single item, and physical and mental health changes were measured with the SF-12 Version 2 Health Survey. Mixed-model regression with backward deletion was conducted until only predictors with p

Coordination in nurses' listening activities and communication about patient-nurse relationships.

The purpose of this analysis was to examine whether nurses' listening behavior, especially the coordination of their nonverbal involvement activities with those of their patients, communicates information about patient-nurse relationships. Participants were 126 college women who responded to a 30-item instrument measuring relational information that was communicated to them by nurses' behavior in videotaped segments of interactions between a patient/actress and 12 nurses. Participants' responses to two consecutive interaction segments were selected for this analysis. The research team coded the patient's and nurses' listening activities, and they calculated coordination and activity rates for all interaction segments. Multiple regression analysis revealed that nurses' verbal listening activities, such as reflection, their nonverbal involvement activities, and their simultaneous coordination of nonverbal involvement activities with those of the patient predicted relational information dimensions of trust/receptivity, depth/similarity/affection, composure, and non-formality. Thus, nurses' listening behavior, including coordination, may contribute to communication about patient-nurse relationships.