Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Nov;62(11):1296-302.
doi: 10.1176/ps.62.11.pss6211_1296.

A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers

Donald M Steinwachs  1 , Debra L Roter, Elizabeth A Skinner, Anthony F Lehman, Maureen Fahey, Bernadette Cullen, Anita Smith Everett, Gerard Gallucci
Affiliations
Randomized Controlled Trial

A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers

Donald M Steinwachs et al. Psychiatr Serv. 2011 Nov.

Abstract

Objective: This study evaluated a Web-based tool to help patients with schizophrenia communicate with clinicians about evidence-based treatments.

Methods: Fifty patients used an interactive Web-based intervention featuring actors simulating a patient discussing treatment concerns (intervention group; N=24) or were shown an educational video about schizophrenia treatment before an appointment for routine follow-up care (control group; N=26). The visits were recorded and analyzed by using the Roter Interaction Analysis System.

Results: Visits by patients in the intervention group were longer (24 versus 19 minutes, p<.05) and had a proportionately greater patient contribution to the dialogue (288 versus 229 statements, p<.05) and a smaller ratio of clinician to patient talk (1.1 versus 1.4, p<.05) compared with visits by the control group. Patients in the intervention group asked more questions about treatment (2 versus .9, p<.05), disclosed more lifestyle information (76 versus 53 statements, p<.005), and more often checked that they understood information (3.6 versus 2.1 checks, p<.05). Clinicians asked more questions about treatment (7.5 versus 5.1, p<.05) and the medical condition (7.8 versus 4.7, p<.05) to control group patients but made more statements of empathy (1.3 versus .4, p<.03) and cues of interest (48 versus 22, p<.05) with the intervention group. The patient-centeredness ratio was greater for visits by patients in the intervention group than by the control group (8.5 versus 3.2, p<.05). Patients' tone was more dominant and respectful (p<.05) and clinicians' tone was more sympathetic (p<.05) during visits by patients in the intervention.

Conclusions: The Web-based tool empowered persons with schizophrenia to engage more fully in a patient-centered dialogue about their treatment.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Roter DL. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Education Monographs. 1977;50:281–315. - PubMed
    1. Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Medical Care. 1989;27:S110–S127. - PubMed
    1. Harrington J, Noble LM, Newman SP. Improving patients’ communication with doctors: a systematic review of intervention studies. Patient Education and Counseling. 2004;52:7–16. - PubMed
    1. Noble LM, Douglas BC, Newman SP. What do patients want and do we want to know? A review of patients’ requests of psychiatric services. Acta Psychiatrica Scandinavica. 1999;100:321–327. - PubMed
    1. Noble LM, Douglas BC, Newman SP. What do patients expect of psychiatric services? A systematic and critical review of empirical studies. Social Science and Medicine. 2001;52:985–998. - PubMed

Publication types