Quality of doctor-patient relationship in patients with high somatic symptom severity in China

Heng Wu; Xudong Zhao; Kurt Fritzsche; Rainer Leonhart; Rainer Schaefert; Xiayuan Sun; Astrid Larisch

doi:10.1016/j.ctim.2014.12.006

Quality of doctor-patient relationship in patients with high somatic symptom severity in China

Complement Ther Med. 2015 Feb;23(1):23-31. doi: 10.1016/j.ctim.2014.12.006. Epub 2015 Jan 4.

Authors

Heng Wu¹, Xudong Zhao², Kurt Fritzsche³, Rainer Leonhart⁴, Rainer Schaefert⁵, Xiayuan Sun⁶, Astrid Larisch⁷

Affiliations

¹ Department of Psychosomatic Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
² Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
³ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Freiburg, Germany. Electronic address: kurt.fritzsche@uniklinik-freiburg.de.
⁴ Institute of Psychology, University of Freiburg, Germany.
⁵ Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.
⁶ Department of Psychological Medicine, Peking Union Medical College Hospital, PUMC, Beijing, China.
⁷ Department of Psychosomatics and Psychotherapy, University of Gießen and Marburg GmbH, Gießen, Germany.

PMID: 25637149
DOI: 10.1016/j.ctim.2014.12.006

Abstract

Background: High somatic symptom severity (SSS) is associated with reduced health-related function and may affect doctor-patient interactions. This study aimed to explore the quality of the doctor-patient relationship (DPR) and its association with SSS in Chinese general hospitals outpatients.

Patients and methods: This multicenter cross-sectional study assessed the quality of DPR from both the doctor's and patient's perspective in general outpatients (n=484) from 10 departments of Psychosomatic Medicine (PM), Traditional Chinese Medicine (TCM), and Biomedicine (BM). SSS was assessed with the PHQ-15. The quality of the DPR was measured with the CARE, PDRQ-9, and DDPRQ-10 questionnaires. In addition, several standard instruments were used to assess psychosocial variables such as depression, anxiety, sense of coherence and quality of life.

Results: From the doctor's perspective, patients with high SSS were rated as significantly more difficult than patients with low SSS. No differences were noted from the perspective of the patients. Patients from the TCM department rated the quality of their DPR significantly higher than those in BM and PM and were rated from doctor's perspective as less difficult than those in BM and PM. Multiple regression analysis revealed satisfaction of treatment, time of treatment and psychosocial variables, such as age, health related anxiety, depression, mental quality of life and sense of coherence as predictors for DPR.

Conclusion: PM and BM departments should learn from TCM departments to be empathic, to manage patients with high SSS and to establish long-term relationships with their patients.

Keywords: Doctor–patient relationship; Somatic symptom severity; Somatoform disorders; Traditional Chinese medicine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / psychology*
China
Cross-Sectional Studies
Depression / psychology*
Female
Hospitals, General
Humans
Male
Middle Aged
Outpatients / psychology
Physician-Patient Relations*
Quality of Life / psychology*
Severity of Illness Index