The physician–patient working alliance

ObjectiveCognitive and emotional dimensions of the physician–patient relationship (working alliance) were examined in relation to patients’ beliefs about the usefulness of treatment (perceived utility), patients’ beliefs about being able to adhere to treatment (adherence self-efficacy beliefs), patients’ follow through on their treatment plan (adherence), and patients’ satisfaction.MethodsParticipants were 51 men and 67 women who averaged 38.9 years of age (S.D. = 12.28). Seventy-two were Euro-American, 23 African-American, 6 Asian-American, 11 Hispanic, and 6 “Other.” They reported an average of 7.3 years (S.D. = 7.48) since being diagnosed with a chronic medical illness and an average of 7.1 (S.D. = 4.88) visits to their doctor within the last year. Patients’ conditions included HIV+/AIDS, hypertension, diabetes, asthma, and cancer.ResultsResults show moderate to strong relationships between working alliance and perceived utility (r = 0.63, P < 0.001), self-efficacy (r = 0.47, P < 0.001), adherence (r = 0.53, P < 0.001), and satisfaction (r = 0.83, P < 0.001). Regression analyses showed that ratings of the working alliance (SB = 0.25, P < 0.005) and self-efficacy beliefs (SB = 0.48, P < 0.001) predicted patient adherence and that working alliance ratings (SB = 0.83, P < 0.001) also predicted patient satisfaction.ConclusionThe working alliance can be measured in medical care and appears to be strongly associated with patients’ adherence to and satisfaction with treatment.Practice implicationsThe working alliance is important in medical treatment, as it is associated with patient adherence and satisfaction. Patients’ self-efficacy ought to be assessed and promoted as it is also associated with treatment adherence.