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Whose advocacy counts in shaping elderly patients’ satisfaction with physicians’ care and communication?

Authors Kahana B, Yu J, Kahana E, Langendoerfer KB

Received 13 February 2018

Accepted for publication 12 April 2018

Published 25 June 2018 Volume 2018:13 Pages 1161—1168


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker

Boaz Kahana,1 Jiao Yu,2 Eva Kahana,2 Kaitlyn Barnes Langendoerfer2

1Department of Psychology, Cleveland State University, 2Department of Sociology, Case Western Reserve University, Cleveland, OH, USA

Purpose: The purpose of this article was to examine the relative importance of patients’ self-advocacy and perceived physicians’ advocacy for impacting patients’ satisfaction in terms of physician communication and physician–patient relationship. We also examine the influence of physicians’ emotional support and patients’ demographic as well as health characteristics on patients’ satisfaction.
Sample: Our sample includes interviews with 806 community dwelling older adults (mean age =77.82 years, SD=8.41). The sample included residents of a large retirement community in Clearwater, FL, USA. Respondents were also included from representative samples of older adults living in Orlando and Miami, FL, USA, and Cleveland, OH, USA.
Methods and results: Using multiple hierarchical regression analyses, we found that patients’ age and functional limitations were negatively associated with their care satisfaction. When compared with White patients, African-American patients were less satisfied with their physicians while Latino patients expressed greater satisfaction with their medical care. We found limited evidence of patients’ self-advocacy and such advocacy did not serve as a significant predictor of satisfaction with physicians. In contrast, patients’ perception of physicians’ readiness to act as patient advocates was a significant predictor of patients’ satisfaction. Emotional support of physicians was also associated with patients’ satisfaction.
Conclusion: These findings raise questions about consumer empowerment among older adults and underscore their desire for and appreciation of physicians’ advocacy. Findings are discussed in the context of power imbalance between elderly patients and their doctors.

physicians’ emotional support, patient proactivity, patient-centered care, evaluations of medical care, paternalistic model of primary care

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