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Patient-centered communication during primary care visits for depressive symptoms: what is the role of physician personality?

Abstract：

BACKGROUND:Patient-centered communication (PCC) is associated with more appropriate treatment of depression in primary care. Aside from patient presentation, little is known about other influences on PCC. We investigated whether PCC is influenced by personality dispositions of primary care providers, independent of patient presentation. METHODS:Forty-six primary care providers completed personality scales from the NEO-Personality Inventory, revised and provided care to 88 standardized patients presenting with either major depression or adjustment disorder with comorbid musculoskeletal symptoms, either making or not making a medication request. Coders scored each visit using the measure of PCC, assessing physicians' ability to explore the patient's illness experience (component 1), understand the patient's psychosocial context (component 2), and involve the patient in collaborative discussions of treatment (component 3). RESULTS:Adjusting for physician demographics, training, and patient presentation, physicians who were more open to feelings explored the patient's experience of illness more (P = 0.05). More dutiful, or rule-bound physicians engaged in greater exploration of the patient's psychosocial and life circumstances (P = 0.04), but involved the patient less in treatment discussions (P = 0.03). Physicians reporting more anxious vulnerability also involved the patient less (P = 0.03). Physician demographics, training, and patient presentation explained 4-7% of variance in the measure of patient-centered communication components, with personality explaining an additional 4-7% of the variance. CONCLUSIONS:Understanding of personality dispositions that promote or detract from PCC may help medical educators better identify trainees of varying aptitude, facilitate medical career counseling, and address individual training needs in a tailored fashion.

journal_name

Med Care

journal_title

Medical care

authors

Chapman BP,Duberstein PR,Epstein RM,Fiscella K,Kravitz RL

doi

10.1097/MLR.0b013e31817924e4

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

806-12

issue

eissn

0025-7079

issn

1537-1948

pii

00005650-200808000-00007

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Patient-centered communication during primary care visits for depressive symptoms: what is the role of physician personality?