Patient Preference and Adherence (Dec 2022)
Illness Beliefs, Treatment Beliefs, and Fulfilled Treatment Expectations in Psychosomatic Rehabilitation: Associations with Patient Satisfaction
Abstract
Manuela Glattacker,1 Matthias Rudolph,2 Jürgen Bengel,3 Rieka von der Warth1 1Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; 2Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate); Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany; 3Section of Rehabilitation Psychology and Psychotherapy; Department of Psychology; University of Freiburg, Freiburg, GermanyCorrespondence: Manuela Glattacker, Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, Freiburg, D-79106, Germany, Tel +49 761 270 36940, Email [email protected]: Patients’ illness and treatment beliefs have been shown to predict health outcomes in many health care settings. However, information about their impact on patient satisfaction is scarce. The aim of this study was to investigate illness- and rehabilitation-related treatment beliefs and met rehabilitation-related treatment expectations and their relationship with patient satisfaction in psychosomatic rehabilitation.Methods: In a repeated measures study design, patients filled out questionnaires 2 to 3 weeks before the start of rehabilitation and at the end of an inpatient rehabilitation 6 to 7 weeks later. The predictive value of illness beliefs, treatment beliefs, and fulfilled treatment expectations regarding patient satisfaction was analyzed with multiple hierarchical regression analyses controlling for sociodemographic and clinical variables.Results: Two hundred sixty-four patients participated. The sample was composed of equal numbers of men and women (n = 129 each). The mean age was 50.4 years. Most patients had diagnoses from the ICD– 10 diagnostic group F3 (affective disorders; n = 145) or F4 (neurotic, stress-related and somatoform disorders; n = 94). Sociodemographic and clinical variables were not associated with patient satisfaction. The explained variance of patient satisfaction increased to 10% by adding illness beliefs (namely personal control and coherence) (p = 0.006), to 5% by adding rehabilitation-related treatment beliefs (namely concerns) (p = 0.063), and to 49% by adding fulfilled expectations (namely a positive discrepancy between expectations and experiences related to outcome expectations and related to participation and treatment structure, and a negative discrepancy between expectations and experiences related to concerns) (p < 0.001) as predictor variables.Conclusion: This study highlights the relationship of fulfilled (rehabilitation-related) treatment expectations with patient satisfaction in psychosomatic rehabilitation. Given the evidence underlining the importance of patients’ illness and treatment beliefs and expectations, it is vital that these constructs are addressed in corresponding interventions.Keywords: psychosomatic rehabilitation, patient satisfaction, common sense model of self-regulation, illness beliefs, treatment beliefs, fulfillment of treatment beliefs
