{
  "abstract": "Background Physicians frame medical information for patients in different ways, impacting patient outcomes. What underlies their framing choices has not been investigated. Objective To explore the use and function of information framing practices in medical interactions.Design Explorative, quantitative observational study with a mixed-methods design.Setting and participants 28 videorecorded hospital interactions, ranging from short-term/acute (orthopaedic surgery, gynaecology) to long-term/chronic care (oncology, gastroenterology) and involving 14 physicians and 28 patients.Outcome measures Using a previously developed coding system, we analysed physicians’ framing practices. We extracted information sharing functions qualitatively, checking 10% of the analysis with an independent assessment from the physicians. To explore whether variation in physicians’ use of information frames stemmed from individual or clinical specialty differences, we estimated intraclass correlations. To assess how their use of information frames varied at the macro level (across clinical specialties) and micro (the immediate function in the interaction), we estimated linear mixed models adjusted for the number of words.Results Variation in framing practices was mainly observed at the level of physicians nested within the same clinical unit (9.5% of the overall variance explained vs 1.3% for the unit level and 0.7% for the individual level). Physicians from different clinical units differed significantly in how they framed information, with the main differences between the gastroenterology and oncology units (mean difference=1.88; 95% CI 0.97; 2.79; p<0.001). The primary function of their information sharing also varied significantly across clinical specialties (all p<0.001 in χ 2 tests). Physicians from more short-term care units were oriented towards shared understanding, from gastroenterology towards inviting and convincing efforts and from oncology towards personal communication.Conclusion Results revealed signature marks of clinical units in terms of information sharing practices. Physicians’ information framing choices were driven both by the macro level (the clinical unit) and micro (the specific function for sharing information at that moment), thus highlighting potential areas for future interventions.",
  "authors": [
    {
      "affiliations": [
        "Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Akershus, Norway"
      ],
      "name": "Julia Menichetti"
    },
    {
      "affiliations": [
        "Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Akershus, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Jūratė Šaltytė Benth"
    },
    {
      "affiliations": [
        "Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Akershus, Norway"
      ],
      "name": "Jennifer Gerwing"
    },
    {
      "affiliations": [
        "Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Akershus, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Christofer Lundqvist"
    },
    {
      "affiliations": [
        "Northwestern University, Evanston, Illinois, USA",
        "Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA"
      ],
      "name": "Marla L Clayman"
    },
    {
      "affiliations": [
        "Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Akershus, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Pål Gulbrandsen"
    }
  ],
  "title": "What influences how physicians frame information for patients? An explorative quantitative study on hospital interactions from different specialties",
  "uid": "5b153ad2-1539-5e8a-99f9-403b1bff03d2"
}