TY - JOUR
T1 - Patient-provider communication in nephrology care for adolescents and young adults
AU - Coburn, S. S.
AU - Eakin, M. N.
AU - Roter, D.
AU - Pruette, C.
AU - Brady, T.
AU - Mendley, S.
AU - Tuchman, S.
AU - Fivush, B.
AU - Riekert, K. A.
N1 - Publisher Copyright:
© 2017
PY - 2017/9
Y1 - 2017/9
N2 - Objective To compare the relative quantity of talk between providers, caregivers, and adolescents and young adults (AYAs) with chronic kidney disease (CKD) and how communication differs by age. Methods During nephrology clinic visits, conversations between AYAs with CKD (N = 99, ages 11–20, median = 15), their caregivers, and providers (N = 19) were audiotaped and coded using the Roter Interaction Analysis System. Linear mixed models tested AYA age differences in talk frequency by AYAs, caregivers, and providers. Post-hoc analyses tested differences in talk using AYA age groups. Results During clinic visits, providers spoke the most (63.7%), and caregivers spoke more (22.6%) than AYAs (13.7%). Overall talk differed by AYA age in AYAs (p < 0.001) and caregivers (p < 0.05), but not providers. Higher AYA age was associated with more AYA talk (biomedical information-giving, partnering, rapport-oriented) and less caregiver biomedical information-giving (ps < 0.001–0.05). In post-hoc analyses, young adults talked more than adolescents; caregiver talk decreased in the middle-adolescent group. Conclusions Increases in AYA talk occur primarily in young adulthood, whereas caregiver talk decreases in middle adolescence. This may indicate an appropriate developmental shift but raises concerns about conversational gaps during middle-adolescence. Practice implications During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication.
AB - Objective To compare the relative quantity of talk between providers, caregivers, and adolescents and young adults (AYAs) with chronic kidney disease (CKD) and how communication differs by age. Methods During nephrology clinic visits, conversations between AYAs with CKD (N = 99, ages 11–20, median = 15), their caregivers, and providers (N = 19) were audiotaped and coded using the Roter Interaction Analysis System. Linear mixed models tested AYA age differences in talk frequency by AYAs, caregivers, and providers. Post-hoc analyses tested differences in talk using AYA age groups. Results During clinic visits, providers spoke the most (63.7%), and caregivers spoke more (22.6%) than AYAs (13.7%). Overall talk differed by AYA age in AYAs (p < 0.001) and caregivers (p < 0.05), but not providers. Higher AYA age was associated with more AYA talk (biomedical information-giving, partnering, rapport-oriented) and less caregiver biomedical information-giving (ps < 0.001–0.05). In post-hoc analyses, young adults talked more than adolescents; caregiver talk decreased in the middle-adolescent group. Conclusions Increases in AYA talk occur primarily in young adulthood, whereas caregiver talk decreases in middle adolescence. This may indicate an appropriate developmental shift but raises concerns about conversational gaps during middle-adolescence. Practice implications During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication.
KW - Adolescents
KW - Caregivers
KW - Chronic kidney disease
KW - Nephrology
KW - Patient-provider communication
KW - Pediatric
KW - Subspecialty
KW - Transition
KW - Young adults
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U2 - 10.1016/j.pec.2017.03.026
DO - 10.1016/j.pec.2017.03.026
M3 - Article
C2 - 28433407
AN - SCOPUS:85017578377
SN - 0738-3991
VL - 100
SP - 1680
EP - 1687
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 9
ER -