Rheumatology care: Involvement in medical decisions, received information, satisfaction with care, and unmet health care needs in patients with rheumatoid arthritis and ankylosing spondylitis.
OBJECTIVE
To examine levels of received information, involvement in medical decisions, and satisfaction with care, to explore factors related to current involvement in medical decisions, and to assess patients' unmet health care needs related to their disease.


METHODS
A total of 1,193 patients with rheumatoid arthritis and ankylosing spondylitis completed self-reported health status questionnaires, including registration of sociodemographic data and questions about rheumatology care. Separate questions addressed information received, involvement in decisions, and satisfaction with care. Aspects of unmet health were assessed by an open-ended question.


RESULTS
The majority of patients reported medium to high levels of received information, involvement in medical decisions, and satisfaction with care. High involvement in medical decisions was univariately associated with high levels of perceived information and satisfaction, as well as with lower age and a good health status. In the multivariate analyses, patient satisfaction (odds ratio [OR] 4.21) and a high level of received information (OR 7.85), age (OR 0.99), and >12 years of formal education (OR 1.46) remained as significant predictors to current involvement. Nearly one-third reported a variety of unmet health care needs, and this report was associated with poor health.


CONCLUSIONS
The results indicate a need for a more flexible and patient centered care model, in which patients to a larger degree can decide which services they need and how these services should be delivered.
Kjeken
Ingvild
I
National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, boks 23 Vinderen, 0319 Oslo, Norway. ingvild.kjeken@nrrk.no
Dagfinrud
Hanne
H
Mowinckel
Petter
P
Uhlig
Till
T
Kvien
Tore K
TK
Finset
Arnstein
A
D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation*; D003657:Decision Making; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010358:Patient Participation; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012219:Rheumatology / Q000379:methods; D013167:Spondylitis, Ankylosing / Q000523:psychology / Q000534:rehabilitation*