Interpersonal Processes of Care Survey: Patient‐Reported Measures for Diverse Groups

Abstract

Objective. To create a patient-reported, multidimensional physician/patient interpersonal processes of care (IPC) instrument appropriate for patients from diverse racial/ ethnic groups that allows reliable, valid, and unbiased comparisons across these groups. Data Source/Data Collection. Data were collected by telephone interview. The survey was administered in English and Spanish to adult general medicine patients, stratified by race/ethnicity and language (African Americans, English-speaking Latinos, Spanish-speaking Latinos, non-Latino whites) (N 5 1,664). Study Design/Methods. In this cross-sectional study, items were designed to be appropriate for diverse ethnic groups based on focus groups, our prior framework, literature, and cognitive interviews. Multitrait scaling and confirmatory factor analysis were used to examine measurement invariance; we identified scales that allowed meaningful quantitative comparisons across four race/ethnic/language groups. Principal Findings. The final instrument assesses several subdomains of communication, patient-centered decision making, and interpersonal style. It includes 29 items representing 12 first-order and seven second-order factors with equivalent meaning (metric invariance) across groups; 18 items (seven factors) allowed unbiased mean comparison across groups (scalar invariance). Final scales exhibited moderate to high reliability. Conclusions. The IPC survey can be used to describe disparities in interpersonal care, predict patient outcomes, and examine outcomes of quality improvement efforts to reduce health care disparities.Key Words. Quality of care, race, ethnicity, measurement, measurement invariance, factorial invariance, physician-patient communication, physician-patient interaction Evidence of racial/ethnic disparities in quality of care is accumulating rapidly. Widespread disparities have been observed in many components of quality such as effectiveness of care for chronic and acute health conditions, patient safety, timeliness, communication, respectfulness, and discrimination r Health Research and Educational Trust

Associations Between Antidepressant Adherence and Shared Decision-Making, Patient–Provider Trust, and Communication Among Adults with Diabetes: Diabetes Study of Northern California (DISTANCE)

“…15 Trust was assessed with two items adapted from the Trust in Physicians Scale. 16,17 Shared decision-making was assessed with two items modified from the Interpersonal Processes of Care Instrument, 18,19 one of which is similar to a CAHPS supplementary item (see Table 2 for specific item wording). 15,20 To simplify the survey and improve consistency across items, the time frame (last 12 months) and response choices ("never", "sometimes", "usually", and "always") from the CAHPS were employed for all items.…”

The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California

“…Questions were modified from the 1979 National Survey of Black Americans to assess the experience of stress during the past seven days in various areas including health, money, job, family, and crime [28]. In addition, questions on racial discrimination [29], health literacy [30], aspects of doctor-patient communication [31], preference for doctor-patient decision-making [32], global trust in one's doctor [33], and social support [34] are asked. Finally, questions from the KP Breast Cancer Patient Survey are used to measure difficulty taking time off from work to attend medical appointments and keeping medical appointments due to distance or transportation.…”

Language Concordance, Interpersonal Care, and Diabetes Self-Care in Rural Latino Patients

“…1,2 Interpersonal processes of care (IPC) play a crucial role in this relationship and are defined by three elements: communication, interpersonal style, and patientcentered decision making. [3][4][5] IPC is particularly important in chronic disease management, which requires complex monitoring, multiple medications, and behavior change. In particular, effective participation in diabetes self-care requires clear communication and a positive interpersonal relationship between patients and their providers.…”