October 16, 2000

The clinician-patient relationship is the focus of a new $2.8 million study by researchers at Yale and UConn that is funded by the Patrick and Catherine Weldon Donaghue Medical Research Foundation.

The partnership, based at the Yale School of Nursing, will initially focus on how these relationships affect adherence, or how well patients follow instructions about such matters as taking medication and making lifestyle changes.

Sally Cohen, an associate professor of nursing at Yale and director of the project, calls adherence "one of the most compelling aspects of the health care relationship.

"So much depends upon adherence," she says. "Without it, there is very little any provider can do to improve a patient's health for any significant period of time."

Regina Cusson, a professor of nursing at UConn, will serve as the program's site director in Storrs. "The focus of research is usually on trying to find a cure for illness," she says. "We are now looking at a shift toward helping people live with chronic disease or - better still - helping people stay well. That broadens the scope of what you must examine."

Donaghue trustee Raymond S. Andrews notes that "The human aspect of health care is a critical aspect that isn't getting as much rigorous scientific attention as we'd like to see. If we could systematically dissect these relationships, we might find the key to better care. We have much more knowledge available to us than we ever make effective use of."

Relationships are hard to quantify with traditional research methods. But the Yale/UConn program is designed to delve into this non-traditional area without sacrificing scientific rigor.

"One of the reasons that the relational aspects of care are so little studied is that it is easier to look at outcomes associated with defined interventions," says Judy Krauss, a professor of nursing who will serve as Yale's site director for the project.

"Seeking to understand the process of care, in the context of the health care relationship, however, may well illuminate important pathways to desired outcomes," Krauss adds.

The program will make use of expert panels, representing different health professions and health care consumers, to shape its agenda.

Cohen sees enormous potential for improving health care in understanding its relational aspects. "It's an area we know so little about, and this project will give us the opportunity to take the lead," she says.

The Donaghue Foundation is funding the collaborative program as a prototype, with the possibility that the study of relationships may in the future be expanded beyond the area of adherence.