RESUMEN
BACKGROUND: We developed a questionnaire to examine the influence of physician and patient variables on the quality of the physician-patient relationship. METHODS: More than 300 family medicine patients completed self-report measures of the physician-patient relationship and variables likely to influence it. RESULTS: The quality of relationship was related to continuity of physician care (having a primary physician, duration of that relationship, and frequency of visits) and to patient dispositional variables (neuroticism, positive and negative affectivity) but not to demographic variables. The regression model included having a primary physician, duration of relationship with that physician, and positive affectivity. Relationship quality was, in turn, associated with outcomes (adherence to care, treatment response, satisfaction with care, and commitment to physician). CONCLUSIONS: The quality of physician-patient relationship is influenced by physician continuity and patient dispositional variables. Better understanding of these may contribute to the therapeutic potential of this important relationship.
Asunto(s)
Continuidad de la Atención al Paciente , Satisfacción del Paciente , Relaciones Médico-Paciente , Adolescente , Adulto , Anciano , Continuidad de la Atención al Paciente/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Inventario de Personalidad , Atención Primaria de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Análisis de Regresión , Encuestas y Cuestionarios , Estados Unidos , Adulto JovenRESUMEN
The purpose of this study was to examine the association between hypochondriacal symptoms and the physician-patient relationship. Family medicine patients (n = 310) completed self-report measures of hypochondriacal symptoms, quality of physician-patient relationship, and variables likely to influence that relationship. These variables included physician relationship factors, such as duration of relationship and frequency of visits, as well as patient characteristics, such as neuroticism and positive and negative affectivity. Hypochondriacal symptoms were negatively correlated (r = -.24) with the quality of physician-patient relationship. In addition to hypochondriacal symptoms, the regression model included having a primary physician, length of relationship with that physician, frequency of physician visits, and the level of positive affectivity in the patient. Hypochondriacal symptoms appear to be associated with a less therapeutic physician-patient relationship. Physicians must recognize symptoms of this kind in order to properly address the relationship needs of their patients.
Asunto(s)
Medicina Familiar y Comunitaria , Hipocondriasis/psicología , Satisfacción del Paciente , Relaciones Médico-Paciente , Adolescente , Adulto , Anciano , Análisis Factorial , Femenino , Encuestas de Atención de la Salud , Humanos , Hipocondriasis/diagnóstico , Masculino , Persona de Mediana Edad , Determinación de la Personalidad , Calidad de la Atención de Salud , Análisis de Regresión , Encuestas y CuestionariosRESUMEN
PURPOSE: This study compared in one data set the relative importance of most previously examined risk factors for different symptoms of insomnia. METHODS: Data were obtained from personal interviews of 1,588 adults in a rural area. Statistical methods evaluated the association of 42 risk factors with any insomnia and each of four insomnia subtypes: difficulty with initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and restless sleep (RS). RESULTS: Insomnia rates were greater in this rural population than most U.S. studies and greater in the United States than other countries. The correlations between insomnia subtype and energy level was highest for RS, -0.29, and lowest for EMA, -0.11. All sleep disturbances increased monotonically with depressive symptoms, but the increase was greatest for RS (r = 0.57) and weakest for EMA (r = 0.24). Anxiety and pain also were independently associated with each insomnia subtype. Insomnia problems of spouses were uncorrelated. Other risk factors were independently associated with some insomnia subtypes but not others. For example, the association of age with difficulty maintaining sleep was independent of health measures. CONCLUSION: The results suggest that different insomnias have different rates and risk factors and therefore possibly different etiologies and management strategies.