Skip to main content
Top
Published in: Journal of Clinical Psychology in Medical Settings 3/2014

01-09-2014

The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study

Authors: John H. Porcerelli, William Murdoch, Pierre Morris, Shannon Fowler

Published in: Journal of Clinical Psychology in Medical Settings | Issue 3/2014

Login to get access

Abstract

This study assessed the validity of the Patient–Doctor Relationship Questionnaire-9 (PDRQ-9) in a primary care sample (N = 180). Convergent validity was assessed through a correlation between the patient-rated PDRQ-9 and the physician-rated Difficult Doctor Patient Relationship Questionnaire-10 (DDPRQ-10). Discriminant validity was assessed through correlations between the PDRQ-9 and patient age, patient- and physician-reported health and psychological distress. To determine if the PDRQ-9 could discriminate between groups, patient PDRQ-9 ratings were compared between patients who were treated by faculty physicians versus those who were treated by residents. An exploratory factor analysis confirmed that the PDRQ-9 was made up of a single factor. The PDRQ-9 scale was internally consistent (α = .96) and significantly and negatively correlated with the DDPRQ-10 (r = −.22, p = .003) and was not significantly correlated with patient age, health, or psychological distress. PDRQ-9 ratings were statistically greater in patients who were treated by faculty physicians than those who were treated by residents (p = .01). This study provides additional support for the reliability and validity of the PDRQ-9 as a measure of the doctor–patient relationship in a primary care sample.
Literature
go back to reference Bayer-Fetzer Conference. (2001). Essential elements of communication in medical encounters: The Kalamazoo Consensus Statement. Academic Medicine, 76, 390–393.CrossRef Bayer-Fetzer Conference. (2001). Essential elements of communication in medical encounters: The Kalamazoo Consensus Statement. Academic Medicine, 76, 390–393.CrossRef
go back to reference Bornstein, R. F. (2010). A process dissociation approach to objective-projective test score interrelationships. Journal of Personality Assessment, 78, 47–68.CrossRef Bornstein, R. F. (2010). A process dissociation approach to objective-projective test score interrelationships. Journal of Personality Assessment, 78, 47–68.CrossRef
go back to reference Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81–105.CrossRefPubMed Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81–105.CrossRefPubMed
go back to reference Clark, L., Beesley, H., Holcombe, C., & Salmon, P. (2011). The influence of childhood abuse and adult attachment style on clinical relationships in breast cancer care. General Hospital Psychiatry, 33, 579–586.CrossRefPubMed Clark, L., Beesley, H., Holcombe, C., & Salmon, P. (2011). The influence of childhood abuse and adult attachment style on clinical relationships in breast cancer care. General Hospital Psychiatry, 33, 579–586.CrossRefPubMed
go back to reference Curran, P. J., West, S. G., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16–29.CrossRef Curran, P. J., West, S. G., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16–29.CrossRef
go back to reference Didden, D. G., Philbrick, J. T., & Schorling, J. B. (2001/2002). Anxiety and depression in an internal medicine resident continuity clinic: Difficult diagnoses. International Journal of Psychiatry in Medicine, 31, 155–167. Didden, D. G., Philbrick, J. T., & Schorling, J. B. (2001/2002). Anxiety and depression in an internal medicine resident continuity clinic: Difficult diagnoses. International Journal of Psychiatry in Medicine, 31, 155–167.
go back to reference Hahn, S. R. (2001). Physical symptoms and physician-experienced difficulty in the physician–patient relationship. Annals of Internal Medicine, 134(Supplement), 897–904.CrossRefPubMed Hahn, S. R. (2001). Physical symptoms and physician-experienced difficulty in the physician–patient relationship. Annals of Internal Medicine, 134(Supplement), 897–904.CrossRefPubMed
go back to reference Hahn, S. R., Kroenke, K., Spitzer, R. L., Brody, D., Williams, J. B., Linzer, M., deGruy, F. V. (1996). The difficult patient: Prevalence, psychopathology, and functional impairments. Journal of General Internal Medicine, 11, 1–8.CrossRefPubMed Hahn, S. R., Kroenke, K., Spitzer, R. L., Brody, D., Williams, J. B., Linzer, M., deGruy, F. V. (1996). The difficult patient: Prevalence, psychopathology, and functional impairments. Journal of General Internal Medicine, 11, 1–8.CrossRefPubMed
go back to reference Hahn, S. R., Thompson, K. S., Wills, T. A., Stern, V., & Budner, N. S. (2004). The difficult doctor–patient relationship: Somatization, personality and psychopathology. Journal of Clinical Epidemiology, 47, 647–657.CrossRef Hahn, S. R., Thompson, K. S., Wills, T. A., Stern, V., & Budner, N. S. (2004). The difficult doctor–patient relationship: Somatization, personality and psychopathology. Journal of Clinical Epidemiology, 47, 647–657.CrossRef
go back to reference Hanel, G., Henningson, P., Herzog, W., Sauer, N., Schaefert, R., Szecsenyid, J., Löwe, B. (2009). Depression, anxiety, and somatoform disorders: Vague or distinct categories in primary care? Results from a large cross-sectional study. Journal of Psychosomatic Research, 67, 189–197.CrossRefPubMed Hanel, G., Henningson, P., Herzog, W., Sauer, N., Schaefert, R., Szecsenyid, J., Löwe, B. (2009). Depression, anxiety, and somatoform disorders: Vague or distinct categories in primary care? Results from a large cross-sectional study. Journal of Psychosomatic Research, 67, 189–197.CrossRefPubMed
go back to reference Jackson, J. L., & Kroenke, K. (1999). Difficult patient encounters in the ambulatory clinic: Clinical predictors and outcomes. Archives of Internal Medicine, 159, 1069–1075.CrossRefPubMed Jackson, J. L., & Kroenke, K. (1999). Difficult patient encounters in the ambulatory clinic: Clinical predictors and outcomes. Archives of Internal Medicine, 159, 1069–1075.CrossRefPubMed
go back to reference Kroenke, K., Jackson, J. L., & Chamberlin, J. (1997). Depressive and anxiety disorders in patients presenting with physical complaints: Clinical predictors and outcome. American Journal of Medicine, 103, 339–347.CrossRefPubMed Kroenke, K., Jackson, J. L., & Chamberlin, J. (1997). Depressive and anxiety disorders in patients presenting with physical complaints: Clinical predictors and outcome. American Journal of Medicine, 103, 339–347.CrossRefPubMed
go back to reference Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284–1292.CrossRefPubMed Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284–1292.CrossRefPubMed
go back to reference Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2009). An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics, 50, 613–621.PubMed Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2009). An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics, 50, 613–621.PubMed
go back to reference Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., … Brahler, E. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the patient health questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122, 86–95.CrossRefPubMed Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., … Brahler, E. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the patient health questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122, 86–95.CrossRefPubMed
go back to reference Martín-Fernández, J., delCura-González, M. I., Gómez-Gascón, T., Fernández-López, E., Pajares-Carabajal, G., & Moreno-Jiménez, B. (2009). Patient satisfaction with the patient–doctor relationship measured using the questionnaire (PDRQ-9). Atencion Primaria, 42, 196–203.CrossRef Martín-Fernández, J., delCura-González, M. I., Gómez-Gascón, T., Fernández-López, E., Pajares-Carabajal, G., & Moreno-Jiménez, B. (2009). Patient satisfaction with the patient–doctor relationship measured using the questionnaire (PDRQ-9). Atencion Primaria, 42, 196–203.CrossRef
go back to reference Maunder, R. G., Panzer, A., Viljoen, M., Owen, J., Human, S., & Hunter, J. J. (2006). Physicians’ difficulty with emergency department patients is related to patients’ attachment style. Social Science and Medicine, 63, 552–562.CrossRefPubMed Maunder, R. G., Panzer, A., Viljoen, M., Owen, J., Human, S., & Hunter, J. J. (2006). Physicians’ difficulty with emergency department patients is related to patients’ attachment style. Social Science and Medicine, 63, 552–562.CrossRefPubMed
go back to reference Miller, M. D., & Ferris, D. G. (1993). Measurement of subjective phenomena in primary care research: The visual analogue scale. Family Practice Research Journal, 13, 15–24.PubMed Miller, M. D., & Ferris, D. G. (1993). Measurement of subjective phenomena in primary care research: The visual analogue scale. Family Practice Research Journal, 13, 15–24.PubMed
go back to reference Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097.CrossRefPubMed Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097.CrossRefPubMed
go back to reference Stewart, A. L., Hays, R. D., & Ware, J. E., Jr. (1988). The MOS short-form general health survey: Reliability and validity in a patient population. Medical Care, 26, 724–735. Stewart, A. L., Hays, R. D., & Ware, J. E., Jr. (1988). The MOS short-form general health survey: Reliability and validity in a patient population. Medical Care, 26, 724–735.
go back to reference Stewart, M., Brown, J. B., Donner, A., McWhinney, I. R., Oates, J., Weston, W. W., & Jordon, J. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice, 49, 796–804.PubMed Stewart, M., Brown, J. B., Donner, A., McWhinney, I. R., Oates, J., Weston, W. W., & Jordon, J. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice, 49, 796–804.PubMed
go back to reference Van der Feltz-Cornelis, C. M., Van Oppen, P., Van Marwijk, H. W. J., De Beurs, E., & Van Dyck, R. (2004). A patient–doctor relationship questionnaire (PDRQ-9) in primary care: Development and psychometric evaluation. General Hospital Psychiatry, 26, 115–120.CrossRefPubMed Van der Feltz-Cornelis, C. M., Van Oppen, P., Van Marwijk, H. W. J., De Beurs, E., & Van Dyck, R. (2004). A patient–doctor relationship questionnaire (PDRQ-9) in primary care: Development and psychometric evaluation. General Hospital Psychiatry, 26, 115–120.CrossRefPubMed
go back to reference Wells, K. B., Stewart, A., Hays, R. D., Burnam, M. A., Rogers, W., Daniels, M., … Ware, J. (1989). The functioning and well-being of depressed patients. Journal of the American Medical Association, 262, 914–919.CrossRefPubMed Wells, K. B., Stewart, A., Hays, R. D., Burnam, M. A., Rogers, W., Daniels, M., … Ware, J. (1989). The functioning and well-being of depressed patients. Journal of the American Medical Association, 262, 914–919.CrossRefPubMed
Metadata
Title
The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study
Authors
John H. Porcerelli
William Murdoch
Pierre Morris
Shannon Fowler
Publication date
01-09-2014
Publisher
Springer US
Published in
Journal of Clinical Psychology in Medical Settings / Issue 3/2014
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-014-9407-2

Other articles of this Issue 3/2014

Journal of Clinical Psychology in Medical Settings 3/2014 Go to the issue