The Patient Centered Assessment Method (PCAM) for Action-Based Biopsychosocial Evaluation of Patient Needs: Validation and Perceived Value of the Dutch Translation

Abstract

The Patient Centered Assessment Method (PCAM) is an action-based tool that supports professionals to engage in a biopsychosocial assessment with patients and measure their needs. It is a promising tool for person-centered care. As the Netherlands lacks such a tool, a Dutch version was developed. Furthermore, we aimed to contribute to the relatively limited insights into the psychometric properties and value of the tool when used as part of a needs assessment in primary care. Confirmatory factor analysis was used to study construct validity and Cronbach’s alpha was computed to assess reliability. Furthermore, we interviewed 15 primary care professionals who used the PCAM. It was confirmed that each PCAM domain measures a separate construct, informed by the biopsychosocial model. The tool showed adequate reliability (Cronbach’s alpha = 0.83). Despite face validity concerns, the tool was mainly valued for measurement of patient needs and to facilitate action planning. Criticism of the PCAM pertained to a limited focus on the patient perspective, which is one of the crucial aspects of person-centered care. These rich, mixed-method insights can help to improve the value of the PCAM, as one of the few multifunctional tools to support professionals in holistic assessments.

Rapid Review on the Concept of Positive Health and Its Implementation in Practice

“…Within primary care, several projects are described in which the method of PH, using the dialogue tool and alternative dialogue, were applied as a practical method for implementing a holistic approach. PH aimed to improve connections between healthcare professionals and their patients and to foster a broad perspective on health during consultations [ 48 , 53 , 62 , 63 ]. Within two of these projects, PH was additionally used to serve as a shared framework through which organisations could implement changes to their organisational and financial structures in primary care [ 48 , 53 ].…”

Supporting professionals to implement integrated, person-centered care for people with chronic conditions: the TARGET pilot study

“…However, these data are often lacking as the internationally classified codes for registering social issues, Z-codes, are systematically underutilized by healthcare professionals and exchange of patient information between domains is complicated [ 17 , 49–52 ]. Instead, the PCAM can be used for registering social data: we recently found evidence that PCAM has adequate measurement properties [ 34 ]. Nonetheless, the PCAM is not equally appreciated by PCPs as a conversation support tool, which limits its use and thus the registration of social data [ 34 ].…”

“…Instead, the PCAM can be used for registering social data: we recently found evidence that PCAM has adequate measurement properties [ 34 ]. Nonetheless, the PCAM is not equally appreciated by PCPs as a conversation support tool, which limits its use and thus the registration of social data [ 34 ]. This corresponds with other studies demonstrating the inherent challenges in building instruments that support both a holistic conversation with patients and robust measurement of relevant patient data [ 34 , 53 ].…”

“…The PCAM open fields about ‘Who needs to be involved?’ and ‘Barriers to action?’ were analyzed. We made use of the dataset of PCAMs as previously used for psychometric tests of the PCAM, reported elsewhere [ 34 ]. To ensure independence of observations, this dataset was limited to unique patients, implying that – in a small number of cases – only the most recent PCAM for a unique patient was included in case a patient had several PCAMs registered.…”

“…The 12 items are scored on a four-point traffic light-style system indicating the growing need for (professional) action. More details can be read in a psychometric paper of this instrument, published in 2021 [ 34 ].…”