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J Health Commun. 2018;23(8):807-814. doi: 10.1080/10810730.2018.1528319.

Communication Predictors of Patient and Companion Satisfaction with Alzheimer's Genetic Risk Disclosure.

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a Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , GA , USA.
b Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
c Social and Behavioral Research Branch , National Human Genome Research Institute, National Institutes of Health , Bethesda , Maryland , USA.
d Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
e Department of Community Public Health, Center for Innovative Care in Aging, School of Nursing , Johns Hopkins University , Baltimore , MD , USA.
f Department of Health Behavior and Health Education , University of Michigan School of Public Health , Ann Arbor , MI , USA.
g Division of Genetics, Department of Medicine , Brigham and Women's Hospital , Boston , MA , USA.
h Department of Medicine , Harvard Medical School , Boston , MA , USA.
i Broad Institute of MIT and Harvard , Cambridge , MA , USA.
j Partners Personalized Medicine , Boston , MA , USA.


The objective of this study was to identify how features of Alzheimer's disease (AD) genetic risk disclosure communication relate to patient and visit companion satisfaction. We conducted secondary analyses of 79 session recordings from the fourth REVEAL Study, a randomized-controlled trial of AD genetic risk disclosure among patients with mild cognitive impairment. Patient and companion satisfaction were ascertained from postdisclosure surveys. The Roter Interaction Analysis System (RIAS) was used to code triadic communication between the counselor, patient, and companion. High satisfaction was evident for 24% of patients (N = 19) and 48% of companions (N = 38). Multivariate logistic regressions showed that high patient satisfaction was associated with patients' expression of emotions (OR = 1.1, 95% CI: 1.0-1.1) and companions' questions about psychosocial and lifestyle topics (OR = 1.8, 95% CI: 1.1-2.8). High companion satisfaction was positively related to the RIAS overall patient-centeredness score for the session (OR = 4.0, 95% CI: 1.0-15.6) (all p-values <0.05). Communication predictors of patient and companion satisfaction reflect specific or summary indicators of patient-centeredness. Findings also suggest that visit companions positively influence patient satisfaction. The study results support the growing literature and policy attention directed toward delivering family-centered care.

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