Patient-centredness in chronic illness: what is it and does it matter?
The evidence as to whether patient-centredness is associated with beneficial physical and psychological outcomes is inconsistent. This review of published research on health care communication in chronic illness investigates whether (i) studies of patient-centred consultations use distinctive concepts, (ii) different concepts are differentially associated with health outcomes. Studies of patients with a chronic illness consulting a health professional were included if they measured health professional-patient interaction and a physical or psychological outcome. Thirty studies were identified, falling into two, reliably distinct, categories. In the first, health professionals took the patient's perspective and in the second, they sought to "activate" the patient. The 10 studies taking the latter approach were more consistently associated with good physical health outcomes than were the 20 studies taking the former approach. The suggestion that different types of patient-centredness have different associations with physical health outcomes should be investigated further in experimental studies.
Michie
Susan
S
Department of Psychology, Centre for Outcomes Research and Effectiveness, University College London, 1-19 Torrington Place, London WC1E 7HB, UK. s.michie@ucl.ac.uk
Miles
Jane
J
Weinman
John
J
D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D003142:Communication; D019317:Evidence-Based Medicine; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D010358:Patient Participation; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D012107:Research Design