Actual concordance between veterans’ with [GWI] and their providers’ illness perceptions is not related to patient satisfaction... 2025 Baska et al

[Andy]

Full title: Actual concordance between veterans’ with Gulf War Illness and their providers’ illness perceptions is not related to patient satisfaction nor treatment adherence

Highlights​

• Perceived concordance (shared understanding) is associated with better health outcomes.
• There is a lack of evaluation on if actual concordance influences patient outcomes.
• While perceived concordance influences patient outcomes, our results suggest that actual concordance may not.
• Actual concordance was not related to either Veterans’ nor providers’ perceptions of concordance.
• Veterans and providers have difficulties in estimating if there is shared agreement.

Abstract​

Objective​

Patients with persistent physical symptom (PPS) conditions, such as Gulf War Illness (GWI), report disagreement or “non-concordance” with their providers about PPS conditions and dissatisfaction with healthcare. When patients perceive concordance with their providers about their PPS condition, they have increased satisfaction and adherence. While literature supports perceived concordance, there is a lack of research on actual concordance (i.e., the congruence of patients’ and providers’ perceptions of the patients’ illness).

Methods​

Among dyads of Veterans with GWI and their provider, we tested the hypotheses that greater actual concordance would be associated with greater Veterans’ satisfaction and adherence. We also explored the relationship of actual concordance with Veterans’ and providers’ perceived concordance.

Results​

Correlations suggest there is little agreement between Veterans and providers regarding GWI illness perceptions or perceptions of concordance. Polynomial regression analyses showed that actual concordance was not significantly related to Veterans’ satisfaction, adherence, or perceptions of concordance, nor to providers’ perceptions of concordance.

Conclusion​

Although literature finds Veterans’ perceived concordance with their provider about PPS influences patients’ experiences of care, our results suggest that actual concordance may have limited influence on experiences of care and either Veterans’ or providers’ perceived concordance. That is, the results suggest there does not need to be objective agreement between patients and providers about PPS, rather patients’ perception of agreement influences their satisfaction and adherence.

Practice implications​

Our results suggest that patients with PPS and their providers may have difficulties in estimating if there is shared agreement in the relationship and demonstrate the importance of explicitly assessing patients’ perceptions of concordance.

Paywall

 

[Trish]

Since I can't see beyond the paywall, it's tempting to guess what they are talking about.

My guess, clinician believes it's psychosomatic. Clinician tells patient a lie that they believe it's physical. Patient believes it's physical. Patient complies with treatment advice because they believe clinician's lie, so feel understood.

What else could it be?

 

[Utsikt]

That is, the results suggest there does not need to be objective agreement between patients and providers about PPS, rather patients’ perception of agreement influences their satisfaction and adherence.

Sounds like they are saying that if you learn to be better at gaslighting your patients, they will report being more satisfied.

 

[rvallee]

With some of "they judge themselves on their intent, we judge them on the outcomes, intent and outcomes don't match, thus there is no agreement over whether the outcomes are good, because they are terrible and they disagree because they only consider their intent, and have not formed any understanding of the condition anyway, are clueless about what good outcomes could even look like".

This whole industry where they produce fake satisfaction reports is especially annoying. They can't handle failing, so they spend decades twisting and corrupting data instead of doing real work. It's like Yelp but with only reviews written or approved by the business owners.

Here the problem will "take care of itself". Soon all those suffering from GWI will be dead, and it will happen like so many planned in the 80s about us, predicting that this fad will just go away. In this case it will be true, because they will have denied them any meaningful support and the problems will be buried.

It's so easy to see why they are failing, though. Even they can see it, but they can write down whatever they want instead and find nothing wrong with it. Evil, indifference to suffering, is so banal.