Actual concordance between veterans’ with Gulf War Illness and their providers’ illness perceptions is not related to patient satisfaction nor treatment adherence

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-09-02 DOI:10.1016/j.pec.2025.109329

Rachel L. Boska , L. Alison Phillips , Laura M. Lesnewich , Katharine J. Bloeser , Yong Lin , Peter J. Bayley , Drew A. Helmer , Lisa M. McAndrew

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引用次数: 0

Abstract

Objective

Patients with persistent physical symptom (PPS) conditions, such as Gulf War Illness (GWI), report disagreement or “non-concordance” with their providers about PPS conditions and dissatisfaction with healthcare. When patients perceive concordance with their providers about their PPS condition, they have increased satisfaction and adherence. While literature supports perceived concordance, there is a lack of research on actual concordance (i.e., the congruence of patients’ and providers’ perceptions of the patients’ illness).

Methods

Among dyads of Veterans with GWI and their provider, we tested the hypotheses that greater actual concordance would be associated with greater Veterans’ satisfaction and adherence. We also explored the relationship of actual concordance with Veterans’ and providers’ perceived concordance.

Results

Correlations suggest there is little agreement between Veterans and providers regarding GWI illness perceptions or perceptions of concordance. Polynomial regression analyses showed that actual concordance was not significantly related to Veterans’ satisfaction, adherence, or perceptions of concordance, nor to providers’ perceptions of concordance.

Conclusion

Although literature finds Veterans’ perceived concordance with their provider about PPS influences patients’ experiences of care, our results suggest that actual concordance may have limited influence on experiences of care and either Veterans’ or providers’ perceived concordance. That is, the results suggest there does not need to be objective agreement between patients and providers about PPS, rather patients’ perception of agreement influences their satisfaction and adherence.

Practice implications

Our results suggest that patients with PPS and their providers may have difficulties in estimating if there is shared agreement in the relationship and demonstrate the importance of explicitly assessing patients’ perceptions of concordance.

查看原文本刊更多论文

退伍军人的海湾战争疾病和他们的提供者的疾病感知之间的实际一致性与病人满意度和治疗依从性无关。

目的：海湾战争病（GWI）等持续性躯体症状（PPS）患者报告与服务提供者对PPS状况的不一致或“不一致”，以及对医疗保健的不满。当患者认为他们的PPS条件与他们的提供者一致时，他们会增加满意度和依从性。虽然文献支持感知一致性，但缺乏对实际一致性（即患者和提供者对患者疾病的看法的一致性）的研究。方法：通过对两组GWI退伍军人及其医疗服务提供者的调查，我们验证了更高的实际一致性与更高的退伍军人满意度和依从性相关的假设。我们还探讨了实际一致性与退伍军人和提供者感知一致性的关系。结果：相关性表明，退伍军人和医疗服务提供者对GWI疾病的看法或对一致性的看法几乎没有一致。多项式回归分析显示，实际一致性与退伍军人满意度、依从性、一致性感知以及服务提供者的一致性感知均无显著相关。结论：虽然文献发现退伍军人对其服务提供者关于PPS的感知一致性影响患者的护理体验，但我们的研究结果表明，实际一致性对护理体验以及退伍军人或服务提供者感知一致性的影响可能有限。也就是说，结果表明，患者和提供者之间不需要对PPS有客观的共识，而是患者对共识的感知影响了他们的满意度和依从性。实践启示：我们的研究结果表明，PPS患者和他们的医生可能难以估计他们之间的关系是否有共同的共识，并表明明确评估患者对一致性的看法的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.