Research on relationship-centered care and healthcare outcomes from the Rochester biopsychosocial program: A self-determination theory integration.

Abstract

Researchers in the Program for Biopsychosocial Studies at the University of Rochester have applied quantitative and qualitative research paradigms to explore the healthcare outcomes associated with relationship-centered patient care. Studies converge to show that when primary care physicians are more relationship-centered (versus physician-centered) patients are likely to display higher satisfaction, better adherence to prescriptions, more maintained behavior change, better physical and psychological health, and to initiate less malpractice litigation. Further, when patients' families have more positive interactions, patients have better physical

The Content of a Low-income, Uninsured Primary Care Population: Including the Patient Agenda

“…Health care systems serving a low-income uninsured population might be more effective when integrating multifaceted, interdisciplinary approaches. Physicians who support patient autonomy 87,88 through shared agenda setting and treatment planning can provide to their indigent patients a health ingredient often absent in their worlds-a sense of control in life. 89,90 The authors wish to thank the Marillac Clinic medical assistants, administrative staff, community volunteers, and clinicians who contributed to this study in many essential ways.…”

Relations entre les comportements interpersonnels du psychothérapeute, la motivation des clients face à la thérapie et leur santé mentale /

“…Ryan, Deci et Grolnick (1995a) ont démontré à l'aide de diverses études (Kasser & Ryan, 1993;Ryan & Grolnick, 1986) (Williams, Frankel, Campbell, & Deci, 2000).…”

“…Il n'a également pu être démontré dans la présente étude en contexte psychothérapeutique que les facteurs contextuels et environnementaux qui soutiennent Toujours en contextes cliniques, les résultats actuels n'ont pu rejoindre d'autres études comme celle de Sheldon et al (2003) qui mentionnent que les médecins en relation avec leurs patients de manière à ce que ces derniers se sentent compétents et autonomes, ont des patients qui internalisent mieux l'objectif de santé et qui sont plus autodetermines dans leurs raisons à atteindre cet objectif. Aussi, Williams et al (2000; proposent que le soutien à l'autonomie du médecin en consultation médicale est positivement reliée à la santé mentale et physique du patient. Par exemple, le médecin soutenant l'autonomie de son patient peut améliorer divers comportements de santé comme la persistance dans un traitement pour l'alcool (Ryan et al, 1995b), la cessation tabagique, le contrôle du glucose sanguin dans une population diabétique (Williams & Deci, 1998), le maintien de la perte de poids chez des personnes obèses (Williams et al, 1996) ainsi que l'adhérence médicamenteuse (Williams et al, 1998b).…”

Engaging Client's Family and Friends in Online Counseling

“…Autonomy and choice are to be supported, as opposed to trying to "control" the client. Family members who are demanding, critical, and inflexible are controlling (Williams et al, 2000). This is not to say that all client decisions should be accepted without judgement.…”

“…Such interaction and change presupposes that the family perceives itself as functioning as a system, where changing one person affects another (Doherty & Campbell, 1988). Furthermore, it requires both the client and the family members to consider the environment itself as an important agent of change (Williams, Frankel, Campbell, & Deci, 2000).…”