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Family presence in routine medical visits: A meta-analytical review

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  • Wolff, Jennifer L.
  • Roter, Debra L.

Abstract

Older adults are commonly accompanied to routine physician visits, primarily by adult children and spouses. This is the first review of studies investigating the dynamics and consequences of patient accompaniment. Two types of evidence were examined: (1) observational studies of audio and/or videotaped medical visits, and (2) surveys of patients, families, or health care providers that ascertained experiences, expectations, and preferences for family companion presence and behaviors in routine medical visits. Meta-analytic techniques were used to summarize the evidence describing attributes of unaccompanied and accompanied patients and their companions, medical visit processes, and patient outcomes. The weighted mean rate of patient accompaniment to routine adult medical visits was 37.6% in 13 contributing studies. Accompanied patients were significantly older and more likely to be female, less educated, and in worse physical and mental health than unaccompanied patients. Companions were on average 63 years of age, predominantly female (79.4%), and spouses (54.7%) or adult children (32.2%) of patients. Accompanied patient visits were significantly longer, but verbal contribution to medical dialog was comparable when accompanied patients and their family companion were compared with unaccompanied patients. When a companion was present, health care providers engaged in more biomedical information giving. Given the diversity of outcomes, pooled estimates could not be calculated: of 5 contributing studies 0 were unfavorable, 3 inconclusive, and 2 favorable for accompanied relative to unaccompanied patients. Study findings suggest potential practical benefits from more systematic recognition and integration of companions in health care delivery processes. We propose a conceptual framework to relate family companion presence and behaviors during physician visits to the quality of interpersonal health care processes, patient self management and health care.

Suggested Citation

  • Wolff, Jennifer L. & Roter, Debra L., 2011. "Family presence in routine medical visits: A meta-analytical review," Social Science & Medicine, Elsevier, vol. 72(6), pages 823-831, March.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:6:p:823-831
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    References listed on IDEAS

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    1. Clayman, Marla L. & Roter, Debra & Wissow, Lawrence S. & Bandeen-Roche, Karen, 2005. "Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits," Social Science & Medicine, Elsevier, vol. 60(7), pages 1583-1591, April.
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    6. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
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    Cited by:

    1. Hilke Brockmann, 2012. "Ungesunde Verhältnisse?: Eine Längsschnittanalyse zur Gesundheit von Kindern in zusammen- und getrenntlebenden Familien," SOEPpapers on Multidisciplinary Panel Data Research 503, DIW Berlin, The German Socio-Economic Panel (SOEP).
    2. Duberstein, Paul R. & Hoerger, Michael & Norton, Sally A. & Mohile, Supriya & Dahlberg, Britt & Hyatt, Erica Goldblatt & Epstein, Ronald M. & Wittink, Marsha N., 2023. "The TRIBE model: How socioemotional processes fuel end-of-life treatment in the United States," Social Science & Medicine, Elsevier, vol. 317(C).
    3. Blair, Thomas R.W., 2012. "“Community ambassadors” for South Asian elder immigrants: Late-life acculturation and the roles of community health workers," Social Science & Medicine, Elsevier, vol. 75(10), pages 1769-1777.

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