Understanding physician caring behaviors in the physician -patient -family caregiver relationship

• Main Author: Andrade, Maruza C. M. de
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2005
• Subjects: Caregivers; Gerontology; Health care; Health care management; Physician patient relationships; Public health; Studies
• ISBN: 9780542273056; 0542273055

Physician caring behaviors, the medical management of patients with dementia, and the triadic relationship have been broadly discussed in the literature, but research on dementia care and caring has been limited. This dissertation carried out three qualitative interview studies and a cross-sectional mail survey to investigate physician caring and noncaring behaviors toward patients with dementia and family caregivers during medical visits in the medical office in the context of the triadic relationship, the most important physician caring behaviors, perceptions of feelings, some aspects of the medical care, and predictors of the frequency of physician caring behaviors. Twenty physicians, 15 family caregivers, and 9 patients with dementia participated in the qualitative studies and 71 family caregivers participated in the survey. Kendall's tau b rank correlation, Wilcoxon rank sum test, baseline-category, adjacent-category and binary logistic analyses were used. The level of statistical significance was set at p < .10. The categories of physician caring behaviors identified in the content analysis were connecting, showing respect and integrity, knowing, and providing for the needs. Physician noncaring behaviors were mostly related to not attending to the needs, disrespect, and disconnection of the physician. Descriptions of good feelings were associated with positive perceptions about the triadic relationship. Descriptions of negative feelings were mostly associated with disrespect of the physician. Listening was the most frequently identified as the most important physician caring behavior. The majority of patients had had the first evaluation for memory problems two or more years prior to this study, had two or more physicians over the course of the illness, had seen current physicians for two or more years, and had family caregivers who were always present in the medical visits. Positive associations between satisfaction with the medical care and perceptions of physician caring behaviors were identified. Findings suggest that family caregivers who were women, less educated, younger, religious, and whose relatives had seen fewer physicians over the course of the illness and had longer relationships with current physicians were more likely to perceive physician behaviors as more frequently caring. Implications for research, professional practice, education, and policy are discussed.