Patient-Doctor Depth of Relationship Scale validation and its influence on the outcomes: what is the importance of emotional intelligence when approaching the patient?
DOI:
https://doi.org/10.32385/rpmgf.v40i2.13826Palavras-chave:
Patient-doctor relationship, Patient-Doctor Depth of Relationship Scale, PDDR Scale, Patient Enablement Instrument , PEI, Enablement, Health outcomesResumo
Background: The patient-doctor relationship (DPR), promotes shared decision-making and patient-centered care, implying emotional intelligence and good communication, leading to positive health outcomes.
Objective: To culturally adapt the Patient-Doctor Depth of Relationship Scale (PDDR) and convergently validate with the Patient Enablement Instrument (PEI) to ascertain the correlation between PDR and enablement.
Methods: Cross-cultural adaptation process of the PDDR questionnaire to European Portuguese, through translation, linguistic verification, and reverse translation and also its understandability. Convergent validation with the Patient Enablement Instrument (PEI), after their doctor’s appointment, in a general practice/family medicine health unit. Context information, such as gender, age, living status, educational level, monthly income, Socioeconomic Deprivation Index (SEDI), and clinical appointment with the usual doctor, was also collected.
Results: PDDR showed good understandability and acceptance and strong internal consistency (Cronbach’s α=0.785; intraclass correlation coefficient=0.785). A total of 81 patients participated in the study, most of them female (70.4%). There was a significant difference in the PDDR total score depending on whether the appointment had been with the usual doctor (p<0.001). Both a weak positive non-significant correlation between PDDR and SEDI total scores (ρ=0.300; p=0.790) and a moderate significant negative correlation between PDDR total score and PEI (ρ=-0.396; p<0.001) were found.
Conclusion: The cross-cultural adaptation of the PDDR questionnaire to European Portuguese was carried out. PDDR proved to be a reasonable measure of the patient-doctor relationship, allowing greater patient enablement when a deeper patient-doctor relationship exists.
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Referências
May C, Allison G, Chapple A, Chew-Graham C, Dixon C, Gask L, et al. Framing the doctor-patient relationship in chronic illness: a comparative study of general practitioners’ accounts. Sociol Health Illn. 2004;26(2):135-58.
Chipidza FE, Wallwork RS, Stern TA. Impact of the doctor-patient relationship. Prim Care Companion CNS Disord. 2015;17(5):10.4088/PCC.15F01840.
Chandra S, Mohammadnezhad M, Ward P. Trust and communication in a doctor-patient relationship: a literature review. J Healthc Commun. 2018;3(3):36.
Lopes FA. Relação médico-doente e influência nos outcomes de saúde [dissertation]. Coimbra: Faculdade de Medicina da Universidade de Coimbra; 2018. Availble from: https://hdl.handle.net/10316/82674
Rapley T. Distributed decision making: the anatomy of decisions-in-action. Sociol Health Illn. 2008;30(3):429-44.
Faiman B, Tariman JD. Shared decision making: improving patient outcomes by understanding the benefits of and barriers to effective communication. Clin J Oncol Nurs. 2019;23(5):540-2.
Pieterse AH, Finset A. Shared decision making-much studied, much still unknown. Patient Educ Couns. 2019;102(11):1946-8.
Hughes TM, Merath K, Chen Q, Sun S, Palmer E, Idrees JJ, et al. Association of shared decision-making on patient-reported health outcomes and healthcare utilization. Am J Surg. 2018;216(1):7-12.
Hashim MJ. Patient-centered communication: basic skills. Am Fam Physician. 2017;95(1):29-34.
Hesse C, Rauscher EA. The relationships between doctor-patient affectionate communication and patient perceptions and outcomes. Health Commun. 2019;34(8):881-91.
Cárdenas-Cloud E, Brambila-Tapia AJ, Meda-Lara RM, Pérez-Vázquez FD, Chavarría-Ávila E, Romero Abundis FJ, et al. Evaluation of a psychoeducational intervention including emotional intelligence to increase treatment adherence in rheumatoid arthritis: a pilot study. Reumatismo. 2021;73(3):167-73.
Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826-34.
Carvalho IP, Ribeiro-Silva R, Pais VG, Figueiredo-Braga M, Castro-Vale I, Teles A, et al. O Ensino da Comunicação na relação médico-doente: uma proposta em prática [Teaching doctor-patient communication: a proposal in practice]. Acta Med Port. 2010;23(3):527-32. Portuguese
Lee ML, Hsieh TL, Yang CW, Chen JC, Ju YJ, Hsueh IP. Consistency analysis in medical empathy intervention research. Int J Environ Res Public Health. 2022;19(17):10904.
Senćanski D, Tadić I, Marinković V. Emotional intelligence and pharmaceutical care: a systematic review. J Am Pharm Assoc. 2022;62(4):1133-41.e2.
Rehman R, Tariq S, Tariq S. Emotional intelligence and academic performance of students. J Pak Med Assoc. 2021;71(12):2777-81.
Street Jr RL, Richardson MN, Cox V, Suarez-Almazor ME. (Mis)understanding in patient-health care provider communication about total knee replacement. Arthritis Rheum. 2009;61(1):100-7.
Okunrintemi V, Spatz ES, Di Capua P, Salami JA, Valero-Elizondo J, Warraich H, et al. Patient-provider communication and health outcomes among individuals with atherosclerotic cardiovascular disease in the United States: medical expenditure panel survey 2010 to 2013. Circ Cardiovasc Qual Outcomes. 2017;10(4):e003635.
