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Titolo:
Impact of the physician's participatory style in asthma outcomes and patient satisfaction
Autore:
Adams, RJ; Smith, BJ; Ruffin, RE;
Indirizzi:
Univ Adelaide, Queen Elizabeth Hosp, Dept Med, Woodville, SA 5011, Australia Univ Adelaide Woodville SA Australia 5011 , Woodville, SA 5011, Australia
Titolo Testata:
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY
fascicolo: 3, volume: 86, anno: 2001,
pagine: 263 - 271
SICI:
1081-1206(200103)86:3<263:IOTPPS>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
QUALITY-OF-LIFE; DECISION-MAKING; SELF-MANAGEMENT; SOCIOECONOMIC-STATUS; EDUCATION-PROGRAM; MEDICAL OUTCOMES; GENERAL-PRACTICE; CONTROLLED TRIAL; HEALTH OUTCOMES; CARE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
55
Recensione:
Indirizzi per estratti:
Indirizzo: Adams, RJ Univ Adelaide, Queen Elizabeth Hosp, Dept Med, Woodville, SA 5011, Australia Univ Adelaide Woodville SA Australia 5011 e, SA 5011, Australia
Citazione:
R.J. Adams et al., "Impact of the physician's participatory style in asthma outcomes and patient satisfaction", ANN ALLER A, 86(3), 2001, pp. 263-271

Abstract

Objectives: To identify factors associated with asthma patients' perceptions of the propensity of pulmonologists to involve them in treatment decision-making, and its association with asthma outcomes. Design: Cross-sectional observational study performed from June 1995 to December 1997. Setting: Pulmonary unit of a university teaching hospital. Patients: Adult patients with asthma (n = 128). Measurements and Results: By patient self-report, mean physician's participatory decision making (PDM) style score was 72 (maximum 100, 95% CI 65, 79), PDM scores were significantly correlated (P < .0001) with the duration of clinic visits (r = .63), patient satisfaction (r = .53), duration of tenure of doctor-patient relationship (r = .37), and formal education (r = .22,P = .023). Significantly higher PDM style scores were reported when visitslasted longer than 20 minutes and when a patient had a >6-month relationship with a particular doctor. PDM scores were also significantly correlated with possession of a written asthma action plan (r = .54, P < .0001), days affected by asthma (r = .36, P = .0001), asthma symptoms (r = .23, P = .017), and preferences for autonomy in asthma management decisions (r = .28, P = .0035). Those with PDM scores <50 reported significantly lower quality oflife for all domains of a disease-specific instrument and the Short-Form 36 health survey version 1.0. In multiple regression analysis, PDM style wasassociated with the length of the office visit and the duration of tenure of the physician-patient relationship (R-2 = 0.47, P = .0009). The adjustedodds ratio, per standard deviation decrease in PDM scores, for an asthma hospitalization was 2.0 (95% CI 1.2, 3.2) and for rehospitalization was 2.5 (95% CI 1.2, 4.2). Conclusions: Patients' report of their physician's PDM style is significantly associated with health-related quality of life, work disability, and recent need for acute health services. Organizational factors, specifically longer visits and more time seeing a particular physician, are independentlyassociated with more participatory visits. This has significant policy implications for asthma management.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 07:46:03