Examining doctor-patient communication in dyadic and triadic medical consultations: A qualitative assessment of the needs, perspectives, and typology of older adult patients.

Abstract

This study aims to develop a broader understanding of doctor-patient communication by examining typologies of dyadic and triadic encounters based on perspectives of multiple stakeholders. In-depth interviews with a purposive sample of 80 respondents (8 doctors, 28 dyadic patients, 15 triadic patients, and 29 companions) were undertaken. Each in-depth interview was transcribed and independently analyzed by three independent coders using the grounded theory approach. Dyadic patients prefer autonomy in medical consultations while triadic patients rely on companions for support and decision-making, highlighting their broader needs for independence, emotional support, and health information seeking skills. Based on dependence, four conceptually distinct categories of older adult patients were identified: (1) supported older adults, (2) older adults with diverse support needs, (3) accompanied older adults, and (4) independent older adults. Older adult patients can be categorized based on their specific needs and the involvement of a third party during medical consultations. Effective doctor-patient communication should be tailored to cater to the unique requirements of each consultation and patient profile. Healthcare practitioners need to be more mindful of the diverse typology of older adult patients, and the communication barriers in a population with diverse cultural composition. Communication enhancement strategies are also proposed.