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BMC family practice
Sep 03, 2008;9 49.

Discussions about preventive services: a qualitative study.

Karen E Lasser, Bridget Kelly, Jan Maier, Jennifer Murillo, Sonia Hoover, Karen Isenberg, Deborah Osber, Natasha Pilkauskas, Bayo C Willis, James Hersey
Author Information
  1. Karen E Lasser: Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA, USA. klasser@challiance.org
PMID: 18768086 DOI: 10.1186/1471-2296-9-49

Abstract

BACKGROUND: Elderly minority patients are less likely to receive influenza vaccination and colorectal cancer screening than are other patients. Communication between primary care providers (PCPs) and patients may affect service receipt.
METHODS: Encounters between 7 PCPs and 18 elderly patients were observed and audiotaped at 2 community health centers. Three investigators coded transcribed audiotapes and field notes. We used qualitative analysis to identify specific potential barriers to completion of preventive services and to highlight examples of how physicians used patient-centered communication and other facilitation strategies to overcome those barriers.
RESULTS: Sharing of power and responsibility, the use of empathy, and treating the patient like a person were all important communication strategies which seemed to help address barriers to vaccination and colonoscopy. Other potential facilitators of receipt of influenza vaccine included (1) cultural competence, (2) PCP introduction of the discussion, (3) persistence of the PCP (revisiting the topic throughout the visit), (4) rapport and trust between the patient and PCP, and (5) PCP vaccination of the patient. PCP persistence as well as rapport and trust also appeared to facilitate receipt of colorectal cancer screening.
CONCLUSION: Several communications strategies appeared to facilitate PCP communications with older patients to promote acceptance of flu vaccination and colorectal cancer screening. These strategies should be studied with larger samples to determine which are most predictive of compliance with prevention recommendations.

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Grants

  1. U50/CCU3300860/PHS HHS

MeSH Term

Aged
Boston
Colorectal Neoplasms
Communication
Communication Barriers
Community Health Centers
Female
Health Services for the Aged
Humans
Influenza Vaccines
Influenza, Human
Male
Middle Aged
Patient Acceptance of Health Care
Physician-Patient Relations
Preventive Health Services
Qualitative Research
Socioeconomic Factors
Surveys and Questionnaires

Chemicals

Influenza Vaccines
Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.
Article has an altmetric score of 3

Word Cloud

Created with Highcharts 10.0.0PCPpatientsvaccinationstrategiescolorectalcancerscreeningreceiptbarrierspatientinfluenzaPCPs2usedqualitativepotentialpreventivecommunicationpersistencerapporttrustappearedfacilitatecommunicationsBACKGROUND:ElderlyminoritylesslikelyreceiveCommunicationprimarycareprovidersmayaffectserviceMETHODS:Encounters718elderlyobservedaudiotapedcommunityhealthcentersThreeinvestigatorscodedtranscribedaudiotapesfieldnotesanalysisidentifyspecificcompletionserviceshighlightexamplesphysicianspatient-centeredfacilitationovercomeRESULTS:Sharingpowerresponsibilityuseempathytreatinglikepersonimportantseemedhelpaddresscolonoscopyfacilitatorsvaccineincluded1culturalcompetenceintroductiondiscussion3revisitingtopicthroughoutvisit45wellalsoCONCLUSION:SeveralolderpromoteacceptanceflustudiedlargersamplesdeterminepredictivecompliancepreventionrecommendationsDiscussionsservices:study

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