Abstract
Purpose
To measure the prevalence, type and instigator of verbal interruptions during initial consultations between clinicians and patients with low back pain.
Background
During initial consultations, patients take on average, 92 seconds to outline their problem, if given the chance. Few achieve this, with clinicians interrupting (25–69% of cases) in as little as 12 seconds, either with an ‘overlap’, (a projection error of when a turn ends), or an ‘interruption’ (a start-up before the speaker's talk is complete). The prevalence and impact of these in back pain consultations is unknown.
Methods:
Twenty-five clinical encounters (totalling 975 minutes) between physiotherapists in primary care and patients with back pain were observed, audio-recorded, transcribed verbatim and analysed. Data were managed using a Framework approach and the prevalence and reasons for overlaps and interruptions were determined.
Results
This data set comprised 15,489 turns. Of the 7,659 patients' turns 17% were incomplete, with n=385 overlaps and n=284 interruptions by clinicians (including signs of active listening). The clinician talk, (7,647 turns) had 582 overlaps and 39 interruptions by patients. The main reasons for interruptions were to clarify or seek additional information. The level of experience of the clinician did not affect prevalence; however more interruptions occurred in same-gender encounters.
Discussion
Communication is the most important aspect that health professionals have to master. Raising awareness of interrupting patients is important, to assist clinicians in optimising their non-specific treatment effects and enhancing patient experience. Further work is in progress to measure the impact of not listening to patients.
Conclusion
Clinicians should consider their prevalence rates of interrupting patients and its impact upon care.
This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting.
Conflicts of interest: No conflicts of interest
Sources of funding: Arthritis Research UK.
