COMPUTER-BASED INTERACTION ANALYSIS OF THE CANCER CONSULTATION

There are few data available on which to base recommendations for effe ctive communication in the cancer consultation. This paper describes a computerised interaction analysis system designed specifically for th e cancer consultation and its application in a study investigating the relationship between doctor-patient behaviour and patient outcomes. O ne hundred and forty-two cancer patients attending their first consult ation with a cancer specialist were audio taped and a copy of the tape was retained for interaction analysis. Before the consultation patien t anxiety and information and involvement preferences were measured. O utcomes included recall of information, patient satisfaction with the consultation and psychological adjustment to cancer. Doctor behaviour was shown to vary significantly according to the age, sex, involvement preferences and in/out-patient status of the patient. The ratio of do ctor to patient talk was related to satisfaction with communication, w hile patients whose questions were answered showed better psychologica l adjustment at follow-up. The results suggest that patient-centred co nsultations lead to improved satisfaction and psychological adjustment . These data provide precise information about consultation behaviour which can be used in the documentation of current practice and the eva luation of new interventions to improve communication.