[Influence of the patient's companion on the discussion and length of the clinical interview in primary health care]

[患者陪同人员对基层医疗临床访谈讨论内容和时长的影响]

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Abstract

OBJECTIVE: To find out the percentage of patients who come accompanied to their medical appointments, their companion's profile and his/her influence on the discussion and the length of the clinical interview in Primary Health Care. DESIGN: Descriptive observational study. SETTING: Adoratrices and La Orden Healthcare Centers. Health District: Huelva-Coast. PARTICIPANTS: Non-probabilistic randomized sample of 390 interviews in November 2007. MAIN MEASUREMENTS: Data was collected by 4 external observers on: the companion and his/her characteristics, length of clinical interview, the interview strategies employed, success and differences when with a companion. RESULTS: The companion was present in 30.5% of the clinical interviews (95% CI, 25.9%-35.3%). The typical companion is female (61.3%), 52 years old, wife and co-worker. Strategies were used in 6.7% of interviews (95% CI, 2.8%-15.6%), the most frequent being signalling. The difference as regards initial exposure without interruption was 2s without and with a companion (p=0.276). The interview finished with a difference of 46 s without companion and with companion (p=0.098). As regards the length of the clinical interview, without discussion it was 7 min long and with discussion 8 min and 38 s (p=0.034). There was discussion in 16.4% of the interviews (95% CI, 12.9%-20.5%) and there was agreement in 88.9% (95% CI, 78.4%-95.4%). The most frequent strategy was that of redirecting objectives. CONCLUSIONS: Approximately one third of the patients came accompanied. The most frequent profile was the co-worker. The companion does not have an effect on the length of the interview. Length increases when there is discussion.

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