Quality of care from the patients' perspective: from theoretical concept to a new measuring instrument

Sixma, H.; Kerssens, J.J.; Campen, Crétien van; Peters, L.

doi:10.1046/j.1369-6513.1998.00004.x

Cited by 277 publications

(252 citation statements)

References 71 publications

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“…For measuring the patient's expectations regarding the specific medical encounter a scale was used, based on the combining and adaptation of the Quote scale [29] and the 'Patient Requests Form' (PRF) [24,30]. The questionnaire used here contained 14 items, and revealed three sub-scales: a biomedical scale, a psychosocial scale, and an investigation and treatment scale.…”

Section: Consultation Expectationsmentioning

confidence: 99%

Communicating fatigue in general practice and the role of gender

Meeuwesen

Bensing

Brink-Muinen

2002

Patient Education and Counseling

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The aim of this study has been to obtain more insight into the health condition of fatigued patients, their expectations when visiting the general practitioner (GP), the way they communicate, and possible gender differences. Data consisted of 579 patient questionnaires and 440 video-observations of these patients and 31 GPs. Results showed that fatigue is a common health problem but seldom on the agenda in general practice. More women indicated symptoms of fatigue than men did. Fatigued patients' health was worse than that of non-fatigued patients, and they expected more biomedical and especially psychosocial communication. Furthermore, male fatigued patients expected more biomedical communication than fatigued female patients did. While the GPs accommodated their verbal behavior to fatigued patients by giving more psychosocial information and more counseling, they were not more affective towards the fatigued than towards the non-fatigued patients. Female GPs were more affective than their male colleagues, and they used gender-specific communication strategies to explore the patient's agenda. It seems necessary to use a gender-sensitive approach in communication research. #

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Section: Consultation Expectationsmentioning

confidence: 99%

Communicating fatigue in general practice and the role of gender

Meeuwesen

Bensing

Brink-Muinen

2002

Patient Education and Counseling

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“…4 Patient satisfaction is essentially a subjective concept, crucially determined by expectations. 5 These are likely to vary among countries and among different cultural groups within countries. The measurement of patients' experiences, on the other hand, aims to elicit factual data that may be easier to interpret.…”

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confidence: 99%

Patients’ Experiences With Hospital Care In Five Countries

Coulter¹,

Cleary²

2001

Health Affairs

164

122

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Analysis of patient surveys carried out in Germany, Sweden, Switzerland, the United Kingdom, and the United States in 1998-2000 revealed high rates of problems during inpatient hospital stays. Problems with information and education, coordination of care, respect for patients' preferences, emotional support, physical comfort, involvement of family and friends, and continuity and transition were prevalent in all five countries. These dimensions of patients' experience appear to be salient and relevant in each of the five countries, but attempts to develop international rankings based on this type of evidence will have to overcome a number of methodological problems.T he p a t ie nt 's p e r sp ect iv e on what constitutes high quality in health care is increasingly recognized as essential in quality assessment and improvement efforts. Attempts to define and measure this perspective are now being made at both the provider and system levels. Many national governments have developed performance frameworks that include indicators of responsiveness to patients. Recently, international agencies, such as the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD), have stressed its importance as a key component of system performance.1 WHO included an index of responsiveness to the expectations of consumers in its recent report on health systems around the world.2 This measure ranked countries' health systems according to their performance on two dimensions: respect for persons (including dignity, confidentiality, and autonomy) and client orientation (including prompt attention, quality of amenities, access to social support, and freedom of choice of providers). The initial index, which has sparked a great deal of criticism, was based on the opinions of 1,791 "key informants" in thirty-five countries, the majority of whom were government

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“…When seen as a multidimensional concept based on the relationship between experiences and expectations, a strong measure of client satisfaction can be a useful tool in gathering client perspectives that can inform quality improvement. 23 Larrabee and Bolden point out that although there is quite a large range of tools available for measuring patient satisfaction with nursing care quality, many have not benefited from input from patients about what constitutes nursing care quality, highlighting the need to use "qualitative data about the dimensions of their own populations' definitions of good nursing care when selecting a patient satisfaction instrument, interpreting survey data and implementing improvement activities". 24 In terms of measuring client satisfaction with the overall health care experience, the same principle should apply.…”

Section: Respondent Comments Compared With P-cis Dimensionsmentioning

confidence: 99%

Measuring person-centred care in a sub-acute health care setting

Davis¹,

Byers²,

Walsh³

2008

Aust. Health Review

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Objective: A more appropriate tool to measure the client experience of person-centred care is required to complement other existing measures of quality. A tool developed in the United Kingdom was trialled to determine its utility with a frail older Australian population.Design: A random sample of clients recently discharged from a sub-acute setting over a 6-month period in 2005 were sent a questionnaire and invited to respond, a reply-paid envelope being provided for the return of the questionnaire. The questionnaire comprised the 20-item tool and space to provide additional qualitative comments. Setting:The inpatient wards of a sub-acute facility in Melbourne. Participants:From the random sample of 144 discharged clients, 78 responded to the questionnaire.Main outcome measure: 20-item Patient-Centred Inpatient Scale (P-CIS) developed by Coyle and Williams (2001). Results:Overall, there was a fundamental core of person-centredness as demonstrated by a ratio score of 0.68. Personalisation and respect dimensions are the main strengths of person-centred care in the health care setting in which the P-CIS was trialled, with personalisation scoring 0.75 and respect scoring 0.77. The miscellaneous components scored 0.69. The findings show that areas of the client experience warranting priority quality improvement effort are specific to the dimensions of empowerment (0.58), information (0.58) and approachability/availability (0.43). Conclusions:The P-CIS demonstrates the potential to be a contributing component that informs the monitoring and improvement of quality person-centred care in Australian inpatient health PERSON-CENTRED CARE is considered the optimal way of delivering health care and has been defined simply as "valuing people as individuals". 1 This approach to care is built on the concept of personhood envisaged by Tom Kitwood as the "status or standing bestowed upon What is known about the topic?Person-centred care is considered the optimal way to deliver health care. Health care settings rely heavily on the concept of satisfaction to capture the client experience of care delivery. However, satisfaction is unable to encompass the range of feelings, values and experiences a person has when health care is provided. So instruments measuring client satisfaction cannot capture key characteristics of person-centred care. What does this paper add?This paper advances the debate on measuring the client experience in health care settings. It identifies a way to capture key features of a person-centred approach to care through a measure of personal identity threat which can be used with a frail older population. What are the implications for practice?The P-CIS provides a way to identify strengths and weaknesses in person-centred care delivery in the inpatient setting. It provides a framework enabling care providers in inpatient settings to monitor and modify practice to optimise person-centred care.

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Quality of care from the patients' perspective: from theoretical concept to a new measuring instrument

Cited by 277 publications

References 71 publications

Communicating fatigue in general practice and the role of gender

Communicating fatigue in general practice and the role of gender

Patients’ Experiences With Hospital Care In Five Countries

Measuring person-centred care in a sub-acute health care setting

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