Dinkel Andreas, Schneider Antonius, Schmutzer Gabriele, Brähler Elmar, Henningsen Peter, Häuser Winfried
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München.
Institut für Allgemeinmedizin, Technische Universität München.
Psychother Psychosom Med Psychol. 2016 Mar;66(3-4):120-7. doi: 10.1055/s-0042-100811. Epub 2016 Apr 1.
Patient-centeredness and a strong working alliance are core elements of family medicine. Surveys in Germany showed that most people are satisfied with the quality of the family physician-patient relationship. However, factors that are responsible for the quality of the family physician-patient relationship remain unclear. This study aimed at identifying patient-related predictors of the quality of this relationship.
Participants of a cross-sectional survey representative for the general German population were assessed using standardized questionnaires. The perceived quality of the family physician-patient relationship was measured with the German version of the Patient-Doctor Relationship Questionnaire (PDRQ-9). Associations of demographic and clinical variables (comorbidity, somatic symptom burden, psychological distress) with the quality of the family physician-patient relationship were assessed by applying hierarchical linear regression.
2278 participants (91,9%) reported having a family physician. The mean total score of the PDRQ-9 was high (M=4,12, SD=0,70). The final regression model showed that higher age, being female, and most notably less somatic and less depressive symptoms predicted a higher quality of the family physician-patient relationship. Comorbidity lost significance when somatic symptom burden was added to the regression model. The final model explained 11% of the variance, indicating a small effect.
Experiencing somatic and depressive symptoms emerged as most relevant patient-related predictors of the quality of the family physician-patient relationship.
以患者为中心以及牢固的工作联盟是家庭医学的核心要素。德国的调查显示，大多数人对家庭医生与患者关系的质量感到满意。然而，影响家庭医生与患者关系质量的因素仍不明确。本研究旨在确定与这种关系质量相关的患者因素。
使用标准化问卷对具有德国普通人群代表性的横断面调查参与者进行评估。家庭医生与患者关系的感知质量采用德文版的医患关系问卷（PDRQ - 9）进行测量。通过应用分层线性回归评估人口统计学和临床变量（合并症、躯体症状负担、心理困扰）与家庭医生与患者关系质量之间的关联。
2278名参与者（91.9%）报告有家庭医生。PDRQ - 9的平均总分较高（M = 4.12，SD = 0.70）。最终回归模型显示，年龄较大、女性以及最显著的是躯体症状和抑郁症状较少预示着家庭医生与患者关系质量较高。当将躯体症状负担纳入回归模型时，合并症失去了显著性。最终模型解释了11%的方差，表明效应较小。
躯体症状和抑郁症状是与家庭医生与患者关系质量最相关的患者因素。
