Modelling the Associations Between the Physician-Patient Relationship and Patient Outcomes via Self-Determination Theory Variables in Chronic Disease Management.

Background: The aim of this study was to model the associations between the physician-patient relationship and patient outcomes, considering the mediating role of Self-Determination Theory variables.

Method: The current study comprised a sample (N = 226) of Australians with a diagnosed chronic health condition. Path analysis via structural equation modelling was used to model the relationships between patients' self-reported perception of the physician-patient relationship, motivation (autonomous and controlled), basic psychological needs (satisfaction and frustration), and patient outcomes (treatment adherence, mental health, and physical health).

Results: Stronger physician-patient relationships indirectly predicted better physical and mental health, as well as greater adherence to treatment. This occurred through serial mediation, whereby stronger physician-patient relationships directly predicted need satisfaction, which in turn predicted autonomous motivation. Conversely, weaker physician-patient relationships indirectly predicted poorer mental health and lower adherence to treatment. This occurred through serial mediation where weaker physician-patient relationships predicted need frustration, which in turn predicted controlled motivation. Weaker physician-patient relationships also directly predicted controlled motivation.

Conclusion: Satisfaction of basic psychological needs plays an important role in predicting patient motivation and outcomes. The current findings provide evidence that the physician-patient relationship plays a direct role in facilitating satisfaction and frustration of psychological needs, as well as patient motivation. Attention should be placed on interventions aimed at improving the physician-patient relationship as a means through which to increase need satisfaction, autonomous motivation, and, consequently, patient adherence and outcomes.