Autonomy support in primary care—validation of the German version of the Health Care Climate Questionnaire

Schmidt, Konrad; Gensichen, Jochen; Petersen, Juliana J.; Szécsényi, Joachim; Walther, Mario; Williams, Geoffrey; Freund, Tobias

doi:10.1016/j.jclinepi.2011.06.003

Cited by 29 publications

(36 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to the analysis instructions, a patient HCCQ’s score is calculated by taking the average of the individual item scores to yield a mean score between 1 to 7, after reversing the single-reverse item. Higher average scores represent a higher level of perceived autonomy support [61, 62]. The scale was first developed and validated on the diabetic population by Williams and colleagues [60].…”

Section: Methodsmentioning

confidence: 99%

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

2017

View full text Add to dashboard Cite

BackgroundIncreasing bodies of scientific research today examines the factors and interventions affecting patients’ ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients’ ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed.ObjectiveTo test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway.Material and methodsThis cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 –short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients’ emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed.ResultsAccording to the theoretical model we hypothesized, research results confirmed that patients’ activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients’ quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis.ConclusionsConsistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence.

show abstract

Section: Methodsmentioning

confidence: 99%

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

2017

View full text Add to dashboard Cite

show abstract

“…Higher values indicate higher medication adherence. In addition to that, patients were asked to complete the Health Care Climate Questionnaire21 measuring perceived autonomy support by physicians as well as additional questions about sociodemographic characteristics (eg, age, gender, living with partner) 22. The number of medicines taken by participants was measured as a mean of parallel refilled medications in four quarters in 2009 as documented in pharmacy claims.…”

Section: Methodsmentioning

confidence: 99%

Let’s talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners

Ose¹,

Mahler²,

Vogel³

et al. 2012

PPA

View full text Add to dashboard Cite

BackgroundMedication adherence can be essential for improving health outcomes. Patients with multiple chronic conditions, often receiving multiple medications, are at higher risk for medication nonadherence. Previous research has focused on concordance between patients and providers about which medication should be taken. However, the question of whether patients and providers are concordant in rating actual medication intake has not been answered as yet. This study aimed to explore the extent and predictors of patient – provider concordance in rating medication adherence in patients with multiple chronic conditions.MethodsOverall medication adherence was measured by self-report (Medication Adherence Report Scale, MARS-D) in a sample of 92 patients with multiple chronic conditions. Twelve treating primary care physicians were asked to rate medication adherence in these patients using a mirrored version of the MARS-D. Concordance between external rating and self-reported medication adherence was analyzed descriptively. Predictors of concordance in rating medication adherence were explored in a multilevel analysis.ResultsPatients rate their medication adherence markedly higher than their general practitioner. Accordingly, the percentage of concordance ranges between 40% (forgot to take medication) and 61% (deliberately omitted a dose). In multilevel analysis, concordance in rating medication adherence was positively associated with being the single primary care provider (β 2.24, P < 0.0001) and frequent questioning about medication use (β 0.66, P = 0.0031). At the patient level, “not [being] married” (β −0.81, P = 0.0064) and “number of prescribed medications” (β −0.10, P = 0.0203) were negative predictors of patient – provider concordance in rating medication adherence.ConclusionConcordance for rating medication adherence between general practitioners and their patients was low. Talking about medication on a regular basis and better continuity of care may enhance patient – provider concordance in rating medication adherence as a prerequisite for shared decisions concerning medication in patients with multiple chronic conditions.

show abstract

“…In their clinical encounters, nurses are recognized to be key persons whose strategies might hugely affect the patient's level of engagement in the care process (Jordan et al, 2008; Kutney-Lee et al, 2009; Laschinger et al, 2010; Deyo et al, 2016; Morath and Braaten, 2016). Research on the patients' perspective showed how the patients' perception of professionals' positive attitude toward their self-management behaviors is associated with higher level of patient engagement (Graffigna et al, 2016) and adherence to medical prescriptions (Chan et al, 2009; Schmidt et al, 2012) thus confirming the crucial role of nurses who are often in charge of self-care interventions.…”

Section: Introductionmentioning

confidence: 93%

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

et al. 2017

View full text Add to dashboard Cite

Introduction: Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES.Methods: This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice.Results: Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process.Conclusions: Learning programs teaching nurses about patient engagement strategies and assessment measures in clinical practice are key in supporting the realization of patient engagement in healthcare. Training nurses in this area is feasible and accepted and might have an impact on their ability to engage patients in the chronic care journey. Due to the limitation of the research design, further research is needed to assess the effectiveness of such a program and to verify if the benefits envisaged in this pilot are maintained on a long-term perspective and to test results by employing a randomized control study design.

show abstract

Autonomy support in primary care—validation of the German version of the Health Care Climate Questionnaire

Cited by 29 publications

References 22 publications

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

Let’s talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

Contact Info

Product

Resources

About

Autonomy support in primary care—validation of the German version of the Health Care Climate Questionnaire

Cited by 29 publications

References 22 publications

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

Let&rsquo;s talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

Contact Info

Product

Resources

About

Let’s talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners