TY - JOUR
T1 - Patient-clinician communication
T2 - Associations with important health outcomes among veterans with COPD
AU - Slatore, Christopher G.
AU - Cecere, Laura M.
AU - Reinke, Lynn F.
AU - Ganzini, Linda
AU - Udris, Edmunds M.
AU - Moss, Brianna R.
AU - Bryson, Chris L.
AU - Curtis, J. Randall
AU - Au, David H.
N1 - Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Au has received research funding from the National Institutes of Health-National Heart, Lung, and Blood Institute, the Department of Veterans Affairs, the American Lung Association, and Gilead Science, Inc. Drs Slatore, Cecere, Reinke, Ganzini, Bryson, Curtis, and Au; Mr Udris; and Ms Moss have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
PY - 2010/9/1
Y1 - 2010/9/1
N2 - Background: High quality patient-clinician communication is widely advocated, but little is known about which health outcomes are associated with communication for patients with COPD. Methods: Using a cross-sectional study of 342 veterans enrolled in a randomized controlled trial, we evaluated the association of communication, measured with the quality of communication (QOC) instrument, with subject-reported quality of clinician care, breathing problem confidence, and general self-rated health. We measured these associations using general estimating equations and adjusted odds ratios (OR) of patient-reported outcomes associated with one-point changes in QOC scores. Results: Nearly one-half of the subjects reported receiving the best imaginable care (47%), whereas fewer reported being confident with their breathing problems all the time (29%) or in very good or excellent health (15%). General communication was associated with best-imagined quality of care (OR, 4.29; 95% CI, 2.84-6.48; P < .001) and confidence in dealing with breathing problems all the time (OR, 1.74; 95% CI, 1.34-2.25; P < .001) but not general self-rated health (OR, 1.19; 95% CI, 0.92-1.55; P = .19). Specific clinician behaviors with larger associations with higher quality care included listening, caring, and attentiveness. The associations between general communication and quality care increased over time (P for interaction.03). Conclusions: Communication between patients and clinicians is associated with quality of care and confidence in dealing with breathing problems, and this association may change over time. Attention to specific communication strategies may lead to improvements in the care of patients with COPD.
AB - Background: High quality patient-clinician communication is widely advocated, but little is known about which health outcomes are associated with communication for patients with COPD. Methods: Using a cross-sectional study of 342 veterans enrolled in a randomized controlled trial, we evaluated the association of communication, measured with the quality of communication (QOC) instrument, with subject-reported quality of clinician care, breathing problem confidence, and general self-rated health. We measured these associations using general estimating equations and adjusted odds ratios (OR) of patient-reported outcomes associated with one-point changes in QOC scores. Results: Nearly one-half of the subjects reported receiving the best imaginable care (47%), whereas fewer reported being confident with their breathing problems all the time (29%) or in very good or excellent health (15%). General communication was associated with best-imagined quality of care (OR, 4.29; 95% CI, 2.84-6.48; P < .001) and confidence in dealing with breathing problems all the time (OR, 1.74; 95% CI, 1.34-2.25; P < .001) but not general self-rated health (OR, 1.19; 95% CI, 0.92-1.55; P = .19). Specific clinician behaviors with larger associations with higher quality care included listening, caring, and attentiveness. The associations between general communication and quality care increased over time (P for interaction.03). Conclusions: Communication between patients and clinicians is associated with quality of care and confidence in dealing with breathing problems, and this association may change over time. Attention to specific communication strategies may lead to improvements in the care of patients with COPD.
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U2 - 10.1378/chest.09-2328
DO - 10.1378/chest.09-2328
M3 - Article
C2 - 20299633
AN - SCOPUS:77956791789
SN - 0012-3692
VL - 138
SP - 628
EP - 634
JO - CHEST
JF - CHEST
IS - 3
ER -