Exploring relationship development factors:A qualitative examination of how the patient-provider relationship influences perception, satisfaction, and health outcomes in a diverse group of low-income pregnant women

This research examined relationship development factors that influence perceptions, satisfaction, and health outcomes in nine systematically chosen, low-income, primarily Latina women. These women, between the ages of 20 and 30, were interviewed while they were pregnant and receiving prenatal care. This qualitative study utilized semi-structured, in-depth interviews conducted in the homes of the participants. Interviews were digitally recorded and transcribed. Using a content and context matrix analysis process, the transcripts were organized into four major categories defined in the research as integral to relationship development: patient-centered behaviors, health literacy, race concordance, and continuity. This analysis process was designed to illuminate additional themes as they emerged. Responses were analyzed within and across questions and combined into one large matrix that summarized the commonalities across the participants' responses as per the four focus areas and additional themes. Continuity and patient-centered care behaviors as well as past health care experiences emerged as crucial for the patient-provider relationship development process. Race concordance and health literacy were less critical to the process and did not appear to impact overall perceptions about health care. Results also revealed that relationship development factors were of greater importance to relationships with the physicians than clerical and nursing staff. Relationship development factors focused on patient-centered behaviors, continuity and past health care experiences influenced both the patients' perceptions of their providers and the care they were receiving. Future research could expand understanding of the impact of these factors on patients' perceptions, satisfaction, and health outcomes and help improve care.