Reciprocity within patient-physician and patient-spouse/caregiver dyads: insights into patient-centered care

摘要

PurposeTo explore the reciprocal process of decisional conflict within the patient-physician dyad, and its relationship with patient general health and patient-perceived physician helpfulness. Among the subset of participants who were in a committed relationship, we examined the congruence in reciprocal processes between patient-spouse/caregiver and patient-physician dyads.MethodsAn online retrospective survey of cancer patients was conducted in the USA. The reciprocal process of decisional conflict within the patient-physician dyad was measured using the Decisional Conflict Scale (DCS). The Perception of Spousal Reciprocity Scale (POSRS) was used to measure reciprocity in the patient-spouse/caregiver dyad.ResultsThe final analytic cohort consisted of 116 participants. The average age of participants was 58.4years, the majority were female (66.7%), and the most common diagnosis was breast cancer (27.9%). Participants who perceived their physician as more helpful were more likely to report lower levels of decisional conflict on the DCS total scale and subscales (r range=0.24-0.46, p0.05). Higher scores on the PSORS were associated with lower levels of decisional conflict (r=-0.37, p0.01). Participants not in a relationship had higher levels of decisional conflict about their treatment decisions (M=21.69) than participants in a relationship (M=9.69, t(26.95)=-2.26, p=0.032).DiscussionPhysicians are an important resource for both the patient and caregiver during the cancer journey. Understanding reciprocal processes within the patient-physician relationship related to patient-centered care and including the caregiver in the medical decision-making process can decrease the threat of decisional conflict and subsequent adverse outcomes.