Representations of physician’s role and their impact on compliance

Autori/Curatori Annalisa Venezia, Piergiorgio Mossi, Claudia Venuleo, Giulia Savarese, Sergio Salvatore
Anno di pubblicazione 2019 Fascicolo 2019/2 Lingua Inglese
Numero pagine 22 P. 100-121 Dimensione file 294 KB
DOI 10.3280/PDS2019-002005
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This study deepens the analysis of how the physician’s role is represented in contemporary society and how such a representation affects the patient’s propensity to comply. 468 patients were asked to fill out a questionnaire aimed at detecting the representation of the medical role. The level of compliance was measured by means of a multiple 4-point Likert scale with ques-tions on five aspects: therapy, advice on health, hygienic rules, prohibited behaviours, sugges-tions for a healthy life-style. A procedure combining multiple correspondence analysis and cluster analysis was applied to identify response profiles, corresponding to different represen-tations of the physician’s role. Univariate analysis (ANOVA) was performed to compare clus-ters on compliance levels. Four profiles were identified; the physician is represented in turn as affiliative authority, idealized friend, competent advisor or disappointing opponent. Significant differences were found in the level of compliance characterizing each representation. The find-ings suggest that the knowledge of the ways patients represent their relationship with the phy-sician is a crucial area for a better understanding of the different patient compliance levels.

Lo studio approfondisce l’analisi di come il ruolo medico sia rappresentato nella società contemporanea e come questa rappresentazione influenza la propensione del paziente alla com-pliance. È stato chiesto a 468 pazienti di compilare un questionario volto a rilevare la rappre-sentazione del ruolo del medico. Il livello di compliance è stato misurato tramite una scala Li-kert a 4 punti con domande relative a cinque aspetti: terapia, consigli sulla salute, norme igieni-che, comportamenti vietati, raccomandazioni per uno stile di vita salutare. Una procedura com-binata di analisi delle corrispondenze multiple e analisi dei clusters ha consentito di identificare differenti profili di risposta, corrispondenti a differenti rappresentazioni del ruolo medico. Per confrontare i clusters sui livelli di compliance è stata applicata un’analisi della varianza (ANOVA). Sono stati identificati quattro profili: il medico è rappresentato in termini di autori-tà affiliativa, amico idealizzato, consulente competente o spiacevole avversario. Differenze si-gnificative sono state riscontrate nei livelli di compliance caratterizzanti le diverse rappresenta-zioni. I risultati suggeriscono che la conoscenza dei modi con cui i pazienti rappresentano la loro relazione con il medico è fondamentale per una migliore comprensione dei loro differenti livelli di compliance.

Keywords:Milieu culturale, rappresentazioni del ruolo medico, compliance

  1. McNicholas F. (2012). To adhere or not, and what we can do to help. European Child & Adolescent Psychiatry, 21 (12): 657-663.
  2. Adams J. (2013). Medicalization and the market economy: constructing cosmetic surgery as consumable health care. Sociological Spectrum, 33 (4): 374-389. DOI: 10.1080/02732173.2013.73289
  3. Barksdale D.J. (2009). Provider factors affecting adherence: cultural competency and sensitivity. Ethnicity & disease, 19: S5-3 S5-7.
  4. Benzécri J.P. (1992). Correspondence analysis handbook. New York: Marcel Dekker.
  5. Berger P. and Luckmann T. (1996). The Social Construction of Reality: A Treatise in the Sociology of Knowledge. Doubleday: Anchor books.
  6. Betancourt J.R., Green A.R., Carrillo J.E. and Owusu Ananeh-Firempong I. (2016). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118 (4): 293-302.
  7. Blendon R.J., Hyams T.S. and Benson J.M. (1993). Bridging the gap between expert and public views on health care reform. JAMA, 269 (19): 2573-2578.
  8. Bowen D.J., Helmes A. and Lease E. (2001). Predicting compliance: how are we doing. In Burke L. and Ockene I., editors, Compliance in Healthcare and Research. Armonk, NY: Futura, pp. 25-41.
  9. Brownstein J.S., Freifeld C.C. and Madoff L.C. (2009). Digital disease detection–harnessing the web for public health surveillance. New England Journal of Medicine, 360 (21): 2153-2157.
  10. Carli R. and Salvatore S. (2001). L’immagine della psicologia: una ricerca sulla popolazione del Lazio [The Image of psychology a research on the population of Lazio]. Roma: Kappa.
  11. Ciavolino E., Redd R., Evrinomy A., Falcone M., Fini V., Kadianaki I., Kullasepp K., Mannarini T., Matsopoulos A. and Mossi P. (2017). Views of context. An instrument for the analysis of the cultural milieu. A first validation study. Electronic Journal of Applied Statistical Analysis, 10 (2): 599-628.
  12. Cohen A.B. (2009). Many forms of culture. American Psychologist, 64 (3): 194-204.
  13. Doggrell S.A. (2010). Adherence to medicines in the older-aged with chronic conditions. Drugs & Aging, 27 (3): 239-254. DOI: 10.2165/11532870-000000000-0000
  14. Federman A.D., Cook E.F., Phillips R.S., Puopolo A.L., Haas J.S., Brennan T.A. and Burstin H.R. (2001). Intention to discontinue care among primary care patients: influence of physician behavior and process of care. Journal of General Internal Medicine, 16 (10): 668-674.
  15. Jin J., Sklar G.E., Oh V.M.S. and Li S.C. (2008). Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and Clinical Risk Management, 4 (1): 269-286. DOI: 10.2147/TCRM.S145
  16. Kostev K., Waehlert L., Jockwig A., Jockwig B. and Hadji P. (2014). Physicians’ influence on breast cancer patient compliance. GMS German Medical Science, 12: Doc03. DOI: 10.3205/00018
  17. Lengnick-Hall C.A. (1996). Customer contributions to quality: A different view of the customer-oriented firm. Academy of Management Review, 21 (3): 791-824. DOI: 10.2307/25900
  18. Martin L.R., Williams S.L., Haskard K.B. and DiMatteo M.R. (2005). The challenge of patient adherence. Therapeutics and Clinical Risk Management, 1 (3): 189-199.
  19. McKinlay J.B. and Marceau L.D. (2002). The end of the golden age of doctoring. International Journal of Health Services, 32 (2): 379-416. DOI: 10.2190/JL1D-21BG-PK2N-J0K
  20. Moore P.J., Sickel A.E., Malat J., Williams D., Jackson J. and Adler N.E. (2004). Psychosocial factors in medical and psychological treatment avoidance: the role of the doctor-patient relationship. Journal of Health Psychology, 9 (3): 421-433. DOI: 10.1177/135910530404235
  21. Mossi P. and Salvatore S. (2011). Psychological transition from meaning to sense. European Journal of Education and Psychology, 4 (2): 153-169.
  22. Howarth, C. (2006). A social representation is not a quiet thing: Exploring the critical potential of social representations theory. British Journal of Social Psychology, 45 (1): 65-86. DOI: 10.1348/014466605X4377
  23. Sabaté E. (2003). Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization.
  24. Salvatore S. Fini V., Mannarini T., Valsiner J. and Veltri G.A. (2018). What future for Europe? Symbolic Universes in the time of (post)crisis. New York: Springer Publishing Company.
  25. Schlesinger M. (2002). A loss of faith: the sources of reduced political legitimacy for the American medical profession. The Milbank Quarterly, 80 (2): 185-235.
  26. Valsiner J. (2000). Culture and Human Development. London: Sage.
  27. Venuleo C. (2013). I modelli di valutazione di un servizio Urp espressi dall’utenza di un’azienda sanitaria locale. Un caso studio [the users’ models of evaluating one national health service public-relations department. A case study]. Psicologia della Salute, 3: 29-49. DOI: 10.3280/PDS2013-00300
  28. Venuleo C. and Guacci C. (2014). Lo psicologo di base entro il servizio sanitario. Un caso studio sull’immagine della funzione psicologica e del servizio integrato espressa da pediatri e medici di base [The general psychologist. A case study on the image of the psychologist’s role and integrated primary care service expressed by paediatricians and general practitioners]. Psicologia della Salute, 1: 73-97. DOI: 10.3280/PDS2014-00100
  29. Venuleo C., Mangeli G., Mossi P., Amico A. F., Cozzolino M., Distante A., Ignone G., Savarese G. and Salvatore S. (2018). The Cardiac Rehabilitation Psychodynamic Group Intervention (CR-PGI): an explorative study. Frontiers in Psychology, 9: 1-13.
  30. Venuleo C., Mossi P. and Marinaci T. (2017). Meaning and risk. The role of subjective cultures in the evaluation of hazardous behaviours. Psicologia della Salute, 1: 48-75. DOI: 10.3280/PDS2017-00100
  31. Venuleo C., Salvatore S., Mossi P., Grassi R. and Ruggeri R. (2010). The teaching relationship in a changing world. Outlines for a theory of the reframing setting. European Journal of School Psychology, 5 (2): 151-180.

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Annalisa Venezia, Piergiorgio Mossi, Claudia Venuleo, Giulia Savarese, Sergio Salvatore, Representations of physician’s role and their impact on compliance in "PSICOLOGIA DELLA SALUTE" 2/2019, pp 100-121, DOI: 10.3280/PDS2019-002005