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Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes

  • Julian Barratt (a1) and Nicola Thomas (a2)
  • Please note a correction has been issued for this article.

Abstract

Objective

To determine the discrete nature of social interactions occurring in nurse practitioner consultations and investigate the relationship between consultation social interaction styles (biomedical and patient-centred) and the outcomes of patient satisfaction, patient enablement, and consultation time lengths.

Methods

A case study-based observational interaction analysis of verbal social interactions, arising from 30 primary health care nurse practitioner consultations, linked with questionnaire measures of patient satisfaction and enablement.

Results

A significant majority of observed social interactions used patient-centred communication styles (P=0.005), with neither nurse practitioners nor patients or carers being significantly more verbally dominant. Nurse practitioners guided the sequence of consultation interaction sequences, but patients actively participated through interactions such as asking questions. Usage of either patient-centred or biomedical interaction styles were not significantly associated with increased levels of patient satisfaction or patient enablement. The median consultation time length of 10.1 min (quartiles 8.2, 13.7) was not significantly extended by high levels of patient-centred interactions being used in the observed consultations.

Conclusion

High usage levels of patient-centred interaction styles are not necessarily contingent upon having longer consultation times available, and clinicians can encourage patients to use participatory interactions, whilst still then retaining overall guidance of the phased sequences of consultations, and not concurrently extending consultation time lengths. This study adds to the body of nurse practitioner consultation communication research by providing a more detailed understanding of the nature of social interactions occurring in nurse practitioner consultations, linked to the outcomes of patient satisfaction and enablement.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits nrestricted re-se, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Dr Julian Barratt, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Gorway Road, Walsall WS1 3BD, UK. E-mail: julian.barratt@wlv.ac.uk

Footnotes

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Cite this article: Barratt J, Thomas N. (2018) Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes. Primary Health Care Research & Development page 1 of 11. doi: 10.1017/S1463423618000427

Footnotes

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A correction has been issued for this article: