Relationship between Teach-back and patient-centered communication in primary care pediatric encounters. Issue 7 (July 2017)

• Record Type: Journal Article
• Authors: Badaczewski, Adam; Bauman, Laurie J.; Blank, Arthur E.; Dreyer, Benard; Abrams, Mary Ann; Stein, Ruth E.K.; Roter, Debra L.; Hossain, Jobayer; Byck, Hal; Sharif, Iman
• Is Part Of: Patient education and counseling. Volume 100:Issue 7(2017)
• Page Start: 1345
• Page End: 1352
• Publication Date: 2017-07
• Subjects: Teach-back -- Patient-centered -- Communication -- Global affect; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2017.02.022
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: We have created a new tool to measure Teach-back. Teach-back was associated with more patient-centered communication. Teach-back was associated with increased display of negative affect by parents. Implications for clinical practice and medical education are discussed. Abstract: Objective: We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter. Methods: Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness. Results: Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p = 0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI) = 4.97 (4.47–5.53)]and negative affect [AOR (95% CI) = 5.39 (1.68–17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it. Conclusions: Teach-back was associated with more patient-centered communication and increased affective engagement of parents. Practice implications: Standardizing Teach-back use may strengthen patient-centered communication.