Physician-patient communication affects patient satisfaction in treatment decision-making: a structural equation modelling analysis of a web-based survey in patients with ulcerative colitis

Abstract

Background: The relationship of bidirectional sharing of information between physicians and patients to patient satisfaction with treatment decision-making for ulcerative colitis (UC) has not been examined. Here, we conducted a web-based survey to evaluate this relationship.

Methods: Patients aged ≥ 20 years with UC were recruited from the IBD Patient Panel and Japanese IBD Patient Association. Patients completed our web-based survey between 11 May and 1 June 2020. The main outcomes were patient satisfaction (assessed by the Decision Regret Scale) and patient trust in physicians (assessed by the Trust in Physician Scale).

Results: In this study (n = 457), a structural equation modelling analysis showed that physician-to-patient and patient-to-physician information significantly affected patient satisfaction with treatment decision-making (standardised path coefficient: 0.426 and 0.135, respectively) and patient trust in physicians (0.587 and 0.158, respectively). Notably, physician-to-patient information had a greater impact. For patient satisfaction with treatment decision-making and patient trust in physicians, information on "disease" (indirect effect: 0.342 and 0.471, respectively), "treatment" (0.335 and 0.461, respectively), and "endoscopy" (0.295 and 0.407, respectively) was particularly important, and the level of this information was adequate or almost adequate. Patient-to-physician information on "anxiety and distress" (0.116 and 0.136, respectively), "intention and desire for treatment" (0.113 and 0.132, respectively), and "future expectations of life" (0.104 and 0.121, respectively) were also important for patient satisfaction with treatment decision-making and patient trust in physicians, but these concerns were not adequately communicated.

Conclusions: Adequate physician-patient communication, especially physician-to-patient information, enhanced patient satisfaction with treatment decision-making for UC.

Keywords: Patient satisfaction; Physician–patient communication; Ulcerative colitis.

Fig. 1

Physician–patient communication at the time of treatment decision-making. a Physician-to-patient information. b Patient-to-physician information

Fig. 2

Patient satisfaction with treatment decision-making and patient trust in physicians. a DRS. b TIPS. ^aReversal items. DRS Decision Regret Scale, TIPS Trust in Physician Scale

Fig. 3

Path diagram in the structural equation modelling showing the relationship between physician–patient communication, patient satisfaction with treatment decision-making, and patient trust in physicians. The GFI, AGFI, and RMSEA of the path diagram, including patient-background correlated with DRS or TIPS with an absolute correlation coefficient of ≥ 0.2 were 0.908, 0.860, and 0.080, respectively. Values represent standardized path coefficients that indicate the degree of relationship between variables. *p < 0.05. ^aData reversing the five-level rank values of TIPS. AGFI adjusted goodness-of-fit index, DRS Decision Regret Scale, GFI Goodness-of-fit index, PRO2 two-item patient-reported outcomes, RMSEA root mean square error of approximation, TIPS Trust in Physician Scale

Fig. 4

Correlation diagram between indirect effects of individual information items in the structural equation model and the proportions of patients who reported that information was “somewhat inadequate or inadequate” and information was “poorly communicated or never communicated”. Indirect effects were the value multiplied by the standardised path coefficient via the observed variables of information, the latent variables of information, and DRS or TIPS in the structural equation model. The lines show the mean value for each axis. ^aData reversing the five-level rank values of TIPS. DRS Decision Regret Scale, TIPS Trust in Physician Scale