Table 4.
The Communication Functions of the CFI Coded Through Qualitative Interviews
| Reported Functions | Total Prevalence | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Codebook Category, Subcategory, and Definition | Lazare et al. |
Study Analysis |
Patient Number |
Patient Rank |
Clinician Number |
Clinician Rank |
Total /64 | % | Overall Rank |
| Determining and monitoring the nature of the problem | |||||||||
| Diseases and disorders: the CFI helps clinicians make a biomedical diagnosis | x | x | 3 | 7 | 6 | 7 | 9 | 14.10% | 10* |
| Psychosocial issues: the CFI illustrates how patients respond to their condition before entering medical care | x | x | 1 | 9 | 9 | 6 | 10 | 15.60% | 8* |
| Eliciting data: the CFI encourages communication skills by letting patients tell their own stories, facilitating narration, easing flow of the interview, using appropriate questions, or summarizing information | x | x | 21 | 2 | 25 | 2 | 46 | 71.20% | 2 |
| Perceiving data at multiple levels: the CFI helps clinicians use their five senses and their own personal responses to register patient verbal and non-verbal behavior | x | x | 18 | 4 | 25 | 2 | 43 | 67.20% | 4 |
| Generating and testing hypotheses: the CFI helps clinicians create or test hypotheses based on patient data | x | x | 0 | last | 10 | 5 | 10 | 15.60% | 8* |
| Developing, maintaining, and concluding the therapeutic relationship | |||||||||
| Defining the relationship: the CFI helps clinicians clarify their exact role in the patient's care | x | x | 2 | 8 | 5 | 8 | 7 | 10.94% | 11 |
| Communicating expertise: the CFI helps clinicians demonstrate scientific competence and wisdom in their judgments and decisions | x | x | 0 | last | 3 | 9 | 3 | 4.69% | 13 |
| Communicating care: the CFI helps clinicians communicate positive emotions such as rapport, interest, respect, support, and empathy | x | x | 20 | 3 | 15 | 4 | 35 | 54.70% | 5 |
| Recognizing communication barriers: the CFI helps clinicians recognize and resolve communication problems with patients by openly discussing differences, overcoming patient psychological barriers, providing emotional support, or negotiating communication differences | x | x | 5 | 5 | 15 | 4 | 20 | 31.20% | 6 |
| Eliciting the patient's perspective: the CFI elicits the patient's perspective on definitions, causes, mechanisms, fears, and goals related to the problem | x | x | 18 | 4 | 26 | 1 | 44 | 68.80% | 3 |
| Enhancing rapport through satisfaction with the interview: the CFI increased rapport among patients and clinicians | x | 28 | 1 | 19 | 3 | 47 | 73.40% | 1 | |
| Patient education and implementation of treatment plans | |||||||||
| Determining areas of difference: the CFI helps clarify where patients and clinicians may disagree about ideas regarding the patient's sickness | x | x | 4 | 6 | 10 | 5 | 14 | 25% | 7 |
| Communicating diagnostic significance: the CFI helps clinicians communicate the significance of the problem from a biomedical perspective, taking into account the patient's concerns, beliefs, and fears | x | 0 | last | 0 | last | 0 | 0.00% | last | |
| Negotiating diagnostic procedures and treatment: the CFI helps clinicians discuss diagnosis and treatment options | x | x | 0 | last | 1 | 10 | 1 | 1.56% | 14 |
| Negotiating preventive measures: the CFI helps clinicians negotiate and recommend preventive measures | x | 0 | last | 0 | last | 0 | 0.00% | last | |
| Enhancing coping: the CFI helps clinicians work with patients to discuss coping strategies related to worsening social and psychological functioning from the illness or treatment | x | x | 2 | 8 | 3 | 9 | 5 | 7.81% | 12 |
CFI - Cultural Formulation Interview