Patient participation in clinical encounters: a systematic review to identify self-report measures (original) (raw)
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Health Communication, 2020
Patient satisfaction is important to patient outcomes. Previous attempts to conceptualize satisfaction have often taken an atheoretical approach and focused on doctors' communication skills. Patients are becoming more active health consumers involved in their health care and current definitions of patient satisfaction may not accurately reflect patient expectations about their health consultations. Earlier research found that meeting patients' emotional needs-through empathy and patient-centered communication-is important to patient satisfaction. New research is needed to explore how those needs can be met given the changing trend in patient behaviors and the focus on patient-centredness. This study employed two communication theories-the Willingness to Communicate Model and Communication Accommodation Theory-to consider both patients' communicative decisions, and the intergroup features of the health context that can influence communicative behaviors. Two hundred and fiftythree patients from health clinics in Canada and Australia described what satisfaction meant to them, and identified what aspects of their health consultation were satisfying (or not), and we investigated their perceptions of doctor's emotional expression. Results suggest that patient perceptions of their participation in the consultation predicts their perceptions of doctor emotional expression, and their satisfaction with the consultation. Patients want both emotional and medical needs met in an environment that balances interpersonal and intergroup communication. Our findings suggest the need to expand current definitions of patient satisfaction, patient-centredness and emotional expression. We discuss the implications of these findings for health practitioners and consider future research that addresses the need for more individualized health care.
ANALYSIS & COMMENTARY Measuring Patient Experience As A Strategy For Improving Primary Care
Health Affairs, 2010
Patients value the interpersonal aspects of their health care experiences. However, faced with multiple resource demands, primary care practices may question the value of collecting and acting upon survey data that measure patients' experiences of care. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) suite of surveys and quality improvement tools supports the systematic collection of data on patient experience. Collecting and reporting CAHPS data can improve patients' experiences, along with producing tangible benefits to primary care practices and the health care system. We also argue that the use of patient experience information can be an important strategy for transforming practices as well as to drive overall system transformation.
Engaging patients to improve quality of care: a systematic review
Implementation science : IS, 2018
To identify the strategies and contextual factors that enable optimal engagement of patients in the design, delivery, and evaluation of health services. We searched MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, PsychINFO, Social