Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care

Abstract

Background Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients’ perceptions of PCC. Further aims were to evaluate its content and measurement properties using a mixed-methods approach entailing Rasch and qualitative content analyses. Methods The study was conducted in three iterative phases. Phase one included six key informants to gain a broad view of the concept. Phase two entailed a Delphi study involving two rounds with eight experts who generated ratings on relevance, readability, comprehensiveness and suggestions for revision. Data were analysed using the Item Content Validity Index in conjunction with qualitative comments to improve the questionnaire. Phase three was performed using a mixed-methods design. Quantitative data were collected from patients (n = 553) responding to the questionnaire who were recruited from six in- and outpatient care units in a health care region in Sweden. Data was analysed using the Rasch measurement model. Qualitative data were based on the respondents’ free-text comments, cognitive interviews (n = 10) and field notes, and then analysed with deductive content analysis. Results A questionnaire was developed and operationalised based on the information given by key informants in phase one and then validated for its content by experts in phase two. In phase three Rasch analyses revealed problems with targeting, thresholds and two misfitting items. These problems were corroborated by data from the qualitative analyses, which also revealed some issues of wording and interpretation of items. When thresholds were resolved and two items removed, the questionnaire met the assumptions of the Rasch model. Conclusions Experts gave the questionnaire content high ratings and it met measurement requirements assumed by the Rasch model after revisions. Those problems on targeting that remain need to be addressed in future studies. Meanwhile, we regard the questionnaire as of sufficient quality to be useful in benchmarking PCC.

The innovation characteristics of person-centred care as perceived by healthcare professionals: an interview study employing a deductive-inductive content analysis guided by the consolidated framework for implementation research

“…The findings of our study do not support the notion that perceptions of PCC are tied to vocational roles but suggest rather that they are based on individual HCPs being unique in their attitude towards PCC. This is in line with results from a recent study focusing on patients’ perceptions of PCC carried out at the same units as those described in this study [ 30 ]. Patients’ perceptions of PCC in relation to different HCPs were dependent on the individual characteristics ascribed to each unique HCP, and not based on vocational roles [ 30 ].…”

“…This is in line with results from a recent study focusing on patients’ perceptions of PCC carried out at the same units as those described in this study [ 30 ]. Patients’ perceptions of PCC in relation to different HCPs were dependent on the individual characteristics ascribed to each unique HCP, and not based on vocational roles [ 30 ].…”

Patient engagement in care: A scoping review of recently validated tools assessing patients' and healthcare professionals' preferences and experience

“…To the best of our knowledge, this is the first systematic scoping review dimensions related to all of the concepts of patient engagement. 27,30,36,37 Furthermore, we found that no tool simultaneously assesses the core dimensions of the partnership in care presented in our conceptual framework (individualized care, empathy, interpersonal trust, communication, experiential knowledge and self-care). 7 Tools assessing preferences regarding patient engagement in care are relatively scarce.…”

“…(n = 8) of the included tools. 27,28,30,[33][34][35][36][37] Nine tools evaluate two concepts simultaneously. [24][25][26]28,29,31,34,35,38 Of these, six evaluate (37%) both patient-centredness and shared decision-making.…”

“…30 Three tools have been validated in inpatient care settings 30,36,37 and one is a generic tool that can be used in both inpatient and outpatient care. 27 Finally, three scales (18%) only evaluate a single concept. 23,32,33 Figure 2 shows the number of tools assessing one or several concepts of patient engagement in care.…”