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Patient-hospital relationship and quality of life in elderly patients with hypertension.

To investigate the influence of the patient-hospital relationship on the quality of life (QOL) and on medication compliance in elderly patients with hypertension, we developed a comprehensive scale for assessing the patient-hospital relationship. In the first phase, an original questionnaire consisting of 40 items was designed under five fields for global assessment of the concept. We administered this questionnaire to 715 patients with cardiovascular diseases. Variations in the scores were evaluated by factor analysis. Three factors that comprised the majority of variance were derived by principal components analysis and varimax transformation. These orthogonal factors were considered to reflect "convenience of outpatient clinic", "satisfaction with clinical staff", and "communication with physician". We adopted three items under each of the three domains. Using this instrument, we assessed the patient-hospital relationship in 402 elderly outpatients with hypertension at 8 clinical centers. QOL and medication compliance were simultaneously assessed. A linear regression analysis revealed a significant positive correlation between patient-hospital relationship and QOL scores (r = 0.403, p < 0.0001), which means that patient-hospital relationship explained up to 16% of the total variability in scores on the Overall Quality of Life scale. The medication compliance was also better in patients with higher scores on the Patient-Hospital Relationship scale. These results indicate that the patient-hospital relationship is one of the substantial factors determining QOL and medication compliance in elderly patients with hypertension.