Psychosocial Factors in Older Patients 'Medical Encounters

This article reviews the literature and presents some new preliminary findings on physician-older patient communication about psychosocial issues in primary care medical visits. The authors examine the importance of psychosocial talk in medical encounters, the barriers to these discussions, and the prevalence and specific content of psychosocial discussions in primary care medical encounters. The research suggests that the preponderance of talk in the medical encounter is biomedical, with little attention to psychosocial topics. The differential attention to the biomedical sphere may be more common and more problematic with the elderly. A research agenda in three areas is proposed. Investigations are needed on: (a) the determinants, outcomes, and nature of physician-older patient communication about psychosocial issues; (b) the psychosocial factors that are problematic in older patients' lives and have relevance for their medical care; and (c) the psychosocial issues that arise when the older patient is sick or disabled.