Spouse abuse, patient-physician communication, and patient satisfaction.

INTRODUCTION: This study examines differences in physician communication and patient satisfaction with physician care, contrasting women who have and have not been abused by spouses or intimate partners.
METHODS: A nationally representative sample of women participated in a telephone survey including questions on spouse abuse, health status, satisfaction with physicians, and communication with physicians. This article uses data from the survey describing 1,082 married or cohabitating respondents 18-64 years of age who had a regular physician and made at least one doctor visit in 1992.
RESULTS: Overall, 7.3% of respondents reported being physically abused by a spouse during the previous year. Abused women were much more likely than other women to report both poor communication and dissatisfaction with physicians. Only 9.7% of the abused women had discussed the abuse with a physician. Controlling for socio-demographic and health-related factors in logistic regression analysis, we found that spouse abuse more than doubled respondents' odds of being dissatisfied with physician care. When the quality of patient-physician communication was added to the model, the influence of spouse abuse became insignificant. Instead, women reporting poor communication with physicians were four times more likely than others to be dissatisfied with physician care.
CONCLUSIONS: Spouse abuse creates barriers to patient-physician communication, and poor communication contributes to lower satisfaction with care. Careful interviewing by trained clinicians is essential to identify and address abusive situations and to prevent further damage to women's physical and mental health.