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Physiological responses to proposals during dyadic decision-making conversations.

ABSTRACT: A novel conversation-analytically informed paradigm was used to examine how joint decision-making interaction, with its various types of proposal sequences, is reflected in the physiological responses of participants. Two types of dyads-dyads with one depressed and one non-depressed participant (N = 15) and dyads with two non-depressed participants (N = 15)-engaged in a series of conversational joint decision-making tasks, during which we measured their skin conductance (SC) responses. We found that the participants' SC response rates were higher and more synchronized during proposal sequences than elsewhere in the conversation. Furthermore, SC response rates were higher when the participant was in the role of a proposal speaker (vs. a proposal recipient), and making a proposal was associated with higher SC response rates for participants with depression (vs. participants without depression). Moreover, the SC response rates in the proposal speaker were higher when the recipient accepted (vs. not accepted) the proposal. We interpret this finding with reference to accepting responses suggesting a commitment to future action, for which the proposal speaker may feel specifically responsible for. A better understanding of the physiological underpinnings of joint decision-making interaction may help improve democratic practices in contexts where certain individuals experience challenges in this regard.

SUBMITTER: Stevanovic M

PROVIDER: S-EPMC7822527 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Physiological responses to proposals during dyadic decision-making conversations.

Stevanovic Melisa M Tuhkanen Samuel S Järvensivu Milla M Koskinen Emmi E Savander Enikö E Valkia Kaisa K

PloS one 20210122 1

A novel conversation-analytically informed paradigm was used to examine how joint decision-making interaction, with its various types of proposal sequences, is reflected in the physiological responses of participants. Two types of dyads-dyads with one depressed and one non-depressed participant (N = 15) and dyads with two non-depressed participants (N = 15)-engaged in a series of conversational joint decision-making tasks, during which we measured their skin conductance (SC) responses. We found ...[more]

PMID: 33481838

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Project description:ObjectiveTo investigate the impact of cost conversations occurring with or without the use of encounter shared decision-making (SDM) tools in medication adherence.Patients and methodsUsing a coding scheme that included the occurrence and characteristics of cost conversation, we analyzed a randomly selected sample of 169 video recordings of clinical encounters. These videos were obtained during the conduct of practice-based randomized clinical trials comparing care with and without SDM tools for patients with diabetes, osteoporosis, and depression. Medication adherence was described in 2 ways: as a binary (yes/no) outcome, in which the patient met at least 80% adherence, or as a continuous variable, which was the percent of days that the patient adhered to their medication. The secondary analysis took place in 2018 from trials that ran between 2007 and 2015.ResultsMost patients were White (155, 93.4%), educated (104, 63.4% completed college), middle-aged (mean age, 58 years), female (104, 61.5%), and from diabetes (86, 50.9%), depression (43, 25.4%), and osteoporosis (40, 23.7%) trials. Cost conversations occurred in 119 clinical encounters (70%) and were more frequent in those encounters in which SDM tools were used (P=.03). Furthermore, 97 (57.4%) of the participants reported more than 80% medication adherence and 70.3±29.34 percentage of days with adherent medication of 70 days. In the multiple regression model, the only factor associated with adherence (binary or continuous) was the condition of the trial in which people participated. For the participants who had cost conversations, the use of an SDM tool, their sex, the nature of cost conversation (direct or indirect), the nature of cost concerns (treatment or patient issue), and the clinician-offered strategies (yes or no) were not associated with adherence.ConclusionIn this videographic analysis of SDM practice-based clinical trials, cost conversations were not associated with the general measures of medication adherence. Future studies should assess whether a tailored cost conversation intervention would impact the cost-related nonadherence among patients.

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Physiological responses to proposals during dyadic decision-making conversations.

Publications

Physiological responses to proposals during dyadic decision-making conversations.

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