<![CDATA[This study examined the associations between patient-centered care (PCC)-based communication and patient understanding, engagement, satisfaction, and adherence among individuals with cardiovascular disease at Pakuhaji Hospital, Indonesia. A quantitative cross-sectional analytic design was employed. Data were collected from 100 cardiac patients using validated structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS, including confirmatory factor analysis and structural path analysis. The measurement model demonstrated satisfactory validity and reliability. Among PCC indicators, verbal communication and shared decision-making showed the strongest contributions, whereas interactive education showed the weakest contribution. Structural analysis indicated that PCC-based communication was not significantly associated with patient understanding (β = −0.155, p = 0.160). However, the model identified a significant sequential indirect pathway, in which understanding was positively associated with engagement, engagement was associated with satisfaction, and satisfaction was associated with adherence behavior. The overall model demonstrated acceptable goodness-of-fit indices, supporting its structural adequacy. These findings suggest that PCC-based communication is associated with patient outcomes through a sequence of interrelated constructs rather than through direct associations with adherence. Strengthening patient comprehension and engagement may be relevant for improving downstream behavioral outcomes in cardiovascular care.]]>
