OLDER PATIENT SATISFACTION WITH COMMUNICATION DURING AN INITIAL MEDICAL ENCOUNTER

There has been extensive research on the factors associated with patie nt satisfaction with communication during medical encounters, however, little attention has been paid to satisfaction among subgroups of pat ients, including the elderly. It is inappropriate to assume that all p atients have the same physician-patient relationship needs, and thus, they will all be satisfied with the same communication approaches duri ng medical visits. In this study, we examine the interactional correla tes of older patient satisfaction with an initial visit with a general internist. A multidisciplinary team composed of social scientists and physicians used the Multi-dimensional Interaction Analysis system to code audiotapes. Patients and physicians completed post-visit satisfac tion questionnaires. Older patient satisfaction was positively correla ted with the following variables: physician questioning and supportive ness on patient-raised topics; patient information-giving on patient-r aised topics; the length of the visit; the physician's use of question s worded in the negative; shared laughter between and the patient; and physician satisfaction. These findings suggest that older patients pr efer encounters in which: (1) there is physician supportiveness and sh ared laughter; (2) they are questioned about and given an opportunity to provide information on their own agenda items; and (3) physicians p rovide some structure for the first meeting through their use of quest ions worded in the negative. The authors caution that although this sa mple of older patients appears to be satisfied with a communication st yle usually considered characteristic of the traditional model of the physician-patient relationship (i.e. a warm interpersonal style and ph ysician-generated structure for the visit), older patients in other se ttings and future cohorts of elderly patients may prefer other communi cation approaches. It is also suggested that aspects of communication which provide satisfaction to patients in first visit may be different than aspects of communication associated with patient satisfaction in follow-up visits.