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

Abstract

To 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. An 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. The 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, p < 0.05). Higher scores on the PSORS were associated with lower levels of decisional conflict (r = - 0.37, p < 0.01). 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). Physicians 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.