Chen Q, Beal EW, Schneider EB, Okunrintemi V, Zhang XF, Pawlik TM. Patient-provider communication and health outcomes among individuals with hepato-pancreato-biliary disease in the USA. J Gastrointest Surg. 2018;22(4):624-32.
Olaisen RH, Schluchter MD, Flocke SA, Smyth KA, Koroukian SM, Stange KC. Assessing the longitudinal impact of physician-patient relationship on functional health. Ann Fam Med. 2020;18(5):422-9.
Almeida IM, Fonseca IS, Mota DM, Beirão IB, Moreira SM. Comunicação na prática clínica, a perspetiva dos doentes com cancro: tradução do questionário PACE (Patient Assessment Of Cancer Communication Experiences) para Português [Communication in clinical practice, the perspective of patients with cancer: translation of the PACE (Patient Assessment of Cancer Communication Experiences) questionnaire to European Portuguese]. Acta Med Port. 2022;35(11):807-15. Portuguese
Callender LF, Johnson AL, Pignataro RM. Patient-centered education in wound management: improving outcomes and adherence. Adv Skin Wound Care. 2021;34(8):403-10.
Santos P, Nazaré I, Martins C, Sá L, Couto L, Hespanhol A. As normas de orientação clínica em Portugal e os valores dos doentes [The Portuguese guidelines and patients values]. Acta Med Port. 2015;28(6):754-9. Portuguese
Pintalhão I, Botas P, Pereira C, Santiago LM. Desenvolvimento de tradução para Português do Patient Enablement Instrument [Portuguese translation of the Patient Enablement Instrument]. Rev ADSO. 2013;1(2):18-22. Portuguese
Santiago LM, Reis AF, Botas PC, Pereira CD. Medicina centrada no paciente e capacitação do consulente medicina geral e familiar [Patient-centered medicine and enablement in the general practice/family medicine setting]. Rev ADSO. 2015;3(5):19-32. Portuguese
Ridd MJ, Lewis G, Peters TJ, Salisbury C. Patient-doctor depth-of-relationship scale: development and validation. Ann Fam Med. 2011;9(6):538-45.
Reis AF, Santiago LM, Botas P. Medicina centrada no paciente e capacitação do consulente em medicina geral e familiar. Rev ADSO. 2015;05):1-14.
Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Pearson; 2012. ISBN 9780205849574
Nunnally JC. Pyschometric theory. New York: McGraw-Hill; 1978. ISBN 9780070474659
Aroso M, Seabra P. Expectativas dos utentes na consulta nos cuidados de saúde primários [Patients’ expectations in the primary health care appointment]. Rev Port Med Geral Fam. 2021;37(2):109-18. Portuguese
Domingues SG. O ato médico como interação simbólica [The medical act as symbolic interaction]. Rev Port Med Geral Fam. 2019;35(6):496-500. Portuguese
Pereira AV, Jorge GP, Guerra NC, Branco PR. O médico de família ideal: perspectiva do utente [The ideal family doctor: the patient’s perspective]. Rev Port Clin Geral. 2008;24(5):555-64. Portuguese
Silva PR. A comunicação na prática médica: o seu papel como componente terapêutico [Communication in medical practice: its role in therapy]. Rev Port Clin Geral. 2008;24(4):505-12. Portuguese
Santiago LM, Rosendo I, Simões JA. A avaliação prática em consulta na Unidade Curricular de Medicina Geral e Familiar no ano letivo de 2017-2018. Rev ADSO. 2019;(10):11-7.
Freitas M, Santiago LM, Rosendo I, Simões JA. Impacto educacional do método de ensino de medicina geral e familiar nos estudantes de medicina da Universidade de Coimbra em 2017-2018 [Educational impact of a methodology of teaching general practice/family medicine in medicine students of the University of Coimbra in 2017-18]. Rev ADSO. 2019;(11):17-25. Portuguese
Ayers JW, Poliak A, Dredze N, Leas EC, Zhu Z, Kelley JB, et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Intern Med. 2023;183(6):589-96.
Amaral R, Santiago LM. Qualidade da consulta de medicina geral e familiar percecionada pelo utente e pelo médico. Rev ADSO. 2016;(6):32-41.
Simões JA, Alberto KP, Simões PA, Maurício K, Rosendo I, Santiago LM. Communication and health: doctor-patient relationship in patients with multimorbidity, an exploratory study. Fam Med Prim Care Rev. 2019;21(4):377-80.
PORDATA. População residente segundo os censos: total e por sexo [homepage]. PORDATA; 2022 [updated 2023 Mar 07; cited 2023 Mar 17]. Available from: https://www.pordata.pt/Portugal/Popula%C3%A7%C3%A3o+residente+segundo+os+Censos+total+e+por+sexo-1
PORDATA. Alunos do sexo feminino em % dos matriculados no ensino superior: total e por área de educação e formação [homepage]. PORDATA; 2023 [updated 2023 Oct 19; cited 2023 Mar 19]. Available from: https://www.pordata.pt/portugal/alunos+do+sexo+feminino+em+percentagem+dos+matriculados+no+ensino+superior+total+e+por+area+de+educacao+e+formacao+-1051
Coelho BM, Santiago LM. Medicina centrada na pessoa: validação populacional de um instrumento de medida pela pessoa [Person-centered medicine: validation of a person perception instrument]. Rev Port Med Geral Fam. 2022;38(3):247-56. Portuguese
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