This study focused upon physician/patient interaction as it pertains to patient involvement in personal health-care planning decision making, and self-care. The study was a multi-intervention trial that allowed for testing the effectiveness of two instruments used separately or simultaneously, in combination. Participants were 73 female patients, ages 41 to 76, diagnosed with essential hypertension and requiring medication for control.

Patients were randomly assigned to four groups: 1) a control group that was given no intervention, 2) a Pre-Knowledge Intervention (PKI) group that was given an interactive treatment plan with foreknowledge of what their physicians would probably do at their next office visits should the patients’ blood pressures not be under control, 3) a Question Asking Intervention (QAI) group that was instructed and encouraged to increase their question asking and assertiveness with their physicians, and 4) a fourth group that was given a combination of both PKI and QAI.

Intervention materials were designed to be inexpensive, easily administered with minimal expenditure of staff and professional time, and effective in enhancing patient self-efficacy. Fourteen information and perceptual variables were used to measure the effects of the interventions. The use of the interventions showed little effect on Lifestyle or General Self-Efficacy during the study.

Patients’ foreknowledge of the physicians’ planned medical intervention, when used by itself, produced a more negative view of the physician and his manner. When QAI was added the negative effect disappeared. QAI used alone increased patients’ knowledge of hypertension. PKI produced no significant increase in patients hypertensive knowledge. Further, neither PKI nor QAI alone had any effect on the patients’ personal interactive self-efficacy, but when used together, there was a statistically significant increase.

Physicians showed some limited ability to predict how their patients would respond to questions about the physicians and the physician/patient interaction. The demonstration of significant lifestyle changes and health benefits await further research.


School of Public Health

First Advisor

Jerry W. Lee

Second Advisor

Christine M. Neish

Third Advisor

Kenneth W. Hart

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Physician-Patient Relations; Self Care



Page Count

x; 240

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives