The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus

Objective. To examine the effect of physical and mental health status and s ocial support on patient satisfaction with health care in patients with sys temic lupus erythematosus (SLE). Study design. Using a cross-sectional design, 220 SLE patients were recruit ed from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patient-c ompleted questionnaires. Measures. Independent variables included demographics, disease duration, ph ysician-rated indices of disease activity (SLAM R) and disease damage (SLIC C/ACR), patient self-reported health status (SF-36), and perceived social s upport (ISEL). Patient satisfaction with medical care (PSQ-IV) was the depe ndent variable. Analyses. Univariate analyses were performed to describe the sample and exa mine univariate associations between the independent variables and patient satisfaction with medical cave. A hierarchical multiple linear regression a nalysis was computed to determine the relative importance of physician-rate d indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demograph ic variables. Results. A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, educat ion, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P < 0.01), better self-reported mental (P < 0.05) and phys ical health status (P < 0.005) and higher perceived social support (P < 0.0 05) were significant predictors of patient satisfaction (R-2 = 0.15, P < 0. 0001). Conclusion. The findings suggest that self-reported physical and mental hea lth status and social support are more important than clinical status varia bles in understanding patient satisfaction with medical care.