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The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus

D Da Costa, AE Clarke, PL Dobkin, J-L Senecal, PR Fortin, DS Danoff, JM Esdaile
DOI: http://dx.doi.org/10.1093/intqhc/11.3.201 201-207 First published online: 1 June 1999

Abstract

Objective: To examine the effect of physical and mental health status and social support on patient satisfaction with health care in patients with systemic lupus erythrematosus (SLE).

Study design: Using a cross-sectional design, 220 SLE patients were recruited from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patients-completed questionnaires.

Measures: Independent variables included demographics, disease duration, physician-rated indices of disease activity (SLAM-R) and disease damage (SLICC/ACR), patient self-reported health status (SF-36), and perceived social support (ISEL). Patient satisfaction with medical care (PSQ-IV) was the dependent variable.

Analyses: Univariate analyses were performed to describe the sample and examine univariate associations between the independent variables and patients satisfaction with medical care. A hierarchical multiple linear regression analysis was computed to determine the relative importance of physician-rated indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demographic variables.

Results: A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, education, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P<0.01), better self-reported mental (P<0.05) and physical health status (P<0.005) and higher perceived social support (P<0.05) were significant predictors of patient satisfaction (R2=0.15, P<0.0001).

Conclusion: The findings suggest that self-reported physical and mental health status and social support are more important than clinical status variables in understanding patient satisfaction with medical care.

Key words: health status, patient satisfaction, social support