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Biomedical subjects

W B Stiles

Publications and source records attributed to W B Stiles.

49 records · Page 3Linked to original sources
PubMed1981

Parent-child interaction in the laboratory: effects of role, task, and child behavior pathology on verbal response mode use.

Fourth-, fifth-, or sixth-grade children identified as aggressive, withdrawn, or nondeviant by a consensus of teacher and peer ratings interacted with one of their parents in a modified revealed difference task. Transcripts of the interactions were coded according to a taxonomy of verbal response modes (VRMs). Comparison of VRM profiles showed small and equivocal differences between trait groups. However, differences between roles (parent and child) and differences between two phases of the task ("reach agreement" on a problematic situation and "tell you how you feel" in that situation) were large and highly significant. Results support the hypothesis that intersubjective coding categories, such as VRMs, are sensitive to role, task, and relationship variables but relatively insensitive to enduring individual differences in personality or behavior pathology.

Aggression↗
PubMed1979

Verbal response modes and psychotherapeutic technique.

This paper presents a taxonomy of verbal response modes and applies that taxonomy to the verbal behavior of psychotherapists of three contrasting schools: client-centered, gestalt, and psychoanalytic. The taxonomy consists of a theoretically based set of classificatory principles that define a mutually exclusive and exhaustive set of modes. Its purpose is to describe dyadic verbal interaction comprehensively and quantitatively. Such description is a necessary first step in investigating the therapeutic effectiveness of different interaction styles.

Cognition↗
PubMed1979

Verbal response mode profiles of patients and physicians in medical screening interviews.

The medical importance of the patient-physician relationship is widely acknowledged, but research on its effects has been hampered by the lack of a method to quantify its clinically relevant features. In this study a new method of coding verbal interaction was applied to 52 interviews with adults in a general medical screening clinic. "Average interaction profiles" for patients and for physicians in the medical history, physical examination, and conclusion segments of the interviews provided detailed descriptions of the relationship that appear to be accurate and coincide with descriptions derived from clinical experience, textbooks, and other studies. The profiles yield quantitative indexes of such crucial aspects of the relationship as the manner in which patients give a history and physicians trasmit information to patients.

Adult↗
PubMed1979

Interaction exchange structure and patient satisfaction with medical interviews.

The verbal interaction between patients and physicians in 52 initial interviews in a university hospital screening clinic was studied using a new discourse coding system. Factor analysis of category frequencies showed that each interview segment, medical history, physical examination, and conclusion, consisted mainly of two or three types of verbal exchange. Patient satisfaction with the interviews, assessed with a questionnaire that yields separate scores for satisfaction with cognitive and affective aspects, was found to be associated with exchanges involving the transmission of information in particular interview segments. Affective satisfaction was associated with transmission of information from patient to physician in "exposition" exchanges during the medical history, in which patients told their story in their own words. Cognitive satisfaction was associated with transmission of information from physician to patient in "feedback" exchanges during the conclusion segment, in which physicians gave patients information about illness and treatment.

Adolescent↗
PubMed1978

The Medical Interview Satisfaction Scale: development of a scale to measure patient perceptions of physician behavior.

Patient satisfaction is a variable of increasing interest to researchers, clinicians, and medical educators. Of several studies reviewed, only a few have shown evidence of careful methodology. Most surveys have focused on general evaluations of doctors and/or health care services or of a particular facility. The present article reports the development of a scale to measure patient satisfaction with an encounter with a physician or other primary care provider. Methods of item generation and pretesting are detailed. The overall reliability of the scale (Cronbach's coefficient alpha) is 0.93. The distribution of satisfaction scores is broader than that reported for other scales and approaches the normal in shape. Clinical and research applications of the scale are suggested.

Adult↗
PubMedDate not supplied

Teaching the medical interview: an intervention study.

To study the effects of teaching specific interviewing techniques on verbal behaviors and on health outcomes, internal medicine residents working in a screening clinic were assigned to either an experimental or a control group. The entire clinic visit was audiotaped, transcribed, and coded according to the Verbal Response Mode (VRM) system. Residents in the experimental group were taught interviewing behaviors (patient exposition and physician explanation) that had been found in previous studies to be associated with patient outcomes. Through telephone interviews, patient satisfaction, compliance, and symptom status were determined for all patients. Two hundred and sixty-eight interviews (156 in the experimental group and 112 in the control group) were included in the study. Training did increase patient exposition and physician explanation, but did not affect health outcomes. Residents' attitudes and behaviors during the training are described.

Communication↗
PubMedDate not supplied

Discourse analysis and the doctor-patient relationship.

This article describes a system of discourse analysis, called a "taxonomy of verbal response modes," which can be applied to medical interviews. The taxonomy identifies eight basic categories: disclosure, question, edification, acknowledgement, advisement, interpretation, confirmation, and reflection, which are defined by three principles of classification. The categories are mutually exclusive and exhaustive. Each mode conveys a particular interpersonal intent and also has a characteristic grammatical form. With eight forms and eight intents, the taxonomy includes sixty-four possible verbal response modes, eight "pure modes," in which form and intent coincide, and fifty-six "mixed modes," in which form and intent differ. The taxonomy has yielded fine-grained descriptions of patient-physician interaction and has identified particular types of utterances and verbal exchanges that are associated with patients' satisfaction with their medical interviews. The system provides a detailed descriptive vocabulary that may be useful for teaching interviewing skills.

Humans↗