title: Factors affecting the physician-patient relationship of older veterans with inadequate health literacy: an observational study.
abstract: BACKGROUND
  In Taiwan, older veterans typically match the characteristics of a high prevalence of inadequate health literacy, which is a major barrier to effective communication in delivering proper health care. A good physician-patient relationship increases patients' trust and willingness to communicate, so an awareness of the factors that influence this relationship could improve it over time and enhance patients' health.
  
  
  OBJECTIVE
  To explore factors related to the physician-patient relationship among older veterans with inadequate health literacy in Taiwan.
  
  
  METHODS
  Observational study in veterans' homes.
  
  
  METHODS
  Data were collected using self-report questionnaires in face-to-face interviews. Patients with a Test of Functional Health Literacy in Adults score <60 (defined as inadequate health literacy) were recruited. Demographic characteristics, the Geriatric Depression Scale-Short Form, Multidimensional Health Locus of Control, and Perceived Involvement in Care Scales were used to identify related factors. Multiple regression and bootstrapping were used for data analyses.
  
  
  RESULTS
  A total of 256 older individuals were defined as having inadequate health literacy. Patients' perceived involvement in health care partially mediated the relationship between Health Locus of Control and the physician-patient relationship. Perceived Involvement in Care, depression score, and Health Locus of Control were predictors of the physician-patient relationship.
  
  
  CONCLUSIONS
  Older patients with inadequate health literacy had difficulty becoming actively involved in health care. The GP is in an ideal position to become a key person in helping such patients become involved in health care, and appropriately treating their depression may improve the physician-patient relationship.
authors: Graduate Institute of Medical Sciences, National Defense Medical Center; Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan.
authors: Chun-Yu
authors: CY
authors: Liang
authors: Kwua-Yun
authors: KY
authors: Wang
authors: Shinn-Jang
authors: SJ
authors: Hwang
authors: Kuan-Chia
authors: KC
authors: Lin
authors: Hsueh-Hsing
authors: HH
authors: Pan
mesh_terms: D000369:Aged, 80 and over; D001294:Attitude to Health; D003863:Depression / Q000453:epidemiology*; D005260:Female; D058006:General Practice / Q000458:organization & administration; D057220:Health Literacy / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014728:Veterans
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