Analyzing the effects of shared decision-making, empathy and team interaction on patient satisfaction and treatment acceptance in medical rehabilitation using a structural equation modeling approach

Objectives: The aims of the study are: (1) To develop and test a theory-based model for the predictive power of "Shared decision making (SDM)", "Empathy" and "Team interaction" for "Patient satisfaction" and "Treatment acceptance". (2) To identify mediating effects of "Compliance" and "Satisfaction with decision". Methods: Within a multi-center cross-sectional study (11 inpatient rehabilitation clinics at different indication fields), the model was evaluated in descriptive and structure analytical terms based on survey data of N = 402 inpatients. Results: The structural equation model proved to exhibit an appropriate data fit. A high proportion of variance of "Patient satisfaction" (61%) and "Treatment acceptance" (67%) can be predicted by "SDM", "Empathy", "Satisfaction with decision" and "Team interaction". While no mediating effects were found for the two subcomponents of "Compliance" ("Patient cooperation", "Adherence"), "Satisfaction with decision" showed a full mediation for "Treatment acceptance" and a partial mediation for "Patient satisfaction". Conclusion: "Team interaction" should be considered as an important predictor of process and patient-centered outcome characteristics. Practice implications: The current findings can be used to derive measures as well as interventions to optimize the organization of participatory care within teams in order to strengthen patient centeredness and to ensure a high quality of care. (c) 2012 Elsevier Ireland Ltd. All rights reserved.