title: The patient-physician relationship in patients with breast cancer: influence on changes in quality of life after rehabilitation.
abstract: OBJECTIVE
  The objective of this study was to examine whether aspects of the patient-physician relationship for breast cancer patients have an influence on the change in health-related quality of life (HRQOL) after inpatient rehabilitation.
  
  
  METHODS
  N = 329 breast cancer patients undergoing inpatient rehabilitation in Germany were surveyed using questionnaires at the beginning of rehabilitation, end of rehabilitation, and 6 months after rehabilitation. Multiple imputations and multilevel models of change were used in the data analyses.
  
  
  RESULTS
  Even after comprehensive adjustment for sociodemographic, medical, psychological variables, and center effects, aspects of the physician-patient relationship were statistically and clinically relevant predictors of HRQOL after rehabilitation. Satisfaction with physician's care appears to have a rather short-term effect, but the effect of promoting patient participation can still be partially determined 6 months after rehabilitation. Other important predictors of HRQOL improvement are optimism, higher level of education, higher income, living with a partner, and the ability to work.
  
  
  CONCLUSIONS
  By taking into consideration the patient's communication and participation needs, physicians can contribute to an improved HRQOL after rehabilitation. The high predictive power of socioeconomic factors shows that rehabilitation care can be more effective if it accounts for the specific situation of socially disadvantaged individuals.
authors.affiliation: Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Engelbergerstr. 21, 79106, Freiburg, Germany. erik.farin@uniklinik-freiburg.de
authors.forename: Erik
authors.initials: E
authors.lastname: Farin
authors.forename: Michaela
authors.initials: M
authors.lastname: Nagl
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008875:Middle Aged; D055361:Multilevel Analysis; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life; D012044:Regression Analysis; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome