The medical interaction and treatment outcomes for patients with congestive heart failure

Margaret A Charous, Marquette University


The purpose of this research was to develop a theoretically-derived qualifiable model of the doctor-patient relationship and to explore its suitability for assessing process-outcome linkages in health care delivery as measured by health-related quality of life, morale, and medication adherence. Empirical research strongly supports the importance of interpersonal processes including medical behavior as a correlate of effective health care outcomes. However, research in this area has been hampered by a lack of a reliable methodology which can quantify this relationship. A measure used in psychotherapy process research derived from Bordin's micro-theory of change suggested a promising venue for exploration. This research reports the development of a new instrument, the Healthcare Treatment Alliance Scale, as a useful methodological tool. This study was conducted at a heart failure clinic at a medical school teaching hospital. The 48 participants ranged in age from 26 to 75 years with a mean age of 56.2 years. The sample was comprised of approximately 60% females and 40% males. Patients completed questionnaires measuring the doctor-patient relationship, medication adherence, quality of life, morale, and social support and stress. This was a descriptive, exploratory study; data were collected at one point in time. The research results demonstrated statistically significant correlations between the doctor-patient relationship and health-related quality of life and morale. In a regression analysis controlling for the effects of illness severity, age, and gender, the doctor-patient relationship emerged as a significant predictor of health-related quality of life. The research results did not substantiate the hypothesis that a positive relationship with the physician was associated with higher compliance. The highly skewed research population was most likely the greatest source of difficulty for testing this hypothesis. A possibly important and unanticipated finding was that stress demonstrated a significant inverse relationship to morale, health-related quality of life, mental health and well-being. Social support did not correlate with outcome measures. These research results suggest the healthcare Treatment Alliance Scale as a useful tool to measure the doctor-patient relationship. These results should be considered preliminary to future research and not as definitive conclusions.

Recommended Citation

Charous, Margaret A, "The medical interaction and treatment outcomes for patients with congestive heart failure" (1997). Dissertations (1962 - 2010) Access via Proquest Digital Dissertations. AAI9811381.