The doctor-patient relationship in general practice. How quality of communication, trust, and epistemological beliefs about medicine affect satisfaction after medical consultation. 17th Biennial European Meeting of the Society for Medical Decision Making Leiden, the Netherlands, June 10-12, 2018

Purpose: analyze: generalized (GR) and dyadic reciprocity (DR) of quality of communication and trust in doctor-patient relations; the associations among patients’ quality of communication, trust, epistemological beliefs and satisfaction. Method(s): Participants were 11 GPs (Mage = 54.16, SD = 12.28, 7 men) and their 149 patients (Mage = 47.48, SD = 9.88, 62.4% women; doctor-patients range 1-30, M = 14, SD = 9.3). After a consultation, doctors and patients independently completed questionnaires on quality of communication (Campbell et al., 2007) and trust (Dugan et al., 2005). Patients completed a questionnaire on their epistemological beliefs about medicine (Kienhues & Bromme, 2012) and satisfaction. Result(s): MLM modelling provided estimation of reciprocity (quality of communication: BGR = .17, SE = .07, Z = 2.31*, BDR = -.78, SE = .15, Z = -5.25***; trust: BGR = .15, SE = .05, Z = 2.51*, BDR = -.65, SE = .12, Z = -4.27***). Hierarchical regression analysis [F(7 141) = 41.32, p < .0001, R2adj. = .66, Step 2] showed that doctor’s years of experience, t = -2.11*, B = -.11, quality of communication skills, t = 2.32*, B = .16, and trust, t = 9.55***, B = .68, were associated with patients’ satisfaction after the visit (controlling for patients’ age, gender, general health, and number of visits). Test of simple mediation yielded significant effects of: a) stability of epistemological beliefs on patients’ trust in doctor, b = .38* (SE = .16); b) patients’ trust in doctor on satisfaction, b = .62*** (SE = .09). Indirect effect of stability of beliefs on satisfaction did not reach the significance. Conclusion(s): Estimation of the generalized reciprocity showed that a physician who perceives high quality of relation/trust tends to have patients who perceive high quality of relation too. As dyadic reciprocity, if a physician perceives high quality of relation/trust with a particular patient (more than with other patients), that patient perceives low quality of relation with that physician (more than the physician’s other patients). Regression and mediation analyses suggested that the patients’ evaluation of quality of communi