Assessing attitudes of patient-centred care among students in international chiropractic educational programs: a cross-sectional survey

Abstract

Background Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students’ attitudes towards patient-centred care compare to those of other health professions or whether they vary internationally, and between academic programs. Objective To assess the association of select variables on student attitude towards patient-centred care among select chiropractic programs worldwide. Methods We conducted a cross-sectional study using the Patient-Practitioner Orientation Scale (PPOS) to assess students’ patient-centred attitudes towards the doctor-patient relationship. Eighteen items were scored on a 1 to 6 Likert scale; higher scores indicating more patient-centredness. All students from seven chiropractic educational programs worldwide were invited to complete an online survey. Results were analyzed descriptively and inferentially for overall, sharing and caring subscales. General linear regression models were used to assess the association of various factors with PPOS scores. Results There were 1858 respondents (48.9% response rate). Student average age was 24.7 (range = 17–58) years and 56.2% were female. The average overall PPOS score was 4.18 (SD = 0.48) and average sharing and caring subscale scores were 3.89 (SD = 0.64) and 4.48 (SD = 0.52), respectively. There were small but significant differences in all PPOS scores by gender, age, and program. Year/semester of study within a program typically was not associated with scores, neither was history of previous chiropractic care nor having family members who are health professionals. Conclusion This is the first international study assessing students’ attitudes of patient-centred care in chiropractic educational programs. We found small but significantly different PPOS scores between chiropractic programs worldwide that did not change across year/semester of study. Scores tended to be lower than those reported among medical students. Observed differences may be related to curricular content, extent of patient exposure and/or regional cultural realities.

Do Physicians’ Attitudes towards Patient-Centered Communication Promote Physicians’ Intention and Behavior of Involving Patients in Medical Decisions?

“…The findings related to PPOS scores were essentially consistent with previous Chinese-based and studies based in some Eastern and Western countries [ 22 , 23 , 24 , 25 , 26 ]. The findings reported that physicians rated relatively high caring and low sharing scores, which indicates a similar pattern that physicians were more patient-centered in the caring subscale than in the sharing subscale [ 22 , 23 , 24 , 25 ]. However, the differences between caring and sharing scores were much higher than the results reported by other researches, with much less patient involvement in information and decision-making.…”

Assessing attitudes of patient-centered care among chiropractic students at a South African university

“…The PPOS was the instrument of choice as it has been shown previously to be valid 46 and reliable. 29,31,34 However, contrary to these previous studies, this current study did not show the PPOS to be a reliable instrument, in the context of the study. Although reliability was limited, certain relevant trends were observed.…”

“…Female students generally have higher average scores than male students, [27][28][29][30][31] and some studies conclude that increasing age influences scores, 29 whereas year of study has shown, in some studies, to have no effect on average scores. 28,[32][33][34] In South Africa, there are 2 university-based chiropractic educational programs that are accredited by the Council for Higher Education and registered with the South African Qualifications Authority. 35 Both these institutions hold international accreditation with the European Council on Chiropractic Education, 36 obtained in 2009 and 2010, respectively.…”

Patient safety in chiropractic teaching programs: a mixed methods study

“…Despite recognition of patient-centeredness as the foundation for quality of patient care [30][31][32], it is often overlooked in patient safety surveys [22,[33][34][35]. A recent pilot project assessing patient-centered attitudes conducted at some of the same chiropractic programs included in our study, revealed a lesser focus on patient-centered care than similar studies with medical students [36,37]. This suggests chiropractic curricular content (and hidden/null curriculum content) likely influences students' attitudes toward patientcentered care.…”