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Oguro N, Yajima N, Ishikawa Y, Sakurai N, Hidekawa C, Ichikawa T, Kishida D, Hayashi K, Shidahara K, Miyawaki Y, Yoshimi R, Sada KE, Shimojima Y, Kurita N. Effect of Attending Rheumatologists' Big 5 Personality Traits on Patient Trust in Patients With Systemic Lupus Erythematosus: The TRUMP2-SLE Project. J Rheumatol 2024; 51:168-175. [PMID: 37914212 DOI: 10.3899/jrheum.2023-0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Differences in communication styles based on physicians' personality traits have been identified, particularly in primary care, and these physician-related factors can be important in building patient-physician trust. This study examined the effects of rheumatologists' personality traits on patients' trust in their attending rheumatologists. METHODS This cross-sectional study included adult Japanese patients with systemic lupus erythematosus (SLE) at 5 academic medical centers between June 2020 and August 2021. The exposures were the Big 5 personality traits (ie, extraversion, agreeableness, openness, conscientiousness, and emotional stability) of attending rheumatologists using the Japanese version of the 10-Item Personality Inventory scale (1-7 points each). The outcome was the patients' trust in their attending rheumatologist using the Japanese version of the 5-item Wake Forest Physician Trust Scale (0-100 points). A general linear model was fitted. RESULTS The study included 505 patients with a mean age of 46.8 years; 88.1% were women. Forty-three attending rheumatologists (mean age: 39.6 years; 23.3% female) were identified. After multivariable adjustment, higher extraversion and agreeableness were associated with higher trust (per 1-point increase, 3.76 points [95% CI 1.07-6.45] and 4.49 points [95% CI 1.74-7.24], respectively), and higher conscientiousness was associated with lower trust (per 1-point increase, -2.17 points [95% CI -3.31 to -1.03]). CONCLUSION Whereas higher extraversion and agreeableness of attending rheumatologists led to higher patient trust in their rheumatologist, overly high conscientiousness may lead to lower trust resulting from the physicians' demand of responsibility and adherence to instructions from patients with SLE.
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Affiliation(s)
- Nao Oguro
- N. Oguro, MD, PhD, Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, and Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto
| | - Nobuyuki Yajima
- N. Yajima, MD, PhD, MPH, Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, and Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima
| | - Yuichi Ishikawa
- Y. Ishikawa, MD, The First Department of Internal Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, and Graduate School of Health Innovation, Kanagawa University of Human Services, Yokosuka
| | - Natsuki Sakurai
- N. Sakurai, MD, C. Hidekawa, MD, R. Yoshimi, MD, PhD, Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Chiharu Hidekawa
- N. Sakurai, MD, C. Hidekawa, MD, R. Yoshimi, MD, PhD, Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Takanori Ichikawa
- T. Ichikawa, MD, PhD, Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, and Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Dai Kishida
- D. Kishida, MD, PhD, Y. Shimojima, MD, PhD, Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Keigo Hayashi
- K. Hayashi, MD, PhD, K. Shidahara, MD, PhD, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Kenta Shidahara
- K. Hayashi, MD, PhD, K. Shidahara, MD, PhD, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Yoshia Miyawaki
- Y. Miyawaki, MD, PhD, MPH, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, and Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama
| | - Ryusuke Yoshimi
- N. Sakurai, MD, C. Hidekawa, MD, R. Yoshimi, MD, PhD, Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Ken-Ei Sada
- K. Sada, MD, PhD, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, and Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku
| | - Yasuhiro Shimojima
- D. Kishida, MD, PhD, Y. Shimojima, MD, PhD, Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Noriaki Kurita
- N. Kurita, MD, PhD, Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, and Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan.
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Ichikawa T, Kishida D, Shimojima Y, Yajima N, Oguro N, Yoshimi R, Sakurai N, Hidekawa C, Sada KE, Miyawaki Y, Hayashi K, Shidahara K, Ishikawa Y, Sekijima Y, Kurita N. Impact of online health information-seeking behavior on shared decision-making in patients with systemic lupus erythematosus: The TRUMP 2-SLE project. Lupus 2023; 32:1258-1266. [PMID: 37651318 DOI: 10.1177/09612033231200104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
OBJECTIVE Providing appropriate health information to patients with systemic lupus erythematosus (SLE) is advantageous in the treatment decision-making process. We aimed to investigate how online health information-seeking behaviors affect shared decision-making (SDM) in patients with SLE. METHODS This cross-sectional study included 464 patients with SLE from five institutions. The main exposure was time spent on the internet per day, divided into four categories (none, <1 h, 1- < 2 h, ≥2 h). Participants categorized their preferred first source of health information as physicians, the internet, or other media. The outcome was the degree of SDM measured via the 9-item Shared Decision-Making Questionnaire (SDM-Q-9). A general linear model was applied. RESULTS Compared to no internet use, longer internet use was associated with a higher SDM-Q-9 score: <1 h, 6.9 points (95% confidence interval [CI] 0.32 to 13.6) and ≥2 h, 8.75 points, (95% CI 0.61 to 16.9). The SDM-Q-9 did not differ between the individuals who chose physicians and those who chose the Internet as their preferred first source of health information (-2.1 points, 95% CI -6.7 to 2.6). Individuals who chose other media had significantly lower SDM-Q-9 scores than those who chose physicians (-7.6 points, 95% CI -13.2 to -1.9). CONCLUSIONS The present study suggests that SDM between physicians and patients is positively associated with online information-seeking behavior, with no negative influence associated with accessing the Internet before clinical consultations. Rheumatologists may need to introduce their patients to websites offering high-quality health information to establish a good physician-patient relationship for SDM.
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Affiliation(s)
- Takanori Ichikawa
- Department of Medicine (Neurology and Rheumatology), School of Medicine, Shinshu University, Matsumoto, Japan
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Dai Kishida
- Department of Medicine (Neurology and Rheumatology), School of Medicine, Shinshu University, Matsumoto, Japan
| | - Yasuhiro Shimojima
- Department of Medicine (Neurology and Rheumatology), School of Medicine, Shinshu University, Matsumoto, Japan
| | - Nobuyuki Yajima
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Nao Oguro
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Natsuki Sakurai
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Chiharu Hidekawa
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ken-Ei Sada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
- Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku
| | - Yoshia Miyawaki
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Keigo Hayashi
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kenta Shidahara
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yuichi Ishikawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
- School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan
| | - Yoshiki Sekijima
- Department of Medicine (Neurology and Rheumatology), School of Medicine, Shinshu University, Matsumoto, Japan
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
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Godfrey EM, Fiastro AE, Ruben MR, Young EV, Bennett IM, Jacob-Files E. Patient Perspectives Regarding Clinician Communication During Telemedicine Compared With In-Clinic Abortion. Obstet Gynecol 2023; 141:1139-1153. [PMID: 37141602 PMCID: PMC10440237 DOI: 10.1097/aog.0000000000005192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/02/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To explore patient perspectives regarding patient-clinician communication during telemedicine medication abortion compared with traditional, facility based, in-clinic visits. METHODS We conducted semi-structured interviews with participants who received either live, face-to-face telemedicine or in-clinic medication abortion from a large, reproductive health care facility in Washington State. Using Miller's conceptual framework for patient-doctor communication in telemedicine settings, we developed questions exploring participants' experiences of the medication abortion consultation, including the clinician's verbal and nonverbal interpersonal approach and communication of relevant medical information, and the setting where care was received. We used inductive-deductive constant comparative analysis to identify major themes. We summarize patient perspectives using patient-clinician communication terms outlined in Dennis' quality abortion care indicator list. RESULTS Thirty participants completed interviews (aged 20-38 years), 20 of whom had medication abortion by telemedicine and 10 who received in-clinic services. Participants who received telemedicine abortion services reported high-quality patient-clinician communication, which came from their freedom to choose their consultation location, and reported feeling more relaxed during clinical encounters. In contrast, most in-clinic participants portrayed their consultations as lengthy, chaotic, and lacking comfort. In all other domains, both telemedicine and in-clinic participants reported similar levels of interpersonal connection to their clinicians. Both groups appreciated medical information about how to take the abortion pills and relied heavily on clinic-based printed materials and independent online resources to answer questions during the at-home termination process. Both telemedicine and in-clinic participant groups were highly satisfied with their care. CONCLUSION Patient-centered communication skills used by clinicians during facility based, in-clinic care translated well to the telemedicine setting. However, we found that patients who received medication abortion through telemedicine favorably ranked their patient-clinician communication overall as compared with those in traditional, in-clinic settings. In this way, telemedicine abortion appears to be a beneficial patient-centered approach to this critical reproductive health service.
