Resources
Bibiliography and Abstracts of RIAS Studies through 2014

Following are abstracts of RIAS studies, listed in alphabetical order by first author. Just click on a letter below to view the abstracts by the author's last name. Monographs and doctoral theses have their own page.

A     B     C     D     E     F     G     H     I     J     K     L     M     N     O     P     Q     R     S

T     U     V     W     X     Y     Z     Monographs & Theses

Z

Zaleta AK, Carpenter BD. Patient-centered communication during the disclosure of a dementia diagnosis. Am J Alzheimers Dis Other Demen. 2010 Sep;25(6):513-20. Epub 2010 Jun 17.
(Bad News Delivery, Companions/Caregivers, United States) This study examined physician use of patient-centered communication during disclosure of a dementia diagnosis. Fifty-four patients (mean age = 74.13) and companions (mean age = 65.67; n = 34 spouses/partners, 12 adult children, 8 other) were diagnosed with very mild (n = 36) or mild (n = 18) dementia at an Alzheimer's Disease Research Center. Audio recordings of these triadic encounters were evaluated with the Roter Interaction Analysis System. Physicians utilized moderate but variable amounts of patient-centered behaviors including positive rapport building, facilitation, and patient activation (P < .001). Physicians far less frequently used emotional rapport building (P < 0.001). Physicians who demonstrated more patient-centered communication also exhibited greater positive affect (P < 0.05). The use of patient-centered behaviors and positive affect was more variable between physicians than within physicians and may be more dependent on individual physician characteristics than dementia severity or age and gender of patients and companions.

Zantinge EM, Verhaak PF, de Bakker DH, van der Meer K, Bensing JM. Does burnout among doctors affect their involvement in patients' mental health problems? A study of videotaped consultations. BMC Fam Pract. 2009 Aug 26;10:60.
(Mental Health, Netherlands)
BACKGROUND: General practitioners' (GPs') feelings of burnout or dissatisfaction may affect their patient care negatively, but it is unknown if these negative feelings also affect their mental health care. GPs' available time, together with specific communication tools, are important conditions for providing mental health care. We investigated if GPs who feel burnt out or dissatisfied with the time available for their patients, are less inclined to encourage their patients to disclose their distress, and have shorter consultations, in order to gain time and energy. This may result in less psychological evaluations of patients' complaints. METHODS: We used 1890 videotaped consultations from a nationally representative sample of 126 Dutch GPs to analyse GPs' communication and the duration of their consultations. Burnout was subdivided into emotional exhaustion, depersonalisation and reduced accomplishment. Multilevel regression analyses were used to investigate which subgroups of GPs differed significantly. RESULTS: GPs with feelings of exhaustion or dissatisfaction with the available time have longer consultations compared to GPs without these feelings. Exhausted GPs, and GPs with feelings of depersonalisation, talk more about psychological or social topics in their consultations. GPs with feelings of reduced accomplishment are an exception: they communicate less affectively, are less patient-centred and have less eye contact with their patients compared to GPs without reduced accomplishment.We found no relationship between GPs' feelings of burnout or dissatisfaction with the available time and their psychological evaluations of patients' problems. CONCLUSION: GPs' feelings of burnout or dissatisfaction with the time available for their patients do not obstruct their diagnosis and awareness of patients' psychological problems. On the contrary, GPs with high levels of exhaustion or depersonalisation, and GPs who are dissatisfied with the available time, sometimes provide more opportunities to discuss mental health problems. This increases the chance that appropriate care will be found for patients with mental health problems. On the other hand, these GPs are themselves more likely to retire, or risk burnout, because of their dissatisfaction. Therefore these GPs may benefit from training or personal coaching to decrease the chance that the process of burnout will get out of hand.

Zantinge EM, Verhaak PF, de Bakker DH, Kerssens JJ, van der Meer K, Bensing JM. The workload of general practitioners does not affect their awareness of patients' psychological problems. Patient Educ Couns. 2007 Jul;67(1-2):93-9. Epub 2007 Mar 26.
(Primary Care, Patientsí Psychological Distress, Netherlands)
OBJECTIVE: To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems. METHODS: Data from 2095 videotaped consultations from a representative selection of 142 Dutch GPs were used. Multilevel regression analyses were performed with the GPs' awareness of the patient's psychological problems and their communication as outcome measures, the GPs' workload as a predictor, and GP and patient characteristics as confounders. RESULTS: GPs' workload is not related to their awareness of psychological problems and hardly related to their communication, except for the finding that a GP with a subjective experience of a lack of time is less patient-centred. Showing eye contact or empathy and asking questions about psychological or social topics are associated with more awareness of patients' psychological problems. CONCLUSION: Patients' feelings of distress are more important for GPs' communication and their awareness of patients' psychological problems than a long patient list or busy moment of the day. GPs who encourage the patient to disclose their psychological problems are more aware of psychological problems. PRACTICE IMPLICATIONS: We recommend that attention is given to all the communication skills required to discuss psychological problems, both in the consulting room and in GPs' training. Additionally, attention for gender differences and stress management is recommended in GPs' training.

Zecca G, Gradi EC, Nilsson K, Bellotti M, Dal Verme S, Vegni E, Moja EA. "All the rest is normal". A pilot study on the communication between physician and patient in prenatal diagnosis. J Psychosom Obstet Gynaecol. 2006 Sep;27(3):127-30.
(Prenatal Diagnosis, Italy)
The aim of the study was to verify in the context of prenatal diagnosis if the communicative style in consultations is modified in relation to the seriousness of the diagnosis. Videoed consultations after executing amniocentesis and ultra-sound scanning of II level were included in the study with the consent of participants. Only visits with Italian speaking couples without psychiatric problems were analyzed for the study. Selected visits were grouped into "low" (L, minor anomalies) and "high" (H, serious anomalies) visits. A modified version of the RIAS tailored for the specific context was used in the analysis. 27 visits, respectively 13 H and 14 L, were studied. Analysis of the communicative structure of the consultations did not show significant differences between the two groups. The communication during the consultation seems to be mostly influenced by a highly disease-centered model that is not dependent on the content of the consultation itself. Only emotional exchanges showed a marginally significant decrease in the H visits (t = 1.995, p = 0.057), suggesting the probable difficulty of the disease-centered model to manage emotional items during a highly dramatic consultation. Due to the exploratory nature of the study, further research is needed to test the preliminary results.

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