Demonstrating the need for and the validity and reliability of a supportive message quality measure within the patient-clinician context.

Abstract

A growing problem in healthcare is interactions in which patients' symptoms are reportedly invalidated by clinicians. The relational science construct of supportive message quality-or behavior generated to provide aid to others perceived as needing such aid-can be leveraged in the study of invalidation by clinicians, especially for a specific communication interaction. Given a recent call to integrate relational science with clinical communication and the increasing research that situates clinicians as a source of support for patients, the purpose of this study was to test this scale within the novel patient-clinician communication context. Data were derived from a larger project seeking to construct a measure of invalidating communication. For the present study, the sample was randomly divided into two groups for a calibration (exploratory factor analysis; EFA; n = 235) and validation (confirmatory factor analysis; CFA; n = 244) approach. EFA yielded one factor. CFA was conducted for both a first-order one-factor and three-factor model and a second-order three-factor model. The first-order three-factor model was a better fit than the one-factor model and comparable to the second-order three-factor model. Structural equation modeling testing the second-order three-factor model with satisfaction yielded an acceptable model. Internal consistency was excellent. The adaptation of this scale in the patient-clinician context is one way to assess the health outcomes of clinicians' message quality toward patients in the assessment of clinician invalidation. It is a step forward in integrating the clinical communication and relational science literatures and expanding how we theorize clinical communication. Being able to measure supportive message quality in the patient-clinician context can yield novel insights into the physiological mechanisms by which clinicians facilitate or impede patients' overall well-being, such as increased inflammation, which has been demonstrated in the relational science literature and has implications for patients' physical health.