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- Title
Depressive symptoms and perceived doctor-patient communication in the Heart and Soul study.
- Authors
Schenker, Yael; Stewart, Anita; Na, Beeya; Whooley, Mary A.
- Abstract
<bold>Background: </bold>Doctor-patient communication is an important marker of health-care quality. Little is known about the extent to which medical comorbidities, disease severity and depressive symptoms influence perceptions of doctor-patient communication in patients with chronic disease.<bold>Methods: </bold>In a cross-sectional study of 703 outpatients with chronic coronary disease, we evaluated the extent to which patient reports of doctor-patient communication were influenced by medical comorbidities, disease severity and depressive symptoms. We assessed patient reports of doctor-patient communication using the Explanations of Condition and Responsiveness to Patient Preferences subscales from the "Interpersonal Processes of Care" instrument. Poor doctor-patient communication was defined as a score of <4 (range 1 to 5) on either subscale. All patients completed the nine-item Patient Health Questionnaire (PHQ) for measurement of depressive symptoms and underwent an extensive evaluation of medical comorbidities and cardiac function.<bold>Results: </bold>In univariate analyses, the following patient characteristics were associated with poor reported doctor-patient communication on one or both subscales: female sex, white or Asian race and depressive symptoms. After adjusting for demographic factors, medical comorbidities and disease severity, each standard deviation (5.4-point) increase in depressive symptom score was associated with a 50% greater odds of poor reported explanations of condition (OR 1.5, 95% CI, 1.2-1.8; p < 0.001) and a 30% greater odds of poor reported responsiveness to patient preferences (OR 1.3, 95% CI, 1.1-1.5; p = 0.01). In contrast, objective measures of disease severity (left ventricular ejection fraction, exercise capacity, inducible ischemia) and medical comorbidities (hypertension, diabetes, myocardial infarction) were not associated with reports of doctor-patient communication.<bold>Conclusions: </bold>In outpatients with chronic coronary heart disease, depressive symptoms are associated with perceived deficits in doctor-patient communication, while medical comorbidities and disease severity are not. These findings suggest that patient reports of doctor-patient communication may partly reflect the psychological state of the patient.
- Subjects
PHYSICIAN-patient relations; CORONARY disease; COMORBIDITY; MEDICAL care; PSYCHOLOGY; DIAGNOSIS; DIAGNOSIS of mental depression; COMPARATIVE studies; MENTAL depression; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PATIENT satisfaction; SENSORY perception; QUESTIONNAIRES; RESEARCH; RESEARCH funding; VERBAL behavior; EVALUATION research; CROSS-sectional method
- Publication
JGIM: Journal of General Internal Medicine, 2009, Vol 24, Issue 5, p550
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-009-0937-5