Advertisement

Community Mental Health Journal

, Volume 55, Issue 3, pp 548–552 | Cite as

Attitudes Toward Patient-Centered Care in the Mental Care Services in Isfahan, Iran

  • Mohammadali Akkafi
  • Haniye Sadat SajadiEmail author
  • Zainab Sadat Sajadi
  • Edward Krupat
Original Paper

Abstract

Understanding patient–physician relationships in mental care services is an indispensable element to improve the quality of mental care, yet little is known about it in Iran. This study measured the attitudes of the patients’ family and personal caregivers (FPCs) and psychiatrists toward patient-centered care. A sample of 88 FPCs of mental patients and 29 psychiatrists in four teaching hospitals of Isfahan city, Iran, providing mental care, were asked to complete the patient-practitioner orientation scale (PPOS). Results showed mean scores of PPOS, sharing and caring for the psychiatrists were 3.4, 3.8, and 3.1, compared to 3.9, 4.2, and 3.7 for the mental patients’ FPCs. There was a significant difference between the PPOS mean scores of the FPC and psychiatrist groups (p < 0.05) indicating that psychiatrists’ attitudes were less patient-centered. Developing medical training interventions, establishing communication skills workshops, and increasing patients’ awareness are some approaches to address the low level of patient-centered care.

Keywords

Patients’ attitudes Patient-centered care Mental patients Psychiatrists Hospital 

Notes

Funding

This study was funded by Isfahan University of Medical Sciences (293009).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Abiola, T., Udofia, O., & Abdullahi, A. (2014). Patient–doctor relationship: The practice orientation of doctors in Kano. Nigerian Journal of Clinical Practice, 17(2), 241–247.CrossRefGoogle Scholar
  2. Ahmad, W., Krupat, E., Asma, Y., Attique, R., Mahmood, U., & Waqas, A. (2015). Attitudes of medical students in Lahore, Pakistan towards the doctor–patient relationship. PeerJ, 3, e1050.CrossRefGoogle Scholar
  3. Asemani, O. (2012). A review of the models of physician-patient relationship and its challenges. Iranian Journal of Medical Ethics and History of Medicine, 5(4), 36–50.Google Scholar
  4. Benjamin, R. M. (2010). Improving health by improving health literacy. Public Health Reports, 125(6), 784.CrossRefGoogle Scholar
  5. Chan, C., & Azman, W. (2012). Attitudes and role orientations on doctor-patient fit and patient satisfaction in cancer care. Singapore Medical Journal, 53(1), 52.Google Scholar
  6. Cochran, W. G. (2007). Sampling techniques. Hoboken: John Wiley & Sons.Google Scholar
  7. Cvengros, J. A., Christensen, A. J., Hillis, S. L., & Rosenthal, G. E. (2007). Patient and physician attitudes in the health care context: Attitudinal symmetry predicts patient satisfaction and adherence. Annals of Behavioral Medicine, 33(3), 262–268.CrossRefGoogle Scholar
  8. Epstein, R. M., Franks, P., Fiscella, K., Shields, C. G., Meldrum, S. C., Kravitz, R. L., & Duberstein, P. R. (2005). Measuring patient-centered communication in patient–physician consultations: Theoretical and practical issues. Social Science & Medicine, 61(7), 1516–1528.CrossRefGoogle Scholar
  9. Falahian, M., Azhari, S., Amiri, Z., & Bina, M. (2000). Approach to physician–patient communication in teaching hospital in Tehran in 1999. Hakim Health System Research Journal, 3(3), 199–206.Google Scholar
  10. Hellin, T. (2002). The physician–patient relationship: Recent developments and changes. Haemophilia, 8(3), 450–454.CrossRefGoogle Scholar
  11. Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: Developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, 46(7), 714–734.CrossRefGoogle Scholar
  12. Hur, Y., Kim, S., Park, J. H., Cho, A.-R., & Choi, C. J. (2014). Changes in medical students’ patient-centeredness attitudes by implementation of clinical performance examination. Korean Journal of Medical Education, 26(2), 99–106.CrossRefGoogle Scholar
  13. Kalateh, S. A., & Bagheri, L. K. (2014). A proposed model about physician-patient interaction according to islamic concepts. Sadra Medical Sciences Journal, 2(3), 315–332.Google Scholar
  14. Kim, M. J. (2013). Differences in attitude toward patient-centeredness in patients and physicians. Korean Journal of Medical Education, 25(2), 149–156.CrossRefGoogle Scholar
  15. Koudriavtseva, T., Onesti, E., Pestalozza, I. F., Sperduti, I., & Jandolo, B. (2012). The importance of physician–patient relationship for improvement of adherence to long-term therapy: Data of survey in a cohort of multiple sclerosis patients with mild and moderate disability. Neurological Sciences, 33(3), 575–584.CrossRefGoogle Scholar
  16. Krupat, E., Bell, R. A., Kravitz, R. L., Thom, D., & Azari, R. (2001). When physicians and patients think alike: Patient-centered beliefs and their impact on satisfaction and trust. Journal of Family Practice, 50(12), 1057–1063.Google Scholar
  17. Krupat, E., Rosenkranz, S. L., Yeager, C. M., Barnard, K., Putnam, S. M., & Inui, T. S. (2000). The practice orientations of physicians and patients: The effect of doctor–patient congruence on satisfaction. Patient Education and Counseling, 39(1), 49–59.CrossRefGoogle Scholar
  18. Madhan, B., Rajpurohit, A. S., & Gayathri, H. (2011). Attitudes of postgraduate orthodontic students in India towards patient-centered care. Journal of Dental Education, 75(1), 107–114.Google Scholar
  19. McCormack, L. A., Treiman, K., Rupert, D., Williams-Piehota, P., Nadler, E., Arora, N. K., & Street, R. L. (2011). Measuring patient-centered communication in cancer care: A literature review and the development of a systematic approach. Social Science & Medicine, 72(7), 1085–1095.CrossRefGoogle Scholar
  20. Mirzazadeh, A., Shahi, F., Jafari, S., Krupat, E., & Jahanian, E. (2010). Comparative study of opinions of patients and clinical faculty members of Babol University of medical sciences on patient-centeredness in doctor-patient relationship using patient-practitioner orientation scale. Journal of Babol University of Medical Sciences, 12(5), 19–25.Google Scholar
  21. Moore, M. (2008). What does patient-centred communication mean in Nepal? Medical Education, 42(1), 18–26.CrossRefGoogle Scholar
  22. Moore, M. (2009). What do Nepalese medical students and doctors think about patient-centred communication? Patient Education and Counseling, 76(1), 38–43.CrossRefGoogle Scholar
  23. Mudiyanse, R. M., Pallegama, R. W., Jayalath, T., Dharmaratne, S., & Krupat, E. (2015). Translation and validation of patient-practitioner orientation scale in Sri Lanka. Education for Health, 28(1), 35.CrossRefGoogle Scholar
  24. Noorbala, A. A., Faghihzadeh, S., Kamali, K., Bagheri Yazdi, S. A., Hajebi, A., Mousavi, M. T., Akhondzadeh, S., Faghihzadeh, E., & Nouri, B. (2015). Mental health survey of the adult population of Iran in 2015. Archives of Iranian Medicine, 20(3), 128–134.Google Scholar
  25. Pereira, C. M., Amaral, C. F., Ribeiro, M. M., Paro, H. B., Pinto, R. M., Reis, L. E., Silva, C. H., & Krupat, E. (2013). Cross-cultural validation of the Patient–Practitioner Orientation Scale (PPOS). Patient Education and Counseling, 91(1), 37–43.CrossRefGoogle Scholar
  26. Rao, J. K., Weinberger, M., & Kroenke, K. (2000). Visit-specific expectations and patient-centered outcomes: A literature review. Archives of Family Medicine, 9(10), 1148.CrossRefGoogle Scholar
  27. Rathert, C., & May, D. R. (2007). Health care work environments, employee satisfaction, and patient safety: Care provider perspectives. Health Care Management Review, 32(1), 2–11.CrossRefGoogle Scholar
  28. Ross, E. F., & Haidet, P. (2011). Attitudes of physical therapy students toward patient-centered care, before and after a course in psychosocial aspects of care. Patient Education and Counseling, 85(3), 529–532.CrossRefGoogle Scholar
  29. Sadat Akhavi, M. (2011). The legal nature of the physician-patient relationship and its causes. Medical Ethics, 5(18), 11–40.Google Scholar
  30. Saul, J. R., Holder, S. M., & Lokey, J. S. (2018). Employing the patient-centered collaborative care approach: A case study of complex geriatric patient with psychopathalogy of treatment resistant depression and primary hyperparathyroidism. Journal of Mental Health and Aging, 2(1), 18–23.Google Scholar
  31. Shaw, W. S., Woiszwillo, M. J., & Krupt, E. (2012). Further validation of the Patient-Practitioner Orientation Scale (PPOS) from recorded visits for back pain. Patient Education and Counseling, 89(2), 288–291.CrossRefGoogle Scholar
  32. Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient education and counseling, 74(3), 295–301.CrossRefGoogle Scholar
  33. Thom, D. H., Kravitz, R. L., Bell, R. A., Krupat, E., & Azari, R. (2002). Patient trust in the physician: Relationship to patient requests. Family practice, 19(5), 476–483.CrossRefGoogle Scholar
  34. Tsimtsiou, Z., Kirana, P.-S., & Hatzichristou, D. (2014). Determinants of patients’ attitudes toward patient-centered care: A cross-sectional study in Greece. Patient Education and Counseling, 97(3), 391–395.CrossRefGoogle Scholar
  35. Vahidi, R., Kaffashi, S., Narimani, M., Sadeghifar, J., Raadabadi, M., Nazari, A., & Heidari, M. (2013). Correlation between knowledge and satisfaction of patients from patient–physician relationship. Journal of Health Promotion Management, 2(3), 66–73.Google Scholar
  36. Wang, J., Zou, R., Fu, H., Qian, H., Yan, Y., & Wanf, F. (2017). Measuring the preference towards patient-centred communication with the Chinese-revised Patient–Practitioner Orientation Scale: A cross-sectional study among physicians and patients in clinical settings in Shanghai, China. British Medical Journal Open, 7, e016902.Google Scholar
  37. Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: A narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65(5), 405–415.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Farabi Teaching HospitalIsfahan University of Medical SciencesIsfahanIran
  2. 2.National Institute for Health ResearchTehran University of Medical SciencesTehranIran
  3. 3.Harvard Medical SchoolBostonUSA

Personalised recommendations