title: The importance of productive patient-professional interaction for the well-being of chronically ill patients.
abstract: OBJECTIVE
  To investigate patient-professional interactions and identify the association between quality of care, productivity of patient-professional interaction, and chronically ill patients' well-being.
  
  
  METHODS
  Questionnaires were distributed to chronically ill patients [T1 (2011), 2,191/4,693 (47 %) respondents; T2 (2012), 1,722/4,350 (40 %) respondents].
  
  
  RESULTS
  Patients perceived a higher degree of productive interaction with general practitioners compared to other professionals. Bivariate analyses showed that patients' well-being at T2 was positively related to well-being at T1 (r = 0.70), quality of care (r = 0.12), and productive patient-professional interaction (r = 0.31; all p ≤ 0.001). Single status (r = -0.14), low education (r = -0.11), and female gender (r = -0.11; all p ≤ 0.001) were negatively associated with well-being. Multivariate analyses showed that after controlling for background characteristics and well-being at baseline quality of care is associated with patients' well-being at T2 (p ≤ 0.01). When productive patient-professional interactions were entered into the equation, they not only were related to patients' well-being (p ≤ 0.001) but also mediated the relationship between the quality of care and well-being. More productive patient-professional interactions were related to better well-being at T2 (B = 0.11), assuming that all other factors in the model remained constant.
  
  
  CONCLUSIONS
  Productive patient-professional interactions are associated with chronically ill patients' well-being over time and mediate the relationship between well-being and quality of care. Improvement of the quality of chronic care delivery should always be accompanied by investment in the quality of relationships and communication between patients and professionals.
authors.affiliation: Department of Health Policy and Management (iBMG), Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands, cramm@bmg.eur.nl.
authors.forename: Jane Murray
authors.initials: JM
authors.lastname: Cramm
authors.forename: Anna Petra
authors.initials: AP
authors.lastname: Nieboer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult