Concordance among patients and physicians about their ideal of autonomy impacts the patient-doctor relationship: A cross-sectional study of Mexican patients with rheumatic diseases.

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Physician-Patient Relations*; Patients/*psychology ; Physicians/*psychology ; Rheumatic Diseases/*epidemiology; Adult ; Female ; Humans ; Male ; Middle Aged ; Primary Health Care ; Psychometrics ; Rheumatic Diseases/psychology ; Rheumatologists/psychology ; Surveys and Questionnaires
    • Abstract:
      Introduction: In patient-doctor interaction both parties play a role. Primary objective was to determine if the concordance among rheumatologists and their patients of their ideal of autonomy was associated with a better patient-doctor relationship. Secondary objective was to describe factors associated to a patient paternalistic ideal of autonomy (PPIA).
      Materials and Methods: This cross-sectional study had 3 steps. Step-1 consisted in translation/cultural local adaption of Ideal Patient Autonomy Scale (IPAS), a 14-items Dutch questionnaire. Step-2 consisted of IPAS validity and reliability in 201 outpatients. Step-3 consisted of the application of IPAS and the patient-doctor relationship questionnaire (PDRQ) to 601 outpatients with a medical encounter, and of IPAS to the 21 attending rheumatologists. Each patient-physician encounter was classified into with/without concordance in the ideal of autonomy and PRDQ scores were compared (Man Whitney U test). Regression analysis was used for associations.
      Results: Step-1 followed ISPOR task force recommendations. Patients from Step-2 and Step-3 were representative outpatients with rheumatic diseases. IPAS structure underwent a modification; the 14 items were redistributed into four subscales, further combined into PPIA vs. patient-centered autonomy ideal. IPAS was valid and reliable. There were 497 patients with a preferred ideal of autonomy, primarily (84.9%) PPIA. There were 363 patient-doctor encounters with concordance in the autonomy ideal and their PDRQ-9 scores were higher. Religious beliefs and higher PDRQ-9 item 8 score ("I feel pleased with my doctor´s treatment") were associated to a PPIA.
      Conclusions: Concordance of autonomy ideal among patients and their rheumatologists positively impacts on the patient-doctor relationship.
      Competing Interests: The authors have declared that no competing interests exist.
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    • Publication Date:
      Date Created: 20201029 Date Completed: 20201214 Latest Revision: 20240330
    • Publication Date:
      20240330
    • Accession Number:
      PMC7595407
    • Accession Number:
      10.1371/journal.pone.0240897
    • Accession Number:
      33119715