Observed Patient-Clinician Communication, by Clinicians’ Self-Rated Mindfulness
| β Coefficient (95% CI) | |||||||
|---|---|---|---|---|---|---|---|
| Clinician Mindfulness Tertilea Mean No. (SD) | Adjusted for Covariatesb | Adjusted for Covariatesb + Visit Length | |||||
| Measure | Low (n=116) | Middle (n=127) | High (n=119) | Middle vs Low | High vs Low | Middle vs Low | High vs Low |
| Overall measures | |||||||
| Visit length, minutes | 22.7 (9.0) | 22.2 (8.9) | 22.5 (10.5) | 2.2 (−1.9 to 6.3) | 5.8 (0.9 to 10.8) | – | – |
| Verbal dominance | 1.36 (0.6) | 1.49 (0.5) | 1.24 (0.4) | 0.12 (−0.10 to 0.34) | −0.09 (−0.34 to 0.15) | 0.12 (−0.12 to 0.37) | −0.15 (−0.45 to 0.15) |
| Clinician behaviors | |||||||
| Rapport-building talk | 80 (37) | 87 (38) | 89 (44)c | 17 (−3 to 38) | 30 (5 to 55) | 12 (−5 to 29) | 15 (−5 to 36) |
| Psychosocial talk | 18 (18) | 23 (27) | 27 (29)c | 5 (−6 to 16) | 16 (3 to 29) | 3 (−8 to 12) | 9 (−3 to 21) |
| Biomedical talk | 120 (63) | 135 (71) | 111 (66) | 27 (−1 to 56) | 17 (−17 to 51) | 16 (−8 to 40) | −12 (−42 to 17) |
| Emotional tone | 11.6 (1.7) | 11.8 (1.7) | 11.8 (1.8) | 0.69 (0.11 to 1.3) | 1.17 (0.46 to 1.9) | 0.60 (0.04 to 1.6) | 0.92 (0.22 to 1.6) |
| Patient behaviors | |||||||
| Rapport-building talk | 95 (48) | 97 (47) | 107 (59)d | 14 (−4 to 33) | 40 (18 to 63) | 6 (−7 to 19) | 19 (3 to 35) |
| Psychosocial talk | 52 (47) | 62 (63) | 78 (55)d | 13 (−9 to 34) | 46 (20 to 73) | 6 (−14 to 25) | 28 (4 to 52) |
| Biomedical talk | 94 (56) | 91 (52) | 96 (65) | 8 (−14 to 29) | 23 (−4 to 50) | 0 (−16 to 16) | 2 (−18 to 22) |
| Emotional tone | 21.1 (1.8) | 21.0 (2.0) | 21.3 (1.6) | 0.07 (−0.53 to 0.66) | 0.62 (−0.12 to 1.36) | 0.04 (−0.56 to 0.64) | 0.53 (−0.22 to 1.29) |
Note: Data are from 3 sites.
↵a Visit-level data for each variable. Verbal dominance is the ratio of clinician to patient talk. Talk variables are numbers of statements. Emotional tone is sum of scaled ratings by coders listening to audiotaped dialogue.
↵b Results from linear regression models using generalized estimating equations to account for clustering of patients within clinicians and adjusting for study site; patient age, sex, race/ethnicity, and current drug use; and clinician age, sex, and race/ethnicity. Referent group for β coefficients is the low clinician mindfulness tertile.
↵c P <.05.
↵d P <.01, for comparisons of middle or high- vs low-mindfulness tertile, accounting for clustering of patients within clinicians and adjusting for study site.