Measuring Patients' Perceptions of Patient-Centered Care: A Systematic Review of Tools for Family Medicine

Abstract

PURPOSE Patient-centered care is widely acknowledged as a core value in family medicine. In this systematic review, we aimed to identify and compare instruments, subscales, or items assessing patients' perceptions of patient-centered care in family medicine. METHODSWe conducted a systematic literature review using the MEDLINE, Embase, and Cochrane databases covering 1980 through April 2009, with a specifi c search strategy for each database. The search strategy was supplemented with searching by hand and expert suggestions. We looked for articles meeting all of the following criteria: (1) describing self-administered instruments measuring patient perceptions of patient-centered care; (2) reporting quantitative or psychometric results of development or validation; (3) being relevant to an ambulatory family medicine context. The quality of each article retained was assessed using a modifi ed version of the Standards for Reporting of Diagnostic Accuracy. Instrument' items were mapped to dimensions of a patient-centered care conceptual framework. RESULTSOf the 3,045 articles identifi ed, 90 were examined in detail, and 26, covering 13 instruments, met our inclusion criteria. Two instruments (5 articles) were dedicated to patient-centered care: the Patient Perception of Patient-Centeredness and the Consultation Care Measure, and 11 instruments (21 articles) included relevant subscales or items. CONCLUSIONSThe 2 instruments dedicated to patient-centered care address key dimensions but are visit-based, limiting their applicability for the study of care processes over time, such as chronic illness management. Relevant items from the 11 other instruments provide partial coverage of the concept, but these instruments were not designed to provide a specifi c assessment of patient-centered care.

Atenção centrada no paciente na prática interprofissional colaborativa

“…The expanded view of illness can be studied through the contributions of Stewart et al 42 , a well-known textbook detailing the principles of patient-centered medicine that embraces the social and psychological factors in the understanding of a disease 15 The international literature looks at the provider-patient relationship as a core component of the conceptual model of PCC 15 due mainly to the need of acknowledging the subjectivity of both physicians and patients and the need of building a therapeutic coalition 15,17,18 . In the professional-patient interaction, a few key elements are cited in describing PCC [15][16][17][18]42,43 In the UK, PCC was considered as a basic ingredient to give high quality medical care and lower the rate of medical errors 16,49 .…”

“…In the professional-patient interaction, a few key elements are cited in describing PCC [15][16][17][18]42,43 In the UK, PCC was considered as a basic ingredient to give high quality medical care and lower the rate of medical errors 16,49 . PCC is also highlighted as a ICP attribute linked to patient's safety and quality of care [50][51][52] .…”

“…On Patients' participation in their care, there is an emphasis on the centrality of the doctor-patient involvement 18,43 through the sharing of information 15 , objectives, power and responsibilities 18 . Involving patients as partners-in-care is considered the cornerstone of PCC.…”

“…The international literature looks at the provider-patient relationship as a core component of the conceptual model of PCC 15 due mainly to the need of acknowledging the subjectivity of both physicians and patients and the need of building a therapeutic coalition 15,17,18 . In the professional-patient interaction, a few key elements are cited in describing PCC [15][16][17][18]42,43 Adding to the four selected reviews, there are other publications on the subject that use PCC as a global example to be considered 47 In the UK, PCC was considered as a basic ingredient to give high quality medical care and lower the rate of medical errors 16,49 .…”

“…In this case the search turned out more than 24.000 articles. Due to the shocking asymmetry between Brazilian and international literature results, resulting of a paucity of national production on the subject, compared with the copious literature resulting from the use of the international descriptors, a choice was made to limit the international analysis to four literature review articles dealing with evaluation, outcomes and core elements of PCC [15][16][17][18] . …”