title: Patient-centredness, self-rated health, and patient empowerment: should providers spend more time communicating with their patients?
abstract: OBJECTIVE
  Patient-centred communication is often employed as a strategy for empowering patients. The purpose of this study was to investigate the relationship between a direct measure of patient empowerment, feeling that one is in control of one's own health and patient satisfaction with communication.
  
  
  METHODS
  A cross-sectional survey of family medicine patients was used to test the theory that, in primary care patients, empowerment is related to satisfaction with several aspects of communication after adjusting for health status, age and gender. Interviews were completed with 680 adult patients for whom complete data were available.
  
  
  RESULTS
  Multiple logistic regression analysis revealed that being highly satisfied with overall communication [adjusted odds ratio (AOR)=2.08], explanations (AOR=2.04), listening (AOR=2.63), use of understandable words (AOR=2.41) and involvement in decisions (2.34) were positively associated with empowerment. Self-rated health was more strongly related to empowerment than satisfaction with communication in every model tested (AORs ranged from 2.8 to 3.0).
  
  
  CONCLUSIONS
  Reliance solely on patient-centred communication to promote empowerment may be insufficient as well as costly. Instead, improved one-to-one communication between patients and providers should be reserved for clinically complex and urgent situations. For other health matters, referral of patients to community health promotion and education programmes should be considered because this may offer a lower-cost approach to empowerment.
authors.affiliation: Family Medicine, Mayo Clinic, Rochester, MN 55905, USA. rohrer.james@mayo.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Laurie
authors.initials: L
authors.lastname: Wilshusen
authors.forename: Steven C
authors.initials: SC
authors.lastname: Adamson
authors.forename: Stephen
authors.initials: S
authors.lastname: Merry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D011209:Power, Psychological; D011320:Primary Health Care / Q000458:organization & administration*; D055815:Young Adult