Hyperemesis gravidarum and patient satisfaction: A path model of patients' perceptions of the patient-physician relationship

Abstract

Objective. To examine the relationship between patients' perceptions of the patient-physician relationship and patients' satisfaction with the overall medical care received from their physicians in the treatment of hyperemesis gravidarum (HG).

Methods. This study investigated patients' beliefs and their views of their physicians' beliefs about the causal explanation of HG, the seriousness of the illness, and the impact of the illness upon patients' daily lives. Also examined were the extent to which patients' beliefs were congruent with their perception of their physicians' beliefs, and patients' ratings of the humanistic characteristics of physicians they deemed important. Ninety-six respondents who had experienced at least one hospitalization from January 1993 through April 1997 responded to interview questions focusing on their HG illness experience. Using both quantitative and qualitative methodological approaches, a path model of patient perception factors associated with patient satisfaction was tested.

Results. Perceived shared beliefs about the etiology of HG for a particular patient's illness were more important direct contributing factors of satisfaction than were the specific causal explanations. The length of the patient-physician relationship provided important indirect effects on patient satisfaction; three key mediating variables were patients' perceptions about physician humanism and perceived agreement about the cause and impact of HG. Pertinent qualitative findings are provided as additional sources of information to supplement the quantitative results.

Conclusion. Knowledge of the patient-physician relationship factors that influence HG women's satisfaction can be used to enhance service delivery and may ultimately improve perinatal outcomes.

Keywords:

• Hyperemesis gravidarum
• patient-physician relationship
• patient satisfaction
• path model