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Affiliation(s)
- Emily M Godfrey
- Departments of Family Medicine and Obstetrics and Gynecology, University of Washington School of Medicine, and the University of Washington School of Medicine, Seattle, Washington
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Kurita N, Oguro N, Miyawaki Y, Hidekawa C, Sakurai N, Ichikawa T, Ishikawa Y, Hayashi K, Shidahara K, Kishida D, Yoshimi R, Sada KE, Shimojima Y, Yajima N. Trust in the attending rheumatologist, health-related hope, and medication adherence among Japanese systemic lupus erythematosus patients. Rheumatology (Oxford) 2022:6747186. [PMID: 36190334 DOI: 10.1093/rheumatology/keac565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/01/2022] [Accepted: 09/20/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Poor medication adherence among patients with systemic lupus erythematosus (SLE) is a critical problem associated with adverse outcomes. This study examined the relationship between trust in one's physician and goal-oriented thinking, hope, and medication adherence among Japanese patients with SLE who were ethnically matched to their physicians. METHODS This cross-sectional study was conducted in the rheumatology outpatient clinics at five academic centres. Patients with SLE who were prescribed oral medications were included. The main exposure was trust in one's physician measured via the 5-item Japanese version of the Wake Forest Physician Trust Scale and the 18-item Health-related Hope Scale, with each score ranging from 0 to 100 points. Medication adherence was measured using the 12-item Medication Adherence Scale with scores ranging from 5 to 60 points. A general linear model was created after adjusting for demographics, socioeconomic status, disease activity, disease duration, basic health literacy, depression, medication variables, experiencing adverse effects, and concerns regarding lupus medications. RESULTS Altogether, 373 patients with SLE were included. The mean age of the patients was 46.4 years; among them, 329 (88.2%) were women. Both trust in one's physician (per 10-point increase: 0.88, 95% confidence interval [95% CI]: 0.53-1.24) and the Health-related Hope score (per 10-point increase: 0.64, 95% CI: 0.33-0.95) were associated with better medication adherence. CONCLUSION This study demonstrated that patients' health-related hope and trust in their rheumatologist were both associated with better medication adherence in SLE.
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Affiliation(s)
- Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.,Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
| | - Nao Oguro
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.,Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshia Miyawaki
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Chiharu Hidekawa
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Natsuki Sakurai
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takanori Ichikawa
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan.,Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuichi Ishikawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health.,Graduate School of Health Innovation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Keigo Hayashi
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenta Shidahara
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Dai Kishida
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ken-Ei Sada
- Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku
| | - Yasuhiro Shimojima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Nobuyuki Yajima
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Kyoto, Japan
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Studenic P, Radner H. Back to Basics: Prioritizing Communication as a Key Instrument in Managing Rheumatoid Arthritis. J Rheumatol 2021; 49:123-125. [PMID: 34599049 DOI: 10.3899/jrheum.210984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patients with rheumatoid arthritis (RA) have come to experience a tremendous increase in therapeutic options with disease-modifying antirheumatic drugs (DMARDs).1 After decades of dissatisfying drug therapy results with conventional synthetic DMARDs (csDMARDs) only, the introduction of the first tumor necrosis factor inhibitors in the late 1990s has revolutionized RA treatment.2.
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Affiliation(s)
- Paul Studenic
- This work was supported through the FOREUM research fellowship grant. P. Studenic, MD, PhD, Karolinska Institutet, Department of Medicine (Solna), Division of Rheumatology, Stockholm, Sweden, and Medical University of Vienna, Department of Medicine 3, Division of Rheumatology, Vienna, Austria; H. Radner, Associate Professor, MD, Medical University of Vienna, Department of Medicine , Division of Rheumatology, Vienna, Austria. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. P. Studenic, Karolinska Institutet, Department of Medicine (Solna), Division of Rheumatology, D2:01, Karolinska Universitetssjukhuset, 171 76 Stockholm, Sweden.
| | - Helga Radner
- This work was supported through the FOREUM research fellowship grant. P. Studenic, MD, PhD, Karolinska Institutet, Department of Medicine (Solna), Division of Rheumatology, Stockholm, Sweden, and Medical University of Vienna, Department of Medicine 3, Division of Rheumatology, Vienna, Austria; H. Radner, Associate Professor, MD, Medical University of Vienna, Department of Medicine , Division of Rheumatology, Vienna, Austria. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. P. Studenic, Karolinska Institutet, Department of Medicine (Solna), Division of Rheumatology, D2:01, Karolinska Universitetssjukhuset, 171 76 Stockholm, Sweden.
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