Project: Research project

Project Details


The major aim of this study is to examine the impacts of physicians'
interactional styles and patients' perceptions of their disease experiences
on patients' understandings of their treatment plans and compliance with
those plans among chronically ill, middle aged and elderly persons.
Compliance is viewed in this context as one form of illness behavior in
contrast to self-care or self-treatment. The secondary aim is to compare
these relationships between women and men. This research is based on a
conceptual model that combines the perception of the chronic disease
experience, factors in the health belief model that have been found to be
consistent predictors of illness behaviors and aspects of the
physician-patient relationship.

An initial random sample of 2000 non-institutionalized persons aged 45 and
older will be drawn from the active membership of a large health
maintenance organization (HMO) in a midwestern, industrial SMSA and
screened to select those with arthritis, diabetes or hypertension, to yield
a final sample of approximately 800. Such a sample is appropriate for this
study because neither access to nor quality of health care varies by race
or gender in the HMO, a situation not found in the general population.
Although generalizability of results will be somewhat limited by the nature
of the sample, the potentially confounding effects of differential access
to health care are eliminated while access to medical records is assured.

Data will be collected from three sources. Face-to-face interviews with
sample members will provide data on patients' perceptions of physicians'
interactional styles, the chronic disease experience, understanding of and
compliance with treatment plans and self-care behaviors. Clinical
information on these treatment plans and clinical outcomes will be obtained
from medical record reviews. In addition, the respondents' primary care
physicians will be surveyed with self-administered questionnaires, to
assess their own perceptions of their interactional styles.

The joint examination of compliance and self-care and the addition of
physician-patient interactions and the chronic disease experience to the
health belief model are unique features of this study.
Effective start/end date9/1/905/31/94


  • National Institute on Aging


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