Doctor-patient interactions in Mexican patients with rheumatic disease

Abstract

Objective: To evaluate the characteristics of physician-patient communications in Mexican patients with rheumatic diseases.

Methods: We prospectively recruited 200 consecutive patients with chronic rheumatic diseases from a rheumatology clinic affiliated with a secondary care hospital in Mexico. All participants completed face-to-face interviews and surveys to determine their perceptions of the medical interaction with the physician at the clinic. Patients were assessed immediately before and after their visits. The Perceptions of Involvement in Care Scale was used to examine 3 factors: the doctor's facilitation of involvement, the level of information exchange, and the patient's participation in decision making. The Medical Outcomes Study scale was used to evaluate the patient satisfaction with the visit. A Patients' Trust in Physicians instrument was also administered.

Results: No differences in communication, satisfaction, or trust were observed across diseases. Most patients indicated they wanted to play a passive role, with the physicians making the decisions. However, concordance between preferred and actual roles was small (weighted kappa = 0.3), suggesting that not all patients played their preferred role.

Conclusion: This is the first study to evaluate doctor-patient communication in Mexican patients with rheumatic diseases. In general, patients preferred to play a passive role in their medical interaction. In addition, they often did not attain their preferred communication style when interacting with their physicians. The effect of these findings in subsequent health outcomes is unknown but deserves further investigation.