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Patient and physician attitudes in the health care context: Attitudinal symmetry predicts patient satisfaction and adherence

  • Published:
Annals of Behavioral Medicine

Abstract

Background: There is increasing interest in the role that patient and physician health-related attitudes may play in predicting patient outcomes.Purpose: This study examined the similarity of the attitudes held by patients and their physicians about the patient role in health care delivery and its relationship to patient outcomes.Methods: Participants were 16 primary care physicians from a single academic medical center and 146 patients who had been seen by their respective physician at least twice during the prior 6 months. Physicians and patients completed two measures reflecting healthcare-related attitudes: the Multidimensional Health Locus of Control questionnaire and the Patient-Practitioner Orientation Scale (PPOS). Patients also completed measures of satisfaction and adherence.Results: Analyses were conducted using hierarchical linear modeling with patients clustered within physicians. Degree of symmetry on internal health locus of control was positively associated with both patient adherence, F(2, 131)=3.75, p=.03, and satisfaction, F(2, 133)=7.16, p=.01. Degree of similarity on the Information/Power Sharing subscale of the PPOS was not positively associated with adherence or satisfaction.Conclusions: These data suggest that patients who are more similar in attitude to their physicians as indicated by internal health locus of control scores (but not PPOS scores) are more satisfied with their medical care and more adherent with treatment recommendations than patients who are less internally focused than their physicians.

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References

  1. Parsons T:The Social System. Glencoe, IL: Free Press, 1951.

    Google Scholar 

  2. Friedson WC:Professional Dominance: The Social Structure of Medical Care. New York: Atheron Press, 1970.

    Google Scholar 

  3. Robison WL, Pritchard MS:Medical Responsibility: Paternalism, Informed Consent, and Euthanasia. Clifton, NJ: Humana, 1979.

    Google Scholar 

  4. Childress JF:Who Should Decide? Paternalism in Health Care. New York: Oxford University Press, 1982.

    Google Scholar 

  5. Janis IL, Mann L:Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment. New York: Free Press, 1977.

    Google Scholar 

  6. Byrne PS, Long BEL:Doctors Talking to Patients. London: Her Majesty’s Stationery Office, 1976.

    Google Scholar 

  7. Stewart M: Effective physician-patient communication and health outcomes: A review.Canadian Medical Journal Association. 1995,152:1423–1433.

    CAS  Google Scholar 

  8. Haug MR, Lavin B:Consumerism in Medicine: Challenging Physician Authority. Beverly Hills, CA: Sage, 1983.

    Google Scholar 

  9. Krupat E, Yeager CM, Putnam S: Patient role orientations, doctor-patient fit, and visit satisfaction.Psychology & Health. 2000,15:707–719.

    Article  Google Scholar 

  10. Swenson SL, Buell S, Zettler P, et al.: Patient-centered communication: Do patients really prefer it?Journal of General Internal Medicine. 2004,19:1069–1079.

    Article  PubMed  Google Scholar 

  11. Levinson W, Kao A, Kuby A, Thisted RA: Not all patients want to participate in decision making: A national study of public preferences.Journal of General Internal Medicine. 2005,20:531–535.

    Article  PubMed  Google Scholar 

  12. Krupat E, Bell RA, Kravitz RL, Thom D, Azari R: When physicians and patients think alike: Patient-centered beliefs and their impact on satisfaction and trust.Journal of Family Practice. 2001,50:1057–1062.

    PubMed  CAS  Google Scholar 

  13. Roter DL, Stewart M, Putnam SM, et al.: Communication patterns of primary care physicians.Journal of the American Medical Association. 1997,277:350–356.

    Article  PubMed  CAS  Google Scholar 

  14. Wanzer M, Booth-Butterfield M, Gruber K: Perceptions of health care providers’ communication: Relationship between patient-centered communication and satisfactionHealth Communication. 2004,16:363–384.

    Article  PubMed  Google Scholar 

  15. Stewart M: What is a successful doctor-patient interview? A study of interactions and outcomes.Social Science & Medicine. 1984,19:167–175.

    Article  CAS  Google Scholar 

  16. Sewitch MJ, Abrahamowicz M, Barkun A, et al.: Patient nonadherence to medication in inflammatory bowel disease.American Journal of Gastroenterology. 2003,98:1535–1544.

    Article  PubMed  Google Scholar 

  17. Betz JB, Boles M, Mullooly JP, Levinson W: Effect of clinician communication skills training on patient satisfaction.Annals of Internal Medicine. 1999,131:822–829.

    Google Scholar 

  18. Joos SK, Hickam DH, Gordon GH, Baker LH. Effects of a physician communication intervention on patient care outcomes.Journal of General Internal Medicine. 1996,96:147–155.

    Article  Google Scholar 

  19. Haug MR, Lavin B: Practitioner or patient—Who’s in charge?Journal of Health and Social Behavior. 1981,22:212–229.

    Article  PubMed  CAS  Google Scholar 

  20. Sewitch MJ, Dobkin PL, Bernatsky S, et al.: Medication non-adherence in women with fibromyalgia.Rheumatology. 2004,43:648–654.

    Article  PubMed  CAS  Google Scholar 

  21. Krupat E, Rosenkranz SL, Yeager CM, et al.: The practice orientations of physicians and patients: The effect of doctor-patient congruence on satisfaction.Patient Education & Counseling. 2000,39:49–59.

    Article  CAS  Google Scholar 

  22. Jahng KH, Martin LR, Golin CE, DiMatteo MR: Preferences for medical collaboration: Patient-physician congruence and patient outcomes.Patient Education & Counseling. 2005,57:308–314.

    Article  Google Scholar 

  23. Christensen AJ, Turner CW, Smith TW, Holman JM, Jr. Gregory MC: Health locus of control and depression in end-stage renal disease.Journal of Consulting & Clinical Psychology. 1991,59:419–424.

    Article  CAS  Google Scholar 

  24. Helgeson VS: Moderators of the relation between perceived control and adjustment to chronic illness.Journal of Personality & Social Psychology. 1992,63:656–666.

    Article  CAS  Google Scholar 

  25. Andrykowski MA, Brady MJ: Health locus of control and psychological distress in cancer patients: Interactive effects of context.Journal of Behavioral Medicine. 1994,17:439–458.

    Article  PubMed  CAS  Google Scholar 

  26. Wallston KA, Wallston BS, DeVellis R: Development of the Multidimensional Health Locus of Control (MHLC) Scales.Health Education Monographs. 1978,6:160–170.

    PubMed  CAS  Google Scholar 

  27. Marshall GN, Hays RD:The Patient Satisfaction Questionnaire Short-Form (PSQ-18). The RAND Corporation, 1994.

  28. Ware JE, Jr. Snyder MK, Wright WR:Development and Validation of Scales to Measure Patient Satisfaction with Medical Care Services. Vol. I, Part B: Results Regarding Scales Constructed from the Patient Satisfaction Questionnaire and Measures of Other Health Care Perceptions. Springfield, VA: National Technical Information Service, 1976, PB 288–329.

    Google Scholar 

  29. Hays RD:The Medical Outcomes Study (MOS) Measures of Adherence. Retrieved August 1, 2005 from http://www.rand.org/health/surveys/MOS.adherence.measures.pdf

  30. Milliken GA, Johnson DE:Analysis of Messy Data. New York: Chapman and Hall/CRC, 1992.

    Google Scholar 

  31. SPSS, Inc.SPSS for Windows (Version 12.0) [Computer software]. Chicago: SPSS, Inc., 2003.

  32. Gordon NP, Hiatt RA, Lampert DI: Concordance of self-reported data and medical record audit for six cancer screening procedures.Journal of the National Cancer Institute. 1993,85:566–570.

    Article  PubMed  CAS  Google Scholar 

  33. Wang PS, Benner JS, Glynn RJ, et al.: How well do patients report noncompliance with antihypertensive medications? A comparison of self-report versus filled prescriptions.Pharmacoepidemiology & Drug Safety. 2004,13:11–19.

    Article  CAS  Google Scholar 

  34. Callahan EJ, Bertakis KD, Azari R, et al.: The influence of patient age on primary care resident physician-patient interaction.Journal of the American Geriatric Society. 2000,48:30–35.

    CAS  Google Scholar 

  35. Bertakis KD, Azari R, Callahan EJ, Robbins JA, Helms LJ: Comparison of primary care resident physicians’ practice styles during initial and return patient visits.Journal of General Internal Medicine. 1999,14:495–498.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychology, University of Iowa, E11 Seashore Hall, 52242, Iowa City, IA

    Jamie A. Cvengros M.A. & Alan J. Christensen Ph.D.

  2. Department of Internal Medicine (Division of General Internal Medicine), University of Iowa, USA

    Alan J. Christensen Ph.D. & Gary E. Rosenthal M.D.

  3. Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City

    Stephen L. Hillis Ph.D. & Gary E. Rosenthal M.D.

  4. VA Medical Center, Iowa City

    Gary E. Rosenthal M.D.

Authors
  1. Jamie A. Cvengros M.A.
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  2. Alan J. Christensen Ph.D.
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  3. Stephen L. Hillis Ph.D.
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  4. Gary E. Rosenthal M.D.
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Corresponding author

Correspondence to Alan J. Christensen Ph.D..

Additional information

Dawn K. Wilson, Ph.D. served as guest editor for this article.

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Cvengros, J.A., Christensen, A.J., Hillis, S.L. et al. Patient and physician attitudes in the health care context: Attitudinal symmetry predicts patient satisfaction and adherence. ann. behav. med. 33, 262–268 (2007). https://doi.org/10.1007/BF02879908

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  • DOI: https://doi.org/10.1007/BF02879908

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