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The patient–physician relationship in patients with breast cancer: influence on changes in quality of life after rehabilitation

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Abstract

Purpose

The objective of this study was to examine whether aspects of the patient–physician relationship for breast cancer patients have an influence on the change in health-related quality of life (HRQOL) after inpatient rehabilitation.

Methods

N = 329 breast cancer patients undergoing inpatient rehabilitation in Germany were surveyed using questionnaires at the beginning of rehabilitation, end of rehabilitation, and 6 months after rehabilitation. Multiple imputations and multilevel models of change were used in the data analyses.

Results

Even after comprehensive adjustment for sociodemographic, medical, psychological variables, and center effects, aspects of the physician–patient relationship were statistically and clinically relevant predictors of HRQOL after rehabilitation. Satisfaction with physician’s care appears to have a rather short-term effect, but the effect of promoting patient participation can still be partially determined 6 months after rehabilitation. Other important predictors of HRQOL improvement are optimism, higher level of education, higher income, living with a partner, and the ability to work.

Conclusions

By taking into consideration the patient’s communication and participation needs, physicians can contribute to an improved HRQOL after rehabilitation. The high predictive power of socioeconomic factors shows that rehabilitation care can be more effective if it accounts for the specific situation of socially disadvantaged individuals.

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Acknowledgments

The project from which the data reported here stem (“Patient-oriented outcome measurement: health valuation and assessment of the relevance of the changes in patients’ participation”) was supported by the German Federal Ministry for Education and Research as part of the funding program “Chronic Illnesses and Patient Orientation”. We thank the participating rehabilitation centers and their staff: Rheingau-Taunus-Klinik (Bad Schwalbach), Median-Klinikum für Rehabilitation (Bad Salzuflen), Reha-Zentrum Todtmoos, Klinik Wehrawald (Todtmoos), Paracelsus Klinik (Scheidegg), Klinik Graal-Müritz (Ostseeheilbad Graal-Müritz), Habichtswald-Klinik (Kassel-Wilhelmshöhe), Rosentrittklinik (Bad Rappenau).

Conflict of interest

The authors declare that they have no competing interests.

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  1. Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Engelbergerstr. 21, 79106, Freiburg, Germany

    Erik Farin & Michaela Nagl

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  1. Erik Farin
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Correspondence to Erik Farin.

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Farin, E., Nagl, M. The patient–physician relationship in patients with breast cancer: influence on changes in quality of life after rehabilitation. Qual Life Res 22, 283–294 (2013). https://doi.org/10.1007/s11136-012-0151-5

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