The Effect of Feeling Respected and the Patient Role on Patient Outcomes

Abstract

Despite respect being central to good doctor-patient relationships, little research has investigated the effect of respect from doctors on patient outcomes. Group-level influences such as patients' identification with a traditional or consumerist patient role have also received little attention. We investigated these factors in two studies. Participants imagined they had tinnitus and either identified with one of the two patient roles (Study 1, n = 85) or completed a scale measuring their usual role preferences (Study 2, n = 54). They read a hypothetical respectful or disrespectful doctor-patient scenario and completed measures of personal self-esteem, visit outcomes, and the Illness Perception Questionnaire. Study 1 was experimental, while Study 2 was quasi-experimental in design. In both studies, participants playing a patient whose doctor's behaviours were respectful reported greater patient satisfaction, adherence, and likelihood of revisiting the doctor, and in Study 1 also scored lower on (imagined) illness identity and consequences and reported higher self-esteem. In Study 1, participants acting as traditional patients reported lower self-esteem. In Study 2, participants self-categorising as traditional patients reported greater patient satisfaction, adherence, trust and respect for the doctor, but lower self-esteem. Respect and the patient role should be considered when predicting health outcomes.

Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012–2013 National Cancer Patient Experience Survey

“…In line with past literature [14,20,21], but drawing on a large sample of cancer patients, the findings show that respect for patients not only entails acknowledgement of their autonomy but also, and importantly, sensitivity to their subjective experiences, such as feelings and vulnerabilities, and care and concern for their emotional well-being. Caring/emotionally sensitive behaviours from hospital staff were found to explain more of the variation in reports of respect than autonomy-supportive behaviours and accounted for most of the differences in reports of respect between patient groups.…”

“…Differences in reported respect could be due to some patient groups being treated with less respect, possibly because of less respectful attitudes towards certain patients [24,35] and/or to differences in patient groups' conceptions and expectations of quality care [30]. Some groups may have generally higher expectations of patient-centred care than others [14] but there may also be differences, cultural or otherwise, in the importance attached to certain expressions of respect.…”

“…The medical and bioethics literature often equates respecting patients with respecting their autonomy, although some authors recognise that respecting patients also implies recognising their value as persons more generally by paying attention to their subjective feelings and vulnerabilities [18,19]. Rare studies have indeed indicated that key components of patient respect encompass not only support of autonomy and provision of information but also caring/emotionally supportive behaviours such as empathy, care, recognising individuality, respecting dignity and paying attention to their needs [14,20,21]. Treating someone with dignity likely forms part of treating someone with respect, that is as a worthy human being [22].…”

“…Quigley et al [11] also showed that reports of how often the physician "showed respect" most strongly predicted overall physician ratings. Respect experiences have also been shown to be associated with patient satisfaction, adherence to advice, receipt of optimal preventive care, seeking needed care [12,13], illness perception [14] and trust in healthcare providers [14,15]. Feeling respected is especially pertinent for cancer patients who are vulnerable and tend to experience high psychological stress, including fears regarding their cancer spreading and their future, lack of control, feelings of uncertainty and depression [16][17].…”

Relationship between communication skills training and doctors' perceptions of patient similarity

“…43 Patients who feel respected are more likely to adhere to the doctor's advice and revisit the doctor, perceive themselves as less ill and experience higher self-esteem. 44 No differences were found in terms of perceived patient similarity according to the doctor's gender, place of work or status as practising doctor or medical student. The lack of a difference in perceived patient similarity between hospital doctors and GPs is surprising since hospital doctors reported less CST.…”