An overview of 19 instruments assessing the doctor-patient relationship: different models or concepts are used

Objectives

The doctor-patient relationship has been linked to patient satisfaction, treatment adherence, and treatment outcome. Many different instruments have been developed to assess this relationship. The large variety makes it difficult to compare results of different studies and choose an instrument for future research. This review aims to provide an overview of the existing instruments assessing the doctor-patient relationship.

Study Design and Setting

We performed a systematic search in PubMed, PsychInfo, EMBASE, and Web of Science for questionnaires measuring the doctor-patient relationship. We appraised each instrument ascertaining the questionnaires focused on the doctor-patient relationship. We compared the content and psychometric characteristics of the instruments.

Results

We found 19 instruments assessing the doctor-patient relationship. The instruments assess a variety of dimensions and use diverse conceptual models for the doctor-patient relationship. The instruments found also vary in terms to which they have been psychometrically tested.

Conclusion

We have provided an overview of 19 instruments assessing the doctor-patient relationship. The selection of an instrument for future research should be based on the model or conceptual basis of the doctor-patient relationship that is most applicable to the study objectives and the health care field in which it will be applied.     

Effectiveness of influenza vaccination in preventing influenza in primary care,Navarre, Spain, 2021/22

Compared with individuals unvaccinated in the current and three previous influenza seasons, in 2021/22, influenza vaccine effectiveness at primary care level was 37% (95% CI: 16 to 52) for current season vaccination, regardless of previous doses, and 35% (95% CI: −3 to 45) for only previous seasons vaccination. Against influenza A(H3N2), estimates were 39% (95% CI: 16 to 55) and 24% (95% CI: −8 to 47) suggesting moderate effectiveness of current season vaccination and possible remaining effect of prior vaccinations.     

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06–0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26–0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01–0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59–15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95–0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.