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A theory-based approach to analysing conversation sequences

Published online by Cambridge University Press:  11 October 2011

Wolf Langewitz ,
Matthias Nübling  and
Heidemarie Weber
Wolf Langewitz*
Affiliation:
Division Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
Matthias Nübling
Affiliation:
Society for Empirical Consulting (GEB), Freiburg i. Brsg., Germany
Heidemarie Weber
Affiliation:
Division Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
*
Address for correspondence: Professor Dr. Wolf Langewitz, Petersgraben 4, CH-4031 Basel (Switzerland). E-mail: wlangewitz@uhbs.ch
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Summary

Aims – To assess the quality of communication generally two procedures are used: one defines categories of utterances and counts their frequency, the other uses global observer ratings. We investigated whether a sequence analysis of utterances yields results which more precisely reflect the process of a conversation. Methods – We re-examined data from a randomised controlled intervention study in which residents' interviews with simulated patients were analysed with the Maastricht History and Advice Checklist (MAAS-R) and the Roter Interaction Analysis System (RIAS). Using the U-file of the RIAS we studied the effect of different types of physician questions (open, closed questions, facilitators, other physician actions) on the length of uninterrupted patients' speech and content of utterances. We investigated also whether reciprocity indices improve after a communication skills training, and whether they correlate with global scores form MAAS-R. Results – Patients respond to a closed question with a mean of 1.78 (± 1.49) utterances as compared to 2.75 (± 2.72) utterances after an open question. The likelihood of a concern was more than lOfold higher after an open question compared to closed questions. Reciprocal sequences make up less than 2 percent of the conversation, Still, they correlate with global items form MAAS-R. The 'empathy index' improves after the training.

Declararation of Interest: preparation of the manuscript was supported by a grant from OncoSuisse.

Keywords

communication sequencescommunication skills trainingRoter Interaction Analysis SystemMAAS-Rreciprocal conversationopen questions patient concerns.
Type
Sequence Analysis of Patient-Provider Interaction
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Special Issue 2: Sequence Analysis of Patient-Provider Interaction , June 2003 , pp. 103 - 108
Copyright
Copyright © Cambridge University Press 2003

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