Factors affecting the physician-patient relationship of older veterans with inadequate health literacy: an observational study.

Abstract

BACKGROUND: In Taiwan, older veterans typically match the characteristics of a high prevalence of inadequate health literacy, which is a major barrier to effective communication in delivering proper health care. A good physician-patient relationship increases patients' trust and willingness to communicate, so an awareness of the factors that influence this relationship could improve it over time and enhance patients' health. AIM: To explore factors related to the physician-patient relationship among older veterans with inadequate health literacy in Taiwan. DESIGN AND SETTING: Observational study in veterans' homes. METHOD: Data were collected using self-report questionnaires in face-to-face interviews. Patients with a Test of Functional Health Literacy in Adults score <60 (defined as inadequate health literacy) were recruited. Demographic characteristics, the Geriatric Depression Scale-Short Form, Multidimensional Health Locus of Control, and Perceived Involvement in Care Scales were used to identify related factors. Multiple regression and bootstrapping were used for data analyses. RESULTS: A total of 256 older individuals were defined as having inadequate health literacy. Patients' perceived involvement in health care partially mediated the relationship between Health Locus of Control and the physician-patient relationship. Perceived Involvement in Care, depression score, and Health Locus of Control were predictors of the physician-patient relationship. CONCLUSION: Older patients with inadequate health literacy had difficulty becoming actively involved in health care. The GP is in an ideal position to become a key person in helping such patients become involved in health care, and appropriately treating their depression may improve the physician-patient relationship.