The Function of Communication Adjustment in Patient-Provider Interactions: A Communication Accommodation Approach to Giving Preventive Health Advice for the Reduction of Type-2 Diabetes

Abstract

Communication between patients and providers is an important issue in contemporary health care. The current dissertation considered how health providers’ communication operates as a core factor influencing patients' anxiety, perceptions of provider communication competence, and intention to follow preventive advice related to type-2 diabetes risks (adherence intention). Type-2 diabetes, or adult-onset diabetes, is a non-communicable disease caused by the failure of the body to produce insulin for transferring sugars into energy for the body to use. This study focused on the patient-provider context as an integral episode for acquiring reliable health information to prevent type-2 diabetes. This dissertation also posited that both interpersonal and intergroup elements are present in provider-patient interactions. Although intergroup research was established in social psychology, the field of intergroup communication research has developed into an expansive research field over the past five decades (Giles, 2012). Interlocutors build awareness and work toward having a common partnership during patient-provider meetings, thus fostering a shared understanding between the health expert (the provider) and non-expert (the individual patient). Researchers have traditionally studied patient-provider interactions as interpersonal communication (i.e., a conversation between two people communicating as distinct individuals). Specifically, this dissertation employed an experimental design and used communication accommodation theory, in conjunction with (CAT: Giles, 1973; Giles, 2016) to test the effect of the health provider’s communication strategies on three major variables: (a) Intergroup anxiety, (b) Communication competence, and (c) Adherence intention. Therefore, the outcome variables included patients’ feelings of intergroup anxiety, perceptions of the health provider’s communication competence (i.e., communication effectiveness and communication appropriateness) and the patient’s decision to adhere to the provider’s preventive advice. The provider advised the patient to reduce the intake of added sugar in foods. In addition, the indirect effects of the health provider’s communication strategies through perceived competence and anxiety on the patient’s decision to adhere to the provider’s preventative advice was also tested. Guided by CAT, the health provider’s communication strategies were manipulated by creating four scripts representing the provider’s communication strategies (4 experimental conditions: fully accommodating [accommodative on discourse management and interpretability]; informative accommodating [accommodative on interpretability but nonaccommodative on discourse management]; conversational accommodating [accommodative on discourse management but nonaccommodative on interpretability]; fully nonaccommodating [nonaccommodating on discourse management and interpretability]). Findings of this study indicated when the relational function of patient-provider communication was accommodative, denoted by the attuning strategy of discourse management, patients felt less intergroup anxiety, perceived the provider to be more competent, and were more likely to adhere to treatment advice compared to when the health provider failed to accommodate on discourse management. Results indicated the health provider’s communication adjustment style had a significant indirect effect on adherence intention through intergroup anxiety and communication competence as two serial mediators. The findings contribute to and extend on the emerging literature that uses interpersonal and intergroup frameworks to study health interactions between patients and providers specializing in a variety of health professions.