[Time-limited contacts with psychosomatic-psychotherapeutic ambulatory care. II. Potential determinants of compliance with therapeutic recommendations].
In a detailed analysis of the data from a follow-up study with 125 patients of a psychosomatic outpatient unit, possible determinants of the utilization of therapeutic recommendations (which was seen as an indicator of compliance) have been analysed. The overall compliance-rate in the sample was 49%. Comparisons of the patients who were compliant or noncompliant (61 vs 37) revealed that demographic as well as diagnostic characteristics hardly differentiated between the two groups. The compliance-rate seems to be higher in patients who had been judged as motivated by their therapist during the time of their contacts with the unit. Besides that, the perception of the atmosphere of the contacts as well as the therapeutic alliance during a maximum of three consultations differed between both groups. Patients who were compliant assessed their life quality more positively at the time of the follow up than the other group. In a second step of the analysis, an attempt was made, by means of cluster analyses, to investigate the relationship between the compliance-rates, and the mode of referral as well as diagnostic characteristics on the one, the judgement of qualitative aspects of the consultations on the other hand. The analysis of the first relationship indicated a tendency for noncompliance in older patients and those suffering from addictions, whereas compliance seemed to be high in younger patients who came to the consultation of their own accord. Multivariate analyses further confirmed the significance of the therapeutic alliance for the prediction of compliance-rates and the importance of several other qualitative aspects of the contacts.(ABSTRACT TRUNCATED AT 250 WORDS)
Strauss
B
B
Abteilung Psychotherapie und Psychosomatik, Zentrum Nervenheilkunde Christian-Albrechts-Universität Kiel.
Speidel
H
H
Probst
P
P
Seifert
A
A
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000523:psychology*; D003258:Consumer Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000628:therapy*; D011614:Psychotherapy, Brief