AIM： To investigate and test a causal model derivedfrom previous meta-analytic data of health provider be-haviors and patient satisfaction.METHODS： A literature search was conducted forrelevant manuscripts that met ...AIM： To investigate and test a causal model derivedfrom previous meta-analytic data of health provider be-haviors and patient satisfaction.METHODS： A literature search was conducted forrelevant manuscripts that met the following criteria：Reported an analysis of provider-patient interaction inthe context of an oncology interview; the study hadto measure at least two of the variables of interest tothe model （provider activity, provider patient-centeredcommunication, provider facilitative communication,patient activity, patient involvement, and patient satis-faction or reduced anxiety）; and the information had tobe reported in a manner that permitted the calculationof a zero-order correlation between at least two of thevariables under consideration. Data were transformedinto correlation coefficients and compiled to producethe correlation matrix used for data analysis. The test of the causal model is a comparison of the expected correlation matrix generated using an Ordinary Least Squares method of estimation. The expected matrix iscompared to the actual matrix of zero order correlation coeffcients. A model is considered a possible ft if the level of deviation is less than expected due to random sampling error as measured by a chi-square statistic. The signifcance of the path coeffcients was tested us-ing a z test. Lastly, the Sobel test provides a test of the level of mediation provided by a variable and provides an estimate of the level of mediation for each connec-tion. Such a test is warranted in models with multiple paths.RESULTS： A test of the original model indicated a lack of ft with the summary data. The largest discrepancy in the model was between the patient satisfaction and the provider patient-centered utterances. The observed correlation was far larger than expected given a medi-ated relationship. The test of a modifed model was un-dertaken to determine possible ft. The corrected model provides a fit to within tolerance as evaluated by the test statistic, χ2 （8, average n = 342） = 10.22. Each of the path coefficients for the model reveals that each one can be considered signifcant, P 〈 0.05. The Sobel test examining the impact of the mediating variables demonstrated that patient involvement is a signifcantmediator in the model, Sobel statistic = 3.56, P 〈 0.05. Patient active was also demonstrated to be a signifcant mediator in the model, Sobel statistic = 4.21, P 〈 0.05. The statistics indicate that patient behavior mediates the relationship between provider behavior and patient satisfaction with the interaction.CONCLUSION： The results demonstrate empirical support for the importance of patient-centered care and satisfy the need for empirical casual support of provider-patient behaviors on health outcomes.展开更多
文摘AIM： To investigate and test a causal model derivedfrom previous meta-analytic data of health provider be-haviors and patient satisfaction.METHODS： A literature search was conducted forrelevant manuscripts that met the following criteria：Reported an analysis of provider-patient interaction inthe context of an oncology interview; the study hadto measure at least two of the variables of interest tothe model （provider activity, provider patient-centeredcommunication, provider facilitative communication,patient activity, patient involvement, and patient satis-faction or reduced anxiety）; and the information had tobe reported in a manner that permitted the calculationof a zero-order correlation between at least two of thevariables under consideration. Data were transformedinto correlation coefficients and compiled to producethe correlation matrix used for data analysis. The test of the causal model is a comparison of the expected correlation matrix generated using an Ordinary Least Squares method of estimation. The expected matrix iscompared to the actual matrix of zero order correlation coeffcients. A model is considered a possible ft if the level of deviation is less than expected due to random sampling error as measured by a chi-square statistic. The signifcance of the path coeffcients was tested us-ing a z test. Lastly, the Sobel test provides a test of the level of mediation provided by a variable and provides an estimate of the level of mediation for each connec-tion. Such a test is warranted in models with multiple paths.RESULTS： A test of the original model indicated a lack of ft with the summary data. The largest discrepancy in the model was between the patient satisfaction and the provider patient-centered utterances. The observed correlation was far larger than expected given a medi-ated relationship. The test of a modifed model was un-dertaken to determine possible ft. The corrected model provides a fit to within tolerance as evaluated by the test statistic, χ2 （8, average n = 342） = 10.22. Each of the path coefficients for the model reveals that each one can be considered signifcant, P 〈 0.05. The Sobel test examining the impact of the mediating variables demonstrated that patient involvement is a signifcantmediator in the model, Sobel statistic = 3.56, P 〈 0.05. Patient active was also demonstrated to be a signifcant mediator in the model, Sobel statistic = 4.21, P 〈 0.05. The statistics indicate that patient behavior mediates the relationship between provider behavior and patient satisfaction with the interaction.CONCLUSION： The results demonstrate empirical support for the importance of patient-centered care and satisfy the need for empirical casual support of provider-patient behaviors on health outcomes.
