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UBC Theses and Dissertations

Observation of communication behavior : the development of a research method for use in health care organizations McGill, Mary Elizabeth

Abstract

The objective of the Dissertation was to validate Sobert Bales' Interaction Process Analysis, and to adapt the method for analysis of staff and patient communications on a hospital ward. A comprehensive review of the group, organizational, and health care literature emphasized the lack of instruments for observing actual communication behavior in this organizational context. The study therefore focused on refining the research method, rather than on analyzing specific interaction patterns. A four-month field study was conducted in a 300-bed rehabilitation and extended care hospital in Southern Saskatchewan. Two wards were selected for study—an adult physical rehabilitation unit and a chronic setting. Subjects included all patients on the two wards, their families, and all staff involved in direct or indirect provision of care. A team of two non-participant observers coded dyadic communication behavior in-process on the wards. Hypotheses were tested regarding the relative importance of organizational position and context in explaining the variance of the interaction profiles. Support was also sought for the construct and face validity of the instrument. The Dissertation included details of the method and the training required to enable other researchers to employ the technique. Procedures for providing feedback to the subjects were also delineated, as active participation was considered crucial to the project's success. Partial support was obtained for two aspects of the construct validity of Interaction Process Analysis—the inclusiveness of the categorization and the independence of the category frequencies. Evidence of face validity was also given. A multivariate analysis of variance demonstrated that the position dyad was the most significant explanatory variable for the interaction profile, but the particular observer was also an important factor. The impact of organizational context varied with the dimension-Alternative explanations were given for the observer effect, and directions explored for future research. The study concluded that Bales' Interaction Process Analysis has a definite contribution to make to the study of behavior in health care organizations.

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