Resources
Bibiliography and Abstracts of RIAS Studies through 2014

Following are abstracts of RIAS studies, listed in alphabetical order by first author. Just click on a letter below to view the abstracts by the author's last name. Monographs and doctoral theses have their own page.

A     B     C     D     E     F     G     H     I     J     K     L     M     N     O     P     Q     R     S

T     U     V     W     X     Y     Z     Monographs & Theses

N

Nakayama C, Kimata S, Oshima T, Kato A, Nitta A. Analysis of pharmacist-patient communication using the Roter Method of Interaction Process Analysis System. Res Social Adm Pharm. 2016 Mar-Apr;12(2):319-26.
(Pharmacy, Standardized Patients, Japan)
BACKGROUND: Effective communication between pharmacists and patients is a crucial factor in ensuring that medications are used properly. However, few studies have examined the contents of actual on-site communications between pharmacists and patients. OBJECTIVE: To identify the characteristics of and problems with routine communications between pharmacists and patients using the Roter Method of Interaction Process Analysis System (RIAS). METHODS: Conversations between pharmacists and simulated patients (SPs) were recorded and transcribed. Using the RIAS technique, their utterances were classified into 42 categories, and these were further divided into 11 clusters, such as open- and closed-ended questions, and analyzed. Furthermore, the influence that the different scenarios performed by the pharmacists may have had on the structure of their communication was investigated. All of the transcripts were double-coded by two certified coders. RESULTS: A total of 57 pharmacists took part in the study. The mean ratio of utterances made by SPs and pharmacists were 44% and 56%, respectively. The percentage of pharmacists' questions was more than double that of SPs' for both open- and closed-ended questions. In the influence that the different scenarios, the scenarios for patients with cancer was significantly higher ratio of utterances by the pharmacists. CONCLUSIONS: Pharmacists' communications tended to focus more on information-gathering activities that concentrated on closed-ended questions and frequent counseling, or directing utterances about the medication than on considering the patient's background. On the other hand, the pharmacists did communicate in ways that matched each patient's disease. This study identified the structure of pharmacists' on-site communications, and revealed the associated characteristics and problems. KEYWORDS: Pharmacist-patient communication; Simulated patient; The Roter Method of Interaction Process Analysis System

Neal RD, Ali N, Atkin K, Allgar VL, Ali S, Coleman T. Communication between South Asian patients and GP’s: comparative study using the Roter Interactional Analysis System. Br. J Gen Pract. 2006 Nov; 56 (532): 869-75.
(Cross-Cultural, United Kingdom)
BACKGROUND: The UK South Asian population has poorer health outcomes. Little is known about their process of care in general practice, or in particular the process of communication with GPs. AIM: To compare the ways in which white and South Asian patients communicate with white GPs. DESIGN OF STUDY: Observational study of video-recorded consultations using the Roter Interactional Analysis System (RIAS). SETTING: West Yorkshire, UK. METHOD: One hundred and eighty-three consultations with 11 GPs in West Yorkshire, UK were video-recorded and analysed. RESULTS: Main outcome measures were consultation length, verbal domination, 16 individual abridged RIAS categories, and three composite RIAS categories; with comparisons between white patients, South Asian patients fluent in English and South Asian patients nonfluent in English. South Asians fluent in English had the shortest consultations and South Asians non-fluent in English the longest consultations (one-way ANOVA F = 7.173, P = 0.001). There were no significant differences in verbal domination scores between the three groups. White patients had more affective (emotional) consultations than South Asian patients, and played a more active role in their consultations, as did their GPs. GPs spent less time giving information to South Asian patients who were not fluent in English and more time asking questions. GPs spent less time giving information to South Asian patients fluent in English compared with white patients. CONCLUSIONS: These findings were expected between patients fluent and non-fluent in English but do demonstrate their nature. The differences between white patients and South Asian patients fluent in English warrant further explanation. How much of this was due to systematic differences in behaviour by the GPs, or was in response to patients' differing needs and expectations is unknown. These differences may contribute to differences in health outcomes.

Nelson EL, Miller EA, Larson KA. Reliability associated with the Roter Interaction Analysis System (RIAS) adapted for the telemedicine context. Patient Educ Couns. 2010 Jan;78(1):72-8. Epub 2009 May 17.
(Telemedicine, United States)
OBJECTIVE: This study's purpose was to adapt the Roter Interaction Analysis System (RIAS) for telemedicine clinics and to investigate the adapted measure's reliability. The study also sought to better understand the volume of technology-related utterance in established telemedicine clinics and the feasibility of using the measure within the telemedicine setting. This initial evaluation is a first step before broadly using the adapted measure across technologies and raters. METHODS: An expert panel adapted the RIAS for the telemedicine context. This involved accounting for all consultation participants (patient, provider, presenter, family) and adding technology-specific subcategories. Ten new and 36 follow-up telemedicine encounters were videotaped and double coded using the adapted RIAS. These consisted primarily of follow-up visits (78.0%) involving patients, providers, presenters, and other parties. Reliability was calculated for those categories with 15 or more utterances. RESULTS: Traditional RIAS categories related to socioemotional and task-focused clusters had fair to excellent levels of reliability in the telemedicine setting. Although there were too few utterances to calculate the reliability of the specific technology-related subcategories, the summary technology-related category proved reliable for patients, providers, and presenters. Overall patterns seen in traditional patient-provider interactions were observed, with the number of provider utterances far exceeding patient, presenter, and family utterances, and few technology-specific utterances. CONCLUSION: The traditional RIAS is reliable when applied across multiple participants in the telemedicine context. Reliability of technology-related subcategories could not be evaluated; however, the aggregate technology-related cluster was found to be reliable and may be especially relevant in understanding communication patterns with patients new to the telemedicine setting. Use of the RIAS instrument is encouraged to facilitate comparison between traditional, face-to-face clinics and telemedicine; among diverse consultation mediums and technologies; and across different specialties. Future research is necessary to further investigate the reliability and validity of adding technology-related subcategories to the RIAS. The limited number of technology-related utterances, however, implies a certain degree of comfort with two-way interactive video consultation among study participants. PRACTICE IMPLICATIONS: Telemedicine continues to increase access to healthcare. The technology-related categories of the adapted RIAS were reliable when aggregated, thereby providing a tool to better understand how telemedicine affects provider-patient communication and outcomes.

Nelson EL, Spaulding R. Adapting the Roter interaction analysis system for telemedicine: lessons from four specialty clinics. J Telemed Telecare. 2005;11 Suppl 1:105-7.
(Telemedicine, United States)
Four specialists (a child psychiatrist, an oncologist, a cardiologist and a rheumatologist) conducted telemedicine clinics using videoconferencing at a bandwidth of 128-384 kbit/s. The consultations were video recorded. The coded interactions from the first two patients recruited from each of the four telemedicine clinics were analyzed. Tapes were coded by two raters. We adapted the Roter interaction analysis system (RIAS) for the telemedicine context. Utterances were coded into socio-emotional and task-focused categories. There were 1055 utterances in total. Providers generated significantly more utterances across categories than patients. In the patient-provider interactions, only 2% of the total utterances related to the technology. The predominance of socio-emotional utterances compared with task-focused utterances for providers was contrary to our expectations. Further studies are required to establish the reliability of the adapted RIAS measure and to increase understanding of telemedicine communication patterns.

Newes-Adeyi G, Heliter DL, Roter DL, Caulfield LE. Improving client-provider communication: evaluation of a training program for women, infants and children (WIC) professionals in New York State. Patient Educ Couns 2004 Nov;55(2):210-7.
(Communication Skills Training, United States)
Results are presented from evaluation of an intensive 1 day training program to improve the growth monitoring counseling skills of Special Supplemental Nutrition Program for Women, Infant and Children (WIC) providers. The training was framed by the patient-centered approach, and focused on a seven-step technique that emphasized eliciting client perspective on the child’s health and negotiating follow-up strategies. Changes in skill were assessed during audio taped mock counseling sessions with simulated clients. Observed intervention effects were moderate but encouraging for future training programs. After the training, more providers elicited client perspective, and provider level of engagement in negotiating with the client increased. At post-test providers asked more open-ended questions that at pre-test, and provider-to-client talk ratio decreased. Increases in provider total and competence-related satisfaction paralleled improvements in counseling proficiency. Study results suggest that counseling skills of non-physician health providers can change after a 1 day focused training: providers were more client-centered in their discussions.

Noordman J, Verhaak P, van Dulmen S. Web-enabled video-feedback: a method to reflect on the communication skills of experienced physicians. Patient Educ Couns. 2011 Mar;82(3):335-40.
(Video Feedback, Netherlands)
OBJECTIVE: To describe our web-enabled video-feedback method designed to reflect on the communication skills of experienced physicians. METHODS: Participating physicians (n=28) received a 'personal web link' to two of their video-recorded consultations. After watching the consultations physicians received feedback by telephone or in a face-to-face meeting, structured around an individualized feedback report. This report contained scores on the communication behavior of the physician in comparison with colleagues and their own communication behavior observed in a previous study, as well as patients' opinions about their physician's communication behavior. The physicians were asked to reflect on their communication skills and to comment on the usefulness and efficiency of the feedback method. RESULTS: Almost all physicians were satisfied with the feedback method and in particular valued the web-enabled link to the video-recorded consultations and the structured written report. Feedback by telephone or face-to-face feedback was considered equally appropriate. CONCLUSION: This web-enabled video-feedback method is a useful and structured design to reflect on the communication skills of physicians. PRACTICE IMPLICATIONS: As part of continuing medical education, feedback on communication skills should become a recurrent activity for experienced physicians. This method can also be used to reflect on the communication skills of medical students.

Noordman J, Verhaak P, van Beljouw I, van Dulmen S. Consulting room computers and their effect on general practitioner-patient communication. Fam Pract. 2010 Dec;27(6):644-51.
(Computer Use, Netherlands)
BACKGROUND: In the western medical world, computers form part of the standard equipment in the consulting rooms of most GPs. As the use of a computer requires time and attention from GPs, this may well interfere with the communication process. Yet, the information accessed on the computer may also enhance communication. OBJECTIVES: The present study affords insight into the relationship between computer use and GP-patient communication recorded by the same GPs over two periods. METHOD: Videotaped GP consultations collected in 2001 and 2008 were used to observe computer use and GP-patient communication. In addition, patients questionnaires about their experiences with communication by the GP were analysed using multilevel models with patients (Level 1) nested within GPs (Level 2). RESULTS: Both in 2008 and in 2001, GPs used their computer in almost every consultation. Still, our study showed a change in computer use by the GPs over time. In addition, the results indicate that computer use is negatively related to some communication aspects: the patient-directed gaze of the GP and the amount of information given by GPs. There is also a negative association between computer use and the body posture of the GP. Computer use by GPs is not associated with other (analysed) non-verbal and verbal behaviour of GPs and patients. Moreover, computer use is scarcely related to patients' experiences with the communication behaviour of the GP. CONCLUSIONS: GPs show greater reluctance to use computers in 2008 compared to 2001. Computer use can indeed affect the communication between GPs and patients. Therefore, GPs ought to remain aware of their computer use during consultations and at the same time keep the interaction with the patient alive.

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