The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains

Abstract

Background: Pharmacological interventions combined with nonpharmacological treatments such as patient-centered care (PCC)-related activities are widely used to enhance outcomes in patients with schizophrenia. However, few studies have examined and identified the PCC factors essential to achieving better outcomes in patients with schizophrenia.Purpose: This study was designed to identify the Picker-Institute-identified PCC domains associated with satisfaction and to determine which of these domains are most important in the context of schizophrenia care.Methods: Data were collected using patient surveys in outpatient settings and record reviews at two hospitals in northern Taiwan between November and December 2016. PCC data were collected in five domains: (a) support of patient autonomy; (b) goal setting; (c) collaboration and integration of healthcare services; (d) information, education, and communication; and (e) emotional support. The outcome measure was patient satisfaction. The study controlled for demographic factors, including age, gender, education, occupation, marriage, and urbanization level in the respondent's area of residence. Clinical characteristics included the Clinical Global Impressions severity and improvement index scores, previous admission, previous emergency department visit, and readmission within 1 year. Methods were adopted to prevent common method variance bias. Multivariable linear regression with stepwise selection and the generalized estimating equation were used to analyze the data.Results: After controlling for confounding factors, the generalized estimating equation model found only three PCC factors significantly associated with patient satisfaction, which differed slightly from the results of the multivariable linear regression. These three factors are as follows, in order of importance: information, education, and communication (parameter = 0.65 [0.37, 0.92], p < .001); emotional support (parameter = 0.52 [0.22, 0.81], p < .001); and goal setting (parameter = 0.31 [0.10, 0.51], p = .004). Conclusions:The three critical PCC-related factors were evaluated in terms of enhancing patient satisfaction in patients with schizophrenia. Practicable strategies related to these three factors should also be developed for implementation in clinical settings.

Patient-centered care in diabetes care-concepts, relationships and practice

“…A recent report revealed that only three out of five examined PCC factors ( i.e. , communication, emotional support, and goal setting) were correlated with increased patient satisfaction among individuals with schizophrenia[ 26 ], but those PCC elements still constitute a paucity of evidence for traumatic brain injury[ 27 ]. Hence, discussing which PCC elements are critical for diabetes care is highly important.…”

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

“…The Patient-Centered Primary Care instrument (PCPC), developed in the Netherlands in collaboration with Harvard University and the Picker Institute, is a tool that has been verified for reliability and validity by applying the Patient-Centered Care (PCC) tool to the primary care environment. 20 The PCC is one of the three most influential models in the United States that form the basis for patient-centered care, 21 and its benefits have been demonstrated through several studies 22–28 and measured in patients to reflect their values and preferences. Therefore, the PCPC tool based on PCC needs to be evaluated and applied after being modified to suit the Korean medical environment, where tools for measuring patient-centeredness for outpatients are lacking.…”