Patient-health Provider Relationship Research Articles

TRUSTING THE PHARMACIST IN DELIVERING MEDICATION INFORMATION: A COMMUNITY-BASED PERSPECTIVE

Objective: Optimal disease management is influenced by a solid patient-health provider relationship; which includes trust in the provider. The study compares respondents’ trust in pharmacists and physicians for the delivery of drug information.
 Methods: Residents of 3 rural communities in Lebanon, aged 40 and above, were invited to participate in the study, 760 accepted. Participants were asked who they trust the most with information about their medication: their physician or their pharmacist.
 Results: Of the total sample, 154 chose the pharmacist as their most trusted source of medication information (20%). Characteristics associated with choosing the pharmacist were: being a male (29.3% vs 16.2% p<.001), of younger age (31.5% among<50 y, 18.8% among 50-64 y, and 14.6% among 65+years p<.001), single (31.6% vs 21.9% married and 9.3 others, p=0.023), working (39.2% vs15.7% p<.001), and insured (2.3% vs 16.4% p=0.048). The multivariate logistic regression model revealed that having a family member with hypertension (OR=1.86 95% 1.23-2.82), or cardiovascular (OR=3.39 95%CI 1.55-7.45) increased the likelihood of trusting pharmacists over medical doctor. On the other hand, a self-report of cardiovascular disease (OR=0.34 95% CI 0.12-0.95) and taking medication (OR=0.41 95% CI 0.25-0.67) were associated with a decrease in the trust in the pharmacist in favor of the physician.
 Conclusion: Although pharmacists are the drug specialists, the majority of the Lebanese rural community residents reported higher trust in their physicians with information about their medication(s).

Factors associated with tuberculosis treatment outcomes among tuberculosis patients attending tuberculosis treatment centres in 2016-2017 in Mogadishu, Somalia.

IntroductionWorld Health Organization (WHO) reported that tuberculosis (TB) was a major health problem and the second leading cause of mortality globally. An estimated 1.8 million TB deaths were reported in 2015. In Somalia, the average TB incidence was 274 cases per 100,000 people in 2014; prevalence was 513 per 100,000 population; and mortality rate excluding human immune deficiency virus (HIV)/TB co-infection was 64/100,000. In addition, the prevalence rates of multi-drug resistant (MDR)-TB are still high, 5.2% among new cases and 40.7% for retreatment cases. The objective of this study was to determine individual and institutional level factors associated with TB treatment outcomes (TB-TOs) among patients attending TBTCs in Mogadishu.MethodsThe study design was cross-sectional, using quantitative and qualitative methods. Data was collected using interviewer administered semi-structured questionnaires and key in-depth interviews in 2016/2017. Qualitative data was coded using NVIVO8 and quantitative data analyzed using descriptive and inferential statistics at 95% confidence interval using SPSS20 software.ResultsThe study used a sample of 385 TB patients. There were 315(81.8%) successful TB-TOs. Individual level factors-marital status, education level, HIV status, treatment category and knowledge on TB influenced TB-TOs (p-value < 0.05). Being married, educated, HIV-negative, new treatment case and knowledgeable on TB increased odds of successful TB-TOs (OR > 0, p value < 0.05) compared to other patients. TBTCs factors did not influence TB-TOs (p-value > 0.05).ConclusionTB-TOs were mainly affected by patient individual factors. There was need for patient education on TB management and treatment; and improved patient-health provider relationship.

Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

IntroductionGlobally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients’ expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors.MethodsHospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values < 0.05 were considered statistically significant.ResultsTwo hundred and seventy eight patients underwent surgery during the study period. Nine patients were excluded due to refusal to participate in the study. A total of 269 out of 278 patients were included in the study with a response rate of 96.8%. The overall level of patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively.ConclusionThe level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

The Need for Mutual Healthcare Interactions in Building Patients’ Trust: The Case of Muleba And Chato Districts, Tanzania

The centrality of patients’ trust in healthcare providers cannot be underestimated given its influence on healthcare outcomes. Analysts and researchers have focused on the conceptualization of trust and factors for the development and lose of trust in healthcare encounters. The notable gap in these discussions has been the lack of analysis on the interrelation between the nature of patient-health provider relationship and patients’ trust. A study of 390 systematically sampled healthcare users was conducted in Chato and Muleba districts to find out the connection between the two aspects of healthcare. As per the analysis of this paper, there is a strong positive correlation between patients’ trust and the nature of patient-health provider relationship as patients’ trust increases with the improvement in patient-health provider relationships. High level of patient’s trust in healthcare providers is associated with mutuality in health care encounters, while low level of trust is associated with paternalism. Therefore, the assurance of patients’ trust in healthcare providers and healthcare institutions demands the provision of necessary illness and treatment information to patients, and minimal involvement of patients in therapeutic decision-making.

La formación entre iguales para pacientes con diabetes mellitus 2. Una evaluación cuantitativa y cualitativa en el País Vasco y Andalucía

ObjectiveTo evaluate a peer training strategy for patients with type2 diabetes mellitus, developed in two training programmes in the Basque Country and Andalusia. DesignQuantitative pre- and post-intervention and qualitative evaluation, developed between 2012 and 2014. PlaceThe Basque Country and Andalusia. ParticipantsA total of 409 patients and trainer-patients, participating in self-management peer training programmes. Intentional sample of 44 patients for the qualitative study. MethodBivariate analysis and net gains for common variables used in questionnaires in the Basque Country and Andalusia: self-reported health, daily activities, physical activity, use of health services, and self-management. Content analysis of 8 focus groups with patients and trainer-patients, including: coding, categorisation, and triangulation of results. ResultsPeer training has a positive impact on physical activity, the use of health services, and self-management, with some gender differences. The peer-training strategy is considered positive, as it strengthens the patient-health provider relationship, generates group support and self-confidence, and improves the emotional management. Patients identify two areas of potential improvement: access and continuity of training strategies, and more support and recognition from health providers and institutions. ConclusionsThe positive impact on health and quality of life that this patient peer-training provides, requires the collaboration of health professionals and institutions, which should improve the access, continuity and adaptation to patient needs and expectations.

The Influence of Healthcare Reforms on Patient-Health Provider Relationships in Chato and Muleba Districts, Tanzania

Previous studies on healthcare reforms in Tanzania reported that healthcare provision has improved significantly since the implementation of the ongoing healthcare reforms. However, the influence of the reforms on the nature of patient-health provider relationships has remained unclear. This paper uses data from a study conducted in Chato and Muleba districts to reveal the nature of the relationships and their determinants. Survey questionnaires (390) were administered to healthcare users selected from catchment areas of four health facilities by using systematic random sampling. The study findings indicate that patient-health provider relationships in the study areas are largely paternalistic in both public and private health facilities, but the level of paternalism is significantly higher in the former. Patients under exemption and waiver modes of access to healthcare significantly face more paternalism than their counterparts under user fees and healthcare insurance. A patient experiences mutual or paternalistic patient-health provider relationship depending on one’s mode of access to healthcare, the level of education, and the type of health facility one attends. Mechanisms need to be devised within the framework of the current healthcare reforms to improve patient-health provider relationships as it is an important aspect in healthcare provision.

Perceptions of gastroenterologists and patients regarding irritable bowel syndrome and inflammatory bowel disease

To compare perceptions of patients and gastroenterologists regarding irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The Illness Perception Questionnaire-Revised was sent to 150 randomly selected hospital-based and community-based gastroenterologists nationwide. Participants were instructed to refer their responses to either IBS or IBD. Patients were recruited during a regular visit to the Gastroenterology Department of a tertiary medical center and completed the same questionnaire. Findings were analyzed according to illness and group. Questionnaires were returned by 55 physicians (29 referred to IBS, 26 to IBD) and 58 patients. Physicians and patients stated that IBD has more severe consequences and benefits more from medical treatment (P<0.05), and that patient coherence is higher for IBD than IBS (P<0.05). Physicians stated that psychological attributes and accidents/injuries play a greater causative role in IBS than in IBD (P<0.01 and P<0.05, respectively). Conversely, patients found no such difference. More patients than physicians attributed both illnesses to risk factors (P=0.07). Both groups believed that the immune system is a more important causative factor in IBD than IBS (P<0.01). The different views of gastroenterologists and patients in terms of the involvement of psychological attributes, risk factors, and accidents/injuries in IBD and IBS could affect the patient-health provider relationship and adversely impact treatment outcome.

Patients in treatment for chronic low back pain have higher externalised beliefs: a cross-sectional study

People with low back pain (LBP) with higher levels of external locus of control have a poorer prognosis and require greater improvements from active interventions in order to consider these interventions worthwhile. Whether locus of control levels differ between participants with LBP in a patient-health provider relationship and those waiting for treatment is unclear. The aim was to investigate if differences in locus of control exist between participants with non-specific chronic LBP being treated (treatment group) and those waiting treatment (control group). 100 participants (50 per group) with low back symptoms for at least three months for the current episode of LBP and aged between 18 and 60 years were recruited. Multidimensional health locus of control questionnaire (MHLC) was used to collect their beliefs. Multiple linear regression adjusted for disability was used to compare health locus of control between both groups. Differences were described as mean differences and 95% confidence intervals. Treatment group scored higher for external locus of control and lower for internal locus of control than control group. Mean differences (95% confidence intervals) were 2.7 points on possible 30-points difference (0.5 to 4.8) for external locus of control and -2.8 points (-5.4 to -0.1) for internal subscale. Health locus of control was found to be different between treatment and control groups. Participants being treated had higher external locus of control and lower internal locus of control than control group.

The Communal Coping Model of Catastrophizing: Patient–Health Provider Interactions

The study sought to elucidate and refine the interpersonal, communicative dimension of the communal coping model (CCM) of catastrophizing. The primary aim was twofold. First, we examined the relations among pain intensity, catastrophizing, and pain behaviors as they function within the patient-health provider relationship. Second, we investigated the role of catastrophizing and pain behaviors in potentially influencing patient satisfaction with the provider, provider attitudes, and provider behavior. Mediation models were examined. The study was cross-sectional design with repeated measures. This study was conducted at a university-based family medicine clinic and a private practice rheumatology clinic. Nineteen health providers and 49 chronic pain patients receiving treatment in a medical setting completed the study. Patient outcome measures included pain intensity, catastrophizing, pain behaviors, and patient satisfaction with the provider. Health provider outcome measures were an assessment of provider attitudes and length of medical exam. The patient's level of catastrophizing entering the medical exam significantly predicted the interactive dynamics between the patient and the health provider during the exam and patient satisfaction after the exam. The patient's perceptions of pain and catastrophic thought processes may be interpersonally expressed to health providers via exaggerated pain behaviors. Current findings indicate suggestions for refining the CCM. Results suggest that alleviation of catastrophic cognitions may facilitate more effective interpersonal communication within the patient-health provider relationship. Identification of those factors that improve patient-provider dynamics has important implications for the advancement of treatment for chronic pain and reducing the costs associated with persistent pain.

Perceptions of gastroenterologists and nurses regarding irritable bowel syndrome and inflammatory bowel disease

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) have similar symptoms, and both adversely affect patients' quality of life. The objective of this study was to compare the perceptions of physicians and nurses regarding IBS and IBD. The Illness Perception Questionnaire Revised, adapted for medical staff, was sent at random to 300 physicians and nurses of gastroenterology departments and outpatient clinics nationwide to assess perceptions of IBS or IBD. Responses were statistically analyzed by illness and professional group. Fifty-five physicians and 43 nurses returned the questionnaire (response rate, 32.6%). Fifty-two questionnaires pertained to IBS and 46 to IBD. More physicians than nurses stated that the course of both illnesses does not improve over time (P<0.05). Both groups showed that medical treatment is of greater benefit for IBD than IBS (P<0.05) and that patients with IBD better understand their illness than patients with IBS (P<0.05). Physicians and nurses hold different attitudes to and perceptions of IBD and IBS in terms of chronicity, severity of the consequences, treatment efficacy, personal control, and illness coherence. These differences may have important effects on the patient-health provider relationship and should be addressed.