A photo-elicitation study of homeless and marginally housed Veterans’ experiences with patient-centered care

Sestito, Samuel F.; Rodriguez, Keri L.; Hruska, Kristina L.; Conley, James W.; Mitchell, Michael A.; Gordon, Adam J.

doi:10.35680/2372-0247.1279

Cited by 2 publications

(1 citation statement)

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“…Understanding whether any new service makes a difference to a historically vulnerable population (e.g., persons with limited material and social resources; medical comorbidity) depends on learning not just about their experiences with the service but also about the health and social concerns of the population itself. This can be done qualitatively, through semi‐structured or cognitive interviews, or through quantitative surveys (McCallum et al, 2019; Montgomery et al, 2014; Ramsay et al, 2019; Sestito et al, 2018; Varley et al, 2020). The statistical precision afforded by validated quantitative surveys comes with a notable risk: investigators may fail to query important aspects of life experience or cardinal determinants of care experience.…”

Section: Introductionmentioning

confidence: 99%

What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience

Varley

Hoge

Riggs

et al. 2022

Health Social Care Comm

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Surveys of people who experience homelessness can portray their life and healthcare experiences with a level of statistical precision; however, few have explored how the very same surveys can deliver qualitative insights as well. In responding to surveys, people experiencing homelessness can use the margins to highlight health and social concerns that investigators failed to anticipate that standard question batteries miss. This study describes the unprompted comments of a large national survey of Veterans with homeless experiences. The Primary Care Quality‐Homeless Services Tailoring (PCQ‐HOST) survey presented 85 close‐ended items to solicit social and psychological experiences, health conditions, and patient ratings of primary care. Amongst 5377 Veterans responding to the paper survey, 657 (12%) offered 1933 unprompted comments across nearly all domains queried. Using a team‐based content analysis approach, we coded and organised survey comments by survey domain, and identified emergent themes. Respondents used comments for many purposes. They noted when questions called for more nuanced responses than those allowed, especially ‘sometimes’ or ‘not applicable’ on sensitive questions, such as substance use, where recovery status was not queried. On such matters, the options of ‘no’ and ‘yes’ failed to capture important contextual and historical information that mattered to respondents, such as being in recovery. Respondents also elaborated on negative and positive care experiences, often naming specific clinics or clinicians. This study highlights the degree to which members of vulnerable populations, who participate in survey research, want researchers to know the reasons behind their responses and topics (like chronic pain and substance use disorders) that could benefit from open‐ended response options. Understanding patient perspectives can help improve care. Quantitative data from surveys can provide statistical precision but may miss key patient perspectives. The content that patients write into survey margins can highlight shortfalls of a survey and point towards future areas of inquiry. Veterans with homeless experience want to provide additional detail about their lives and care experiences in ways that transcend the boundaries of close‐ended survey questions. Questions on substance use proved especially likely to draw comments that went beyond the permitted response options, often to declare that the respondent was in recovery. Respondents frequently clarified aspects of their care experiences related to pain, pain care, transportation and experiences of homelessness.

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Section: Introductionmentioning

confidence: 99%

What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience

Varley

Hoge

Riggs

et al. 2022

Health Social Care Comm

Self Cite

View full text Add to dashboard Cite

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Validation of the Korean Version of Patient-Centered Care Tool: For Outpatients

Kim¹,

Lee²,

Choi³

2023

PPA

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Aim The objective of this study was to assess the validity and reliability of the Korean version of the patient-centered care (K-PCC) instrument for outpatients. The study was conducted due to the absence of a measurement tool specifically designed to evaluate patient-centered care for outpatients. Design This study is a methodological study to verify the validity and reliability of the Korean version of Patient-Centered Care (K-PCC) to measure patient-centeredness for outpatients. Methods As a first step for the evaluation of the tool, the content validity was verified by expert panel. Then, a total of 400 outpatients were recruited, and construct validity was verified through confirmatory factor analysis (CFA) as the second step for the evaluation of the tool. The convergent and discriminant validity of the tool was verified by calculating the standardized factor loads, construct reliability (CR), and average variance extracted (AVE), and calculating the correlation square between the factors as the third and fourth steps for the evaluation of the tool. And as a fifth step for the evaluation of the tool, criterion validity was evaluated by comparing the correlation with the patient-centeredness measurement tool for inpatients (PEx-inpatient). In estimating reliability, internal consistency reliability coefficients were calculated. Results The confirmatory factor analysis supported good fit for the Korean patient-centered care instrument (K-PCC), and the eight-factor structure was validated. The scale comprises 21 items across eight factors: patient preferences (4 items), physical comfort (2 items), coordination of care (2 items), continuity and transition (3 items), emotional support (2 items), access to medical care (3 items), information and education (2 items), and family and friends (3 items). The Cronbach’s alphas ranging between 0.73 and 0.88. Conclusion The Korean patient-centered primary care instrument is a valid and reliable scale to measure patient-centered care for outpatients in the Korean medical environment.

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A photo-elicitation study of homeless and marginally housed Veterans’ experiences with patient-centered care

Cited by 2 publications

References 0 publications

What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience

What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience

Validation of the Korean Version of Patient-Centered Care Tool: For Outpatients

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