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WS5 First Annual Research Symposium on “Energetic and Spiritual Processes of Healing”


D2 Exploration of Patient and Provider Interaction Patterns
Beth Yohalem-Ilsley, Jennifer Schneider, Nancy Vuckovic, Lynn DeBar
, Kaiser Permanente Center for Health Research, Portland, OR
Objectives: This study explores patient-provider interaction patterns across a variety of complementary and alternative medicine (CAM) modalities and allopathic care. Primary goals of the study are to: 1) determine feasibility and acceptability of videotaping treatment sessions, and 2) elucidate domains of interaction within CAM encounters that may not be captured by existing coding methodologies.
Materials and Methods: Six practitioners (5 CAM and 1 allopathic) were recruited, each seeing two participants (n=12). All encounters were video recorded with the camera placed in an unobtrusive location. Within 1 week of the session practitioners and participants separately reviewed the videotape while simultaneously being interviewed by trained qualitative researchers. All debrief interviews were audio-taped and transcribed for analysis. Treatment sessions were also transcribed. The Roter Interaction Analysis System (RIAS) was selected for coding the therapeutic interactions.
Results: 1) Low reactivity to the video camera was reported by both practitioners and participants. 2) Although the RIAS was appropriate for some aspects of the encounter, the system, constructed for use in allopathic encounters, did not account for some unique features of CAM interactions such as: measuring the duration and type of therapeutic touch; distinguishing clearly medical versus psychosocial and spiritual content; references to energy; participant initiated conversation; and the timing and duration of silent time.
Conclusions: Initial analysis indicates that other verbal aspects of the interactions such as use of metaphors and language congruency, and non-verbal aspects of the interaction such as qualification of touch or energy exchange, are important areas in which to develop coding methodologies.
Supported by the NIH-funded Oregon Center for Complementary and Alternative Medicine, Kaiser Permanente Center for Health Research, Portland OR

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