Patients' preferences for decision making and the feeling of being understood in the medical encounter among patients with rheumatoid arthritis

Ishikawa, Hirono; Hashimoto, Hideki; Yano, Eiji

doi:10.1002/art.22355

Cited by 30 publications

(27 citation statements)

References 87 publications

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“…They try to reach out to and create a good relationship with patients through dialogue, to be supportive and encourage them to become involved in the care and show an awareness of patients’ emotional need of support (Zangi et al, 2011). Patients’ involvement in their own care implies a sense of control over the disease, and feelings of being understood are associated with patients’ preferences in decision making (Ishikawa, Hashimoto & Yano, 2006; Ryan, Hassell, Dawes & Kendall, 2003). Adjusted delivery highlights the important issue of an equal dialogue in the encounter as presented by Lempp, Scott, and Kingsley (2006b).…”

Section: Discussionmentioning

confidence: 99%

“Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis

Bergsten

Bergman

Fridlund³

et al. 2011

International Journal of Qualitative Studies on Health and Well

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Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers’ perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers’ experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers’ attitudes and patients’ responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers’ experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients’ expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

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Section: Discussionmentioning

confidence: 99%

“Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis

Bergsten

Bergman

Fridlund³

et al. 2011

International Journal of Qualitative Studies on Health and Well

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“…The patient’s communication-related preferences are among the factors that decide which provider behavior is assessed as positive or negative; these are moderators of the relationship between provider communication behavior and desired endpoints, such as adherence, satisfaction with treatment, and health behavior 14. Studies that explicitly analyze the congruence between patient and provider come to the rather uniform conclusion that congruence is associated with positive effects.…”

Section: Introductionmentioning

confidence: 99%

Predictors of communication preferences in patients with chronic low back pain

Farin¹,

Gramm²,

Schmidt³

2013

PPA

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BackgroundThe objective of this exploratory study was to identify patient-related predictors of communication preferences in patients with chronic low back pain for various dimensions of patient-physician communication (patient participation and orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances).MethodsEleven rehabilitation centers from various parts of Germany participated in collection of data between 2009 and 2011. A total of 701 patients with chronic low back pain were surveyed at the start of rehabilitation. The patient questionnaire captured communication preferences, pain impact, pain intensity, and psychologic variables (fear avoidance beliefs, illness coherence, control beliefs, communication self-efficacy, and personality characteristics). The rehabilitation physicians filled out a documentation sheet containing information on diagnosis, inability to work, duration of the illness, and comorbidity at the beginning and end of rehabilitation. Hierarchical regression analyses were performed.ResultsOn average, effective, open, and patient-centered communication was very important for patients with back pain, emotionally supportive communication was important, and communication about personal circumstances was somewhat important. The variance in communication preferences explained by the predictors studied here was 8%–19%. Older patients showed a lower preference for patient-centered and open communication, but a higher preference for communication about personal circumstances. Patients with psychologic risk factors (eg, fear avoidance beliefs), extroverted patients, and patients with high self-efficacy in patient-physician interaction generally had higher expectations of the physician’s communicative behavior.ConclusionProviders should take into consideration the fact that patients with back pain have a strong need for effective, open, and patient-centered communication. A flexible approach to communication needs appears to be especially important for communication about emotional and personal circumstances, because the patients differ most clearly in this respect. Personal characteristics provided only initial clues to possible preferences; for more precision, an individual assessment (by means of questionnaires or discussion) is needed.

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“…These findings suggest additional testing of the API for groups other than native English‐speaking populations. Other studies have also used modified versions of the API, in which they either added items or used selected items of the sub‐scales, but did not report reasons for their modifications 14–16 . Many studies using an unmodified version of the API did not report results of psychometric testing 17–19 .…”

Section: Introductionmentioning

confidence: 99%

Confirmatory factor analysis and recommendations for improvement of the Autonomy‐Preference‐Index (API)

Simón¹,

Kriston²,

Loh³

et al. 2010

Health Expectations

124

100

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Objective Validation of the German version of the AutonomyPreference-Index (API), a measure of patientsÕ preferences for decision making and information seeking.Methods Stepwise confirmatory factor analysis was conducted on a sample of patients (n = 1592) treated in primary care for depression (n = 186), surgical and internal medicine inpatients (n = 811) and patients with minor trauma treated in an emergency department (n = 595). An initial test of the model was done on calculation and validation halves of the sample. Both local and global indexes-of-fit suggested modifications to the scale. The scale was modified and re-tested in the calculation sample and confirmed in the validation sample. Subgroup analyses for age, gender and type of treatment setting were also performed.Results The confirmatory analysis led to a modified version of the API with better local and global indexes-of-fit for samples of German-speaking patients. Two items of the sub-scale, Ôpreference for decision-makingÕ, and one item of the sub-scale, Ôpreference for information seekingÕ, showed very low reliability scores and were deleted. Thus, several global indexes-of-fit clearly improved significantly. The modified scale was confirmed on the validation sample with acceptable to good indices of fit. Results of subgroup analyses indicated that no adaptations were necessary.Discussion and conclusions This first confirmatory analysis for a German-speaking population showed that the API was improved by the removal of several items. There were theoretically plausible explanations for this improvement suggesting that the modifications might also be appropriate in English and other language versions.

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Patients' preferences for decision making and the feeling of being understood in the medical encounter among patients with rheumatoid arthritis

Cited by 30 publications

References 87 publications

“Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis

“Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis

Predictors of communication preferences in patients with chronic low back pain

Confirmatory factor analysis and recommendations for improvement of the Autonomy‐Preference‐Index (API)

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