Provider self-disclosure during contraceptive counseling. 2017

Merritt McLean, and Jody Steinauer, and Julie Schmittdiel, and Pamela Chan, and Christine Dehlendorf
Kaiser Permanente, 2425 Geary Boulevard, San Francisco, CA 94115, USA. Electronic address: merritt.mclean@kp.org.

OBJECTIVE Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD. METHODS This mixed methods analysis used data from the Provider-Patient Contraceptive Counseling study, for which 349 family planning patients were recruited from 2009 to 2012 from six clinics in the San Francisco Bay Area. Audio-recordings from their visits were analyzed for the presence or absence of PSD, and those visits with evidence of PSD were analyzed using qualitative methods. The associations of patient and provider demographics and patient satisfaction measures, obtained from survey data, with PSD were analyzed using bivariable and multivariable analyses. RESULTS Thirty-seven percent of providers showed evidence of PSD during at least one visit, and PSD occurred in 9% of clinic visits. Fifty-four percent of PSD statements were about intrauterine devices. About half of PSD statements occurred prior to the final selection of the contraceptive method and appeared to influence the choice of method. In post-visit surveys, all patients who reported receiving PSD considered it to be appropriate, and patient-reported PSD was not statistically associated with measures of patient satisfaction. CONCLUSIONS This study provides some support for the appropriateness of PSD during family planning encounters, at least as practiced during the sampled visits. Further research could explore whether this counseling strategy has an impact on patients' ability to identify the best contraceptive methods for them. CONCLUSIONS In this study, PSD did not have a demonstrated negative effect on the provider-patient relationship. In almost half of visits, PSD appeared to influence patients' choice of a method; whether this influence is beneficial needs further research.

UI MeSH Term Description Entries
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D010819 Physician's Role The expected function of a member of the medical profession. Physicians' Role,Physician Role,Physician's Roles,Physicians Role,Physicians' Roles,Role, Physician's,Role, Physicians',Roles, Physician's,Roles, Physicians'
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002755 Choice Behavior The act of making a selection among two or more alternatives, usually after a period of deliberation. Approach Behavior,Approach Behaviors,Behavior, Approach,Behavior, Choice,Behaviors, Approach,Behaviors, Choice,Choice Behaviors
D003267 Contraception Prevention of CONCEPTION by blocking fertility temporarily, or permanently (STERILIZATION, REPRODUCTIVE). Common means of reversible contraception include NATURAL FAMILY PLANNING METHODS; CONTRACEPTIVE AGENTS; or CONTRACEPTIVE DEVICES. Birth Control,Contraceptive Methods,Female Contraception,Fertility Control,Inhibition of Fertilization,Male Contraception,Contraception, Female,Contraception, Male,Contraceptions, Female,Contraceptions, Male,Contraceptive Method,Female Contraceptions,Fertilization Inhibition,Male Contraceptions
D003268 Contraception Behavior Behavior patterns of those practicing CONTRACEPTION. Contraceptive Behavior,Contraceptive Method Switching,Contraceptive Usage,Contraception Behaviors,Contraceptive Behaviors
D003376 Counseling The giving of advice and assistance to individuals with educational or personal problems.
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D005193 Family Planning Services Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths. Family Planning,Family Planning Programs,Planned Pregnancy,Pregnancy, Planned,Family Planning Program,Family Planning Service,Planned Pregnancies,Planning Service, Family,Planning Services, Family,Pregnancies, Planned,Program, Family Planning,Programs, Family Planning,Service, Family Planning,Services, Family Planning
D005260 Female Females

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