Applying dynamic dyadic systems to explore features of relationship-centered care among Spanish and non-Spanish speaking patients
Publication Date
5-1-2025
Document Type
Article
Publication Title
Patient Education and Counseling
Volume
134
DOI
10.1016/j.pec.2025.108650
Abstract
Objective: Relationship-centered care (RCC) positions the exchange between patient and provider as central to patient care. Due to limitations in analytical approach, how the relational exchange develops throughout the clinical visit remains unclear. Dynamic dyadic systems (DDS) perspectives overcome these limitations to reveal interdependencies and evolving patterns in turn-taking sequences within dyads. We applied DDS analyses to examine how features of RCC manifest during clinical visits with Spanish-speaking Latinx and English-speaking non-Latinx patients. Methods: We analyzed transcripts from 13 primary care visits (5 with Latinx patients, 8 with non-Latinx patients). Interaction turns totaled N = 2394 units of analysis. Dyadic time series plots examined the trajectory of clinical encounters and contributions made by patients and providers. Sequence analysis identified distinct turn patterns—or conversational motifs among dyads. Results: Conversational motifs reflected four patterns. In our example, motif distribution differed such that with Latinx Spanish-speaking patients, the provider largely engaged in patient-focused probing dialogue, while relational features of communication were underrepresented. In contrast, with non-Latinx English-speaking patients, providers engaged in more instructive exchange. Conclusion: Results support DDS to analyze patient-provider communication by illustrating interdependencies in reciprocal exchange and inequities in RCC delivery. Practice implications: Findings demonstrate opportunities for behavioral change to enhance cultural sensitivity in the delivery of care.
Keywords
Configural frequency analysis, Dyadic interaction analysis, Patient-provider communication, Primary care, Relationship-centered care, Sequence analysis
Department
Communication Studies
Recommended Citation
Marie C. Haverfield, Yuwei Li, Rachyl Pines, Tyler Kyte, Daria Titova, and Jennifer A. Theiss. "Applying dynamic dyadic systems to explore features of relationship-centered care among Spanish and non-Spanish speaking patients" Patient Education and Counseling (2025). https://doi.org/10.1016/j.pec.2025.108650
