Patient satisfaction and alliance as a function of the physician's self-regulation, the physician's stress and the content of consultation in cancer care

Abstract

Objective:

To investigate which characteristics of the physician and of the consultation are related to patient satisfaction with communication and working alliance.

Methods:

Real-life consultations (n = 134) between patients (n = 134) and their physicians (n = 24) were audio taped. All of the patients were aware of their cancer diagnosis and consulted their physician to discuss the results of tests (CT scans, MRIs or tumour markers) and the progression of their cancer. The consultations were transcribed and coded with the "Defence Mechanisms Rating Scale – Clinician". The patients and physicians completed questionnaires about stress, satisfaction and alliance, and the data were analysed using Robust Linear Modelling.

Results:

Patient satisfaction with communication and working alliance was high. Both were significantly (negatively) related to the physician's neurotic and action defences - in particular to the defences of displacement, self-devaluation, acting-out and hypochondriasis - as well as to the physician's stress level. The content of the consultation was not significantly related to the patient outcomes.

Conclusions:

Our study shows that patient satisfaction with communication and working alliance is not influenced by the content of the consultation but is significantly associated with the physician's self-regulation (defence mechanisms) and stress. The results of this study might contribute to optimizing Communication Skills Training and to improving communication and working alliance in cancer care. This article is protected by copyright. All rights reserved.

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