US military veterans' perceived concordance with their providers regarding persistent physical symptoms prospectively predicts satisfaction with care and adherence to care plans.

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
L Alison Phillips, Laura M Lesnewich, Katharine Bloeser, Yong Lin, Rachel L Boska, Justeen K Hyde, Peter J Bayley, Helena K Chandler, Matthew J Reinhard, Susan L Santos, Rachel Stewart, Drew A Helmer, Lisa M McAndrew
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Abstract

Background: Medically unexplained, persistent physical symptoms and syndromes are commonly seen in primary care. These are debilitating for patients and difficult to treat, causing frustration for patients and providers.

Purpose: This study investigates how well US military veterans with multiple persistent physical symptoms (PPS), called Gulf War illness (GWI), agree with their healthcare providers about their illness. This agreement, called perceived concordance, is hypothesized to influence veterans' satisfaction with care, adherence to care plans, and disability levels.

Methods: Participants were 230 veterans with GWI deployed to the 1990-1991 Gulf War who were recruited from Veteran Affairs primary care and War Related Illness and Injury Study Centers (WRIISCs). Veterans' GWI perceptions and perceived concordance with their providers regarding GWI were assessed at a medical visit. Veterans' self-reported satisfaction with care, adherence to care plans, and disability levels were measured at 1 week, 1 month, and 6 months post-baseline.

Results: Bivariate correlations indicated that veterans' GWI-related illness perceptions were related to veterans' satisfaction with care and reports of functional disability. Beyond these effects, veterans' perceived concordance with the provider regarding GWI was positively associated with satisfaction over time (e.g., fixed-effect estimate = 0.36, P < .001 for 1-week follow-up) and adherence to care plans (fixed-effect estimate averaged across all timepoints = 0.03, P = .03) but was unrelated to reported disability.

Conclusions: Veterans' perceived concordance with their providers about GWI seems to be important for patient satisfaction and adherence to care plans. More research with longer-term follow-up is needed to understand how perceived concordance might influence disability levels and the outcome of care plans.

美国退伍军人在持续身体症状方面与医疗服务提供者的一致性预测了对护理的满意度和对护理计划的依从性。
背景:医学上无法解释的、持续的躯体症状和综合征在初级保健中很常见。这些疾病使患者衰弱,难以治疗,使患者和提供者感到沮丧。目的:本研究调查了患有多种持续性身体症状(PPS)的美国退伍军人,称为海湾战争疾病(GWI),他们对医疗保健提供者关于他们疾病的认同程度。这种一致性被称为感知一致性,它被假设影响退伍军人对护理的满意度、对护理计划的依从性和残疾水平。方法:参与者为230名从退伍军人事务初级保健和战争相关疾病和伤害研究中心(WRIISCs)招募的参加1990-1991年海湾战争的GWI退伍军人。在一次医疗访问中评估了退伍军人对GWI的看法以及对其提供者关于GWI的认知一致性。在基线后1周、1个月和6个月测量退伍军人对护理的自我报告满意度、对护理计划的依从性和残疾水平。结果:双变量相关研究表明,退伍军人的gwi相关疾病感知与退伍军人的护理满意度和功能残疾报告相关。除了这些影响外,退伍军人对医疗服务提供者关于GWI的感知一致性与满意度随时间的推移正相关(例如,固定效应估计= 0.36,P)。结论:退伍军人对医疗服务提供者关于GWI的感知一致性似乎对患者满意度和护理计划的依从性很重要。需要更多的长期随访研究来了解感知一致性如何影响残疾水平和护理计划的结果。
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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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