title: Patient satisfaction and alliance as a function of the physician's self-regulation, the physician's stress, and the content of consultation in cancer care.
abstract: To investigate which characteristics of the physician and of the consultation are related to patient satisfaction with communication and working alliance.
  
  
  
  Real-life consultations (N = 134) between patients (n = 134) and their physicians (n = 24) were audiotaped. All of the patients were aware of their cancer diagnosis and consulted their physician to discuss the results of tests (CT scans, magnetic resonance imaging, or tumor markers) and the progression of their cancer. The consultations were transcribed and coded with the "Defense Mechanisms Rating Scale-Clinician." The patients and physicians completed questionnaires about stress, satisfaction, and alliance, and the data were analyzed using robust linear modeling.
  
  
  
  Patient satisfaction with communication and working alliance was high. Both were significantly (negatively) related to the physician's neurotic and action defenses-in particular to the defenses of displacement, self-devaluation, acting out, and hypochondriasis-as well as to the physician's stress level. The content of the consultation was not significantly related to the patient outcomes.
  
  
  
  Our study shows that patient satisfaction with communication and working alliance is not influenced by the content of the consultation but is significantly associated with the physician's self-regulation (defense mechanisms) and stress. The results of this study might contribute to optimizing communication skills training and to improving communication and working alliance in cancer care.
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.|Department of Clinical Psychology, Emgo+ Institute for Health and Care Research, Cancer Center Amsterdam (CCA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
authors.forename: A M M
authors.initials: AMM
authors.lastname: De Vries
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: M M
authors.initials: MM
authors.lastname: Gholamrezaee
authors.affiliation: Department of Clinical Psychology, Emgo+ Institute for Health and Care Research, Cancer Center Amsterdam (CCA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
authors.affiliation: Department of Clinical Psychology, Emgo+ Institute for Health and Care Research, Cancer Center Amsterdam (CCA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Passchier
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: J-N
authors.initials: JN
authors.lastname: Despland
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Stiefel
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: Y
authors.initials: Y
authors.lastname: de Roten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D017009:Professional Autonomy; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013637:Tape Recording
keywords: alliance; cancer; communication; defense mechanisms; oncology; patient satisfaction