title: Provider and patient perspectives regarding health care for war-related health concerns.
abstract: OBJECTIVE
  To gain insight about Department of Defense providers' and health care beneficiaries' opinions regarding provider-patient communication of health care for post-deployment health concerns.
  
  
  METHODS
  Thirty-five Department of Defense primary care providers and 14 military beneficiaries participated in focus groups at five military medical treatment facilities. We audiotaped, transcribed, and qualitatively analyzed semi-structured focus group interviews to determine attitudes and beliefs about war-related health concerns, symptoms, and health care quality.
  
  
  RESULTS
  Focus groups revealed important insights about provider and patient perspectives of communication and care in four general areas: physician-patient trust, validity of symptoms and concerns, exchange of health information, and barriers to care.
  
  
  CONCLUSIONS
  Provider-patient communication contributes to patient satisfaction with medical care; poor communication may contribute to decreased patient satisfaction and provider effectiveness. The military health care system poses several challenges to provider-patient communication: the dual nature of the provider's role, the occupational relationship between illness and health care, pre- and post-deployment issues, and continuity of care impact patient and provider perspectives. The prevalence of various beneficiary and provider concerns regarding health care communication requires further study, particularly for the severely wounded.
  
  
  CONCLUSIONS
  The quality of information exchanged and of the interpersonal relationship impact medical decision making, particularly in occupational health settings such as the military. Attention to these issues may improve patient outcomes including satisfaction, adherence, trust, health status, and quality of life.
authors.affiliation: Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Davis
authors.forename: Charles C
authors.initials: CC
authors.lastname: Engel
authors.forename: Matthew
authors.initials: M
authors.lastname: Mishkind
authors.forename: Ambereen
authors.initials: A
authors.lastname: Jaffer
authors.forename: Terry
authors.initials: T
authors.lastname: Sjoberg
authors.forename: Tim
authors.initials: T
authors.lastname: Tinker
authors.forename: Martin
authors.initials: M
authors.lastname: McGough
authors.forename: Stacia
authors.initials: S
authors.lastname: Tipton
authors.forename: David
authors.initials: D
authors.lastname: Armstrong
authors.forename: Timothy
authors.initials: T
authors.lastname: O'Leary
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003142:Communication; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel / Q000523:psychology*; D020380:Needs Assessment; D010353:Patient Education as Topic; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D035502:Trust; D014481:United States; D014857:Warfare