The effectiveness of medical care in most cases depends on the quality of informational exchange between the doctor and the patient. Often, selected models of the therapeutic interaction, which are the basis for the doctor-patient relationship and form a common psychological background of this communication are very important. The article presents a brief review of the main models of the therapeutic interaction in the foreign and domestic literature. Also we determined the most preferable of them. We showed the important role of doctor’s communicative competence, as well as the fact that possession of communicative skills allow them to solve medical-diagnostic and organizational problems more effectively while treating the patient. Also we studied the main components of effective interaction, promoting the formation of trust between the patient and the doctor.
The patient’s cooperativity is the major factor which determines the patient’s adherence to doctor’s prescriptions and, consequently, the achievement of disease control. We proposed the “Evaluation of the cooperativity in asthma” questionnaire to evaluate the level, components and types of cooperativity in 141 patients with the mixed or atopic form of asthma (94.3 and 5.7%, respectively) at admission to hospital who were aware about their disease. The analysis of investigated parameters depending on the level of patients’ awareness of their condition (according to the “Awareness of patients about asthma” test), severity and duration of the disease, presence of alexithymia and social and economic index was done. It was found out that patients with asthma exaggerate the degree of their compliance. The general indices of cooperativity (GIC=58.1±7.3%) and understanding of danger (35.8±3.3%) in the patients who were aware about their disease were low. Qualitative characteristics of individual cooperativity components in examined patients are presented. Nearly 76% of the patients showed negative cooperativity inversely correlating with the severity of asthma and the duration of the disease. Positive cooperativity appeared to be directly related with the higher educational level, occupation and higher income level of the patients. Generally speaking, low average GIC ratings and low patients’ adherence to asthma treatment suggest their low cooperativity.
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