Fuertes Jairo N, Anand Prachi, Haggerty Greg, Kestenbaum Michael, Rosenblum Gary C
a Derner Institute of Advanced Psychological Studies, Adelphi University.
Behav Med. 2015;41(2):60-8. doi: 10.1080/08964289.2013.875885. Epub 2014 Sep 3.
Over the past twenty years, the physician-patient relationship (eg, the physician-patient working alliance) has emerged as an integral component to the treatment of patients for a myriad of health conditions. Psychological, emotional, and behavioral dimensions of patients' working alliance with their physicians, along with patients' attachment styles, were examined in relation to rheumatology patients' adherence to treatment plans, outcome expectations, and satisfaction. Study participants were 101 adult outpatients from a rheumatology clinic. Path analyses demonstrated that the physician-patient working alliance predicted outcome expectations (Standardized Beta [SB] = 0.27), and patient satisfaction (SB = 0.62), and that patient satisfaction in turn predicted patient adherence (SB = 0.48). Physicians' ratings of patient adherence were significantly and positively correlated with patients' ratings of the physician-patient working alliance. No significant paths were evident with respect to patient attachment. The physician-patient working alliance directly predicts patient satisfaction, and outcome expectations, and indirectly predicts adherence through patient satisfaction.
在过去二十年中，医患关系（例如，医患工作联盟）已成为治疗患有各种健康状况患者的一个不可或缺的组成部分。研究了患者与医生工作联盟的心理、情感和行为维度，以及患者的依恋风格与风湿病患者对治疗计划的依从性、结果期望和满意度之间的关系。研究参与者是来自一家风湿病诊所的101名成年门诊患者。路径分析表明，医患工作联盟可预测结果期望（标准化β系数[SB]=0.27）和患者满意度（SB=0.62），而患者满意度反过来又可预测患者的依从性（SB=0.48）。医生对患者依从性的评分与患者对医患工作联盟的评分显著正相关。在患者依恋方面没有明显的显著路径。医患工作联盟直接预测患者满意度和结果期望，并通过患者满意度间接预测依从性。
