In a patient-centered medicine approach, adherence to therapy is determined by several psychosocial factors that affect both the physician and the patient: a good relationship, effective communication, feeling respected by their physician are some of them, especially in primary care. The aim of this longitudinal study was to investigate the relationship between patient communication self-efficacy, physician communication styles, as well as perceived by the patient, mental health (emotional, psychological, and social well-being), mental ill ness and adherence to care. A further aim was to identify gender and educational level differences for the variables considered. Based on a sample of 60 patients aged between 18 and 80, and equally distributed by gender, a Path Analysis was calculated. The results showed a central role for the communicative efficacy of patient adherence and psychological well-being. With regard to the communication style of the doctor, as perceived by the patient, problem solving and respect, and hostility (negatively) affected adherence to therapy. The latter is found to be a protective factor from mental illness. There are no differences by gender and educational level. The results, in addition to providing empirical evidence on the role of self-efficacy to communicate to the well-being of patients in a setting as complex as health care, provide information useful for training aimed at improving the communication skills of general practitioners and patients.
Keywords: Adherence, primary care, well-being, patient, mental illness, communication selfefficacy, mental health.