Schoenthaler Antoinette, Chaplin William F, Allegrante John P, Fernandez Senaida, Diaz-Gloster Marleny, Tobin Jonathan N, Ogedegbe Gbenga
Department of Medicine, New York University School of Medicine, New York, NY 10010, USA.
Patient Educ Couns. 2009 May;75(2):185-91. doi: 10.1016/j.pec.2008.09.018. Epub 2008 Nov 14.
To evaluate the effect of patients' perceptions of providers' communication on medication adherence in hypertensive African Americans.
Cross-sectional study of 439 patients with poorly controlled hypertension followed in community-based healthcare practices in the New York metropolitan area. Patients' rating of their providers' communication was assessed with a perceived communication style questionnaire,while medication adherence was assessed with the Morisky self-report measure.
Majority of participants were female, low-income, and had high school level educations, with mean age of 58 years. Fifty-five percent reported being nonadherent with their medications; and 51% rated their provider's communication to be non-collaborative. In multivariate analysis adjusted for patient demographics and covariates (depressive symptoms, provider degree), communication rated as collaborative was associated with better medication adherence (beta=-.11, p=.03). Other significant correlates of medication adherence independent of perceived communication were age (beta=.13, p=.02) and depressive symptoms (beta=-.18, p=.001).
Provider communication rated as more collaborative was associated with better adherence to antihypertensive medications in a sample of low-income hypertensive African-American patients.
The quality of patient-provider communication is a potentially modifiable element of the medical relationship that may affect health outcomes in this high-risk patient population.
评估非裔美国高血压患者对医护人员沟通方式的认知对药物依从性的影响。
对纽约大都市地区社区医疗实践中439名血压控制不佳的高血压患者进行横断面研究。使用感知沟通方式问卷评估患者对医护人员沟通的评分,同时使用莫利斯基自我报告量表评估药物依从性。
大多数参与者为女性、低收入且具有高中学历,平均年龄为58岁。55%的患者报告未坚持服药;51%的患者认为医护人员的沟通缺乏协作性。在对患者人口统计学和协变量(抑郁症状、医护人员学历)进行调整的多变量分析中,被评为具有协作性的沟通与更好的药物依从性相关(β = -0.11,p = 0.03)。与药物依从性相关的其他显著因素,与感知沟通无关的有年龄(β = 0.13,p = 0.02)和抑郁症状(β = -0.18,p = 0.001)。
在低收入非裔美国高血压患者样本中,被评为更具协作性的医护人员沟通与更好的抗高血压药物依从性相关。
患者与医护人员沟通的质量是医疗关系中一个潜在可改变的因素,可能会影响这一高风险患者群体的健康结局。