Mediators of the Focal Relationship Sample Clauses

Mediators of the Focal Relationship. This study proposes that higher level of COC is negatively correlated with experiencing functional decline through two mechanisms: improved care coordination and better physician- patient relationship (including communication and a patient’s trust in their physicians). Improving care coordination has emerged as a key strategy for many payers and policymakers in an effort to prevent medical errors and reduce the use of unnecessary services.[51,52] Care coordination involves physicians’ efforts to work cooperatively, to deliberately organize patient care activities, and continuously share information concerning a patient’s treatment plan to provide safer and more effective care.[53,54] Better coordinated care improves health outcomes (i.e., prevent or delay having difficulties in functionality) by ensuring that care from disparate providers is synchronized.[55] Therefore, higher level of COC could be negatively associated with experiencing functional decline through a better coordinated care process. A second mechanism through which COC is potentially related to experiencing functional decline among older adults with ADRD is through the relationship between the patient and their physicians. Patient-physician relationship is defined as two sub-constructs: communication between the patient and their physicians and the patient’s trust in their physicians. Communication facilitates a physician’s ability to gather true and important information for accurate diagnosis, appropriate counsel, and therapeutic instructions.[56] The trust that a patient has in their physician is the belief that their physician will act in their best interest to deliver effective care, which eventually impact the patient’s concordance to the physician’s treatment plan.[57] A patient with ADRD may become more suspicious of those around them which is caused by confusion and memory loss (including the inability to remember certain people or objects). This suspiciousness presents a huge barrier to effective communication between a patient and their physicians, which might further lead to inappropriate and ineffective treatment.[53] This suspiciousness can lead to an unrealistic distrust among older patients with ADRD. Higher continuity has also been shown to be associated with an increased level of trust between patients and physicians, and improved patient’s trust may potentially improve the quality and outcomes of care.[57,58] Therefore, higher level of COC is expected to be negatively ass...