Jennifer L. Wolff|Debra Roter
Older Adults’ Mental Health Function and Patient-Centered Care: Does the Presence of a Family Companion Help or Hinder Communication?
Johns Hopkins University|Johns Hopkins University
latelife mental health disorders prevalent costly commonly underdiagnosed undertreatedto investigate whether family companion presence routine primary care visits helps hinders patientcentered processes among older adults poor mental health functionobservational study accompanied n 80 unaccompanied n 310 primary care patients ages 65 olderaudiotaped medical visit communication coded roter interactional analysis system three process measures visit duration minutes patientcompanion verbal activity ratio patientcentered communication adjusted patient age gender race physical function participants stratified sf36 mental health subscale mcs using two approaches 1 standardized population midpoint delineate good 50 poor health 50 2 clinically derived cutpoints 35 3549 50when patients poor mental health accompanied family companion patientcompanions provided less psychosocial information physicians engaged less questionasking partnershipbuilding patientcompanions physicians contributed taskoriented biomedical discussion accompanied patients poor mental health less likely experience patientcentered communication relative unaccompanied patients aor 021 95 ci 006 068 difference observed patients good mental health aor 102 95 ci 046 227 verbal activity comparable accompanied patientscompanions unaccompanied patients mental health strata medical visits 23 minutes longer patients good mental health accompanied b 231 p 0006 comparable patients poor mental health b 037 p 0827 study findings amplified lowest functioning mental health subgroup mcs 35 medical visits shorter communication least patientcentered p 0019 patients accompaniedolder adults poor mental health function may experience communication challenges form shorter visits less patientcentered communication family companion present