Article

The patient-physician relationship has effects on adherence and health
outcomes in chronic diseases. This prospective study investigates the effect of
the patient-physician relationship on patients' health-related quality of life
(HRQOL) in the context of cardiac rehabilitation. Methods Three hundred and
thirty-eight German patients filled out questionnaires at the start and end of
rehabilitation and at 6 months follow-up. Patient-physician relationship
variables surveyed were patient involvement (perceived involvement in care
scales), trust in the physician, patient satisfaction (PHYSAT) and physician's
communicative behaviour (KOVA). After adjusting for multiple confounders,
hierarchical regression analyses were conducted to predict the influence of the
patient-physician relationship on HRQOL after rehabilitation. We further examined
clinical relevance using minimal clinically important differences (MCID). Results
In the hierarchical regression analyses, 42.8-54.9% of the variance at the end of
rehabilitation and 22.4-40.5% at follow-up were explained. The patient-physician
variables patient satisfaction, physician's emotionally supportive communication
and effective and open communication accounted for 1.4-2.6% of the variance and
proved statistically and clinically significant for HRQOL change. Further
predictors for better HRQOL were higher income and less trait anger. Conclusion
Aspects of the patient-physician relationship are significant predictors for
patients' HRQOL after rehabilitation. Rehabilitation physicians should
emotionally support the patients and communicate in an effective and open manner
to enhance HRQOL. Implications for rehabilitation Aspects of the
patient-physician relationship have effects on adherence and clinical outcomes in
chronic diseases. In this cardiac sample, the patient-physician relationship had
an influence on patients' health-related quality of life (HRQOL) after inpatient
rehabilitation. Rehabilitation physicians should emotionally support and
encourage the patients and communicate with them in an effective and open manner
to enhance patients' HRQOL.

Langue : ANGLAIS