The congruence of patient communication preferences and physician communication behavior in cardiac patients

The purpose of this study was to examine the communication preferences of patients with chronic ischemic heart disease (CIHD) and matching between the preferences and physician communication behavior. Prior to this, psychometric testing was performed on a questionnaire on the perceived communication behavior of the physician (KOVA Questionnaire).

Patients with CIHD undergoing rehabilitation (N = 342) in Germany were questioned. At the beginning of rehabilitation, patients answered questions about their communication preferences (KOPRA Questionnaire), and at the end of rehabilitation, they answered questions regarding the perceived communication behavior of the physician. Preference-matching values were determined by combining the KOPRA and KOVA items.

The KOVA Questionnaire psychometric properties proved to be good. Patients with CIHD indicated clear and open communication and patient participation were especially important. This was followed by emotionally supportive communication and, finally, communication about personal things. Overall, the behavior of physicians corresponded quite closely with the patients' communication preferences. However, preference matching was low (the physicians demonstrated too little of the desired behavior) regarding the open communication of bad news and explanation of treatments. There was relatively high fulfillment of expectations on the part of patients in terms of seeking information from the physician, the physician's explanation of the diagnosis, and regarding aspects of shared decision making. We observed no gender differences, but did identify age-group differences.

The instruments developed (KOPRA and KOVA questionnaires) can be used for communication studies of patients with chronic conditions. However, some patient communication needs seem to require greater consideration from physicians.