Perceptions of open disclosure interactions: A communication accommodation theory approach

Health communication is a vital component of effective health care and can affect the well-being of patients. One of the most difficult and increasingly common areas of health communication involves informing patients when an error has occurred during medical treatment. This process is termed open disclosure. Open disclosure research to date has been extremely atheoretical and has focused only on the skills required for effective disclosure. This study aims to apply a theoretical foundation to disclosure in an effort to predict either effective or ineffective interactions. To achieve this, Communication Accommodation Theory (CAT) was utilised. Eighty first year Psychology students (M=28, F=52) rated eight short video recordings of open disclosure interactions on 20 items derived from open disclosure research and four communication strategies outlined in CAT. It was predicted that those interactions in which the physicians utilised appropriate levels of discourse management, emotional expression, interpretability and interpersonal control would be perceived by participants as more effective than those interactions in which physicians did not. It was also predicted that those interactions in which physicians offered physical and financial support to patients would be viewed as more effective than those interactions in which physicians did not. Gender of physician and its effect on perceived effectiveness was also briefly examined. A number of 2×2 repeated measures ANOVA’s were performed. Results support all proposed hypotheses, demonstrating the importance of specific communication strategies and behaviours throughout the process of open disclosure. Gender effects were also identified however these should be interpreted with caution