Department of Quality Management and Social Medicine, University Medical Center Freiburg, Engelbergerstrasse 21, Freiburg, Germany.
J Behav Med. 2013 Jun;36(3):246-58. doi: 10.1007/s10865-012-9419-z. Epub 2012 Apr 4.
For patients with chronic diseases, especially those with chronic low back pain, the patient-physician relationship is significant for treatment adherence. In a sample of N = 688 low back pain patients, we examined the hypothesis that aspects of the patient-physician relationship (e.g. satisfaction with care, trust in the physician, patient participation) have a significant association with outcomes (pain, disability, quality of life, pain-related psychological impairment) after a multimodal treatment program (rehabilitation) after adjusting for a number of sociodemographic, medical, and psychological factors. Results show that the patient-physician relationship is significantly associated with the outcome. In the medium term (6 months after rehabilitation), the effect of the patient-physician relationship is clearer than in the short term (end of rehabilitation). In addition, risk factors for less improvement are female gender, higher age, low income, comorbidity, low treatment motivation, fear avoidance beliefs, and external locus of control. Future studies should examine the causal paths between the relationship variables and the outcome variables.
对于患有慢性疾病的患者，特别是慢性腰痛患者，医患关系对治疗依从性很重要。在对 688 名腰痛患者进行的样本研究中，我们检验了这样一个假设，即医患关系的各个方面（如对治疗的满意度、对医生的信任、患者的参与度）与经过多模式治疗方案（康复）后的结果（疼痛、残疾、生活质量、与疼痛相关的心理障碍）之间存在显著关联，调整了一些社会人口统计学、医学和心理因素。结果表明，医患关系与结果显著相关。从中期（康复结束后 6 个月）来看，医患关系的影响比短期（康复结束时）更明显。此外，改善程度较低的风险因素包括女性、年龄较大、收入较低、合并症、治疗动机低、恐惧回避信念和外部控制源。未来的研究应检验关系变量与结果变量之间的因果关系。
