Physician Information-Giving and Partnership-Building Behaviors: Possible Disparities in Health Communications

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  • March 22, 2019
Creator
  • Wall, Yolanda G.
    • Affiliation: School of Nursing
Abstract
  • Localized prostate cancer, where an optimum treatment choice is characterized by uncertainty and ambiguity, often creates a situation in which patients need more information to make treatment decisions (Snow et al., 2007; Wilt et al., 2008). The purposes of this study were: (1) to describe physicians' communication with African American and Caucasian men during treatment decision making consultations for localized prostate cancer, and (2) to examine whether there was a variation in physician communication patterns, specifically information-giving and partnership-building behaviors, by the race, education level, and age of the patient. This study was a secondary analysis of data from a larger completed study, Decision Making under Uncertainty in Men with Prostate Cancer Patients (R01 NR008144-01, Merle H. Mishel, PI and Barbara B. Germino, Co-PI). Eight physicians were subjects in this study. Forty-five men comprised the patient sample. Thirteen of the men were African American and 32 were Caucasian. Physicians in this sample used information-giving behaviors more often with patients who were less than or equal to 65 years old, who had 13 or more years of education, and with Caucasians (as compared to African Americans). Differences between the mean numbers of information-giving utterances by age, education and race using independent t-tests were significant by patient age, but not by patient education or race. Similar to information-giving, physicians were more apt to use partnership-building with Caucasian men (as compared to African American men), those younger than 65, and those who had more than a high school education. Using independent t-tests, the differences between mean numbers of partnership-building utterances by age, education and race were not significant. Physicians used both facilitative and accommodative partnership-building with patients who were younger, more educated, and Caucasian. Physicians in this sample used both facilitative and accommodative partnership-building more often with men younger than 65, having 13 or more years of education, and with Caucasians (as compared to African Americans). Examination of differences between mean facilitative and accommodative partnership-building utterances by age, education and race of the patient using independent t-tests indicated that they were not significant. Overall, physicians were less engaged in partnership-building than information-giving in these consultations.
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  • ... in partial fulfillment of the requirements for the degree of Doctorate of Philosophy in the School of Nursing
Advisor
  • Germino, Barbara B.
Degree granting institution
  • University of North Carolina at Chapel Hill
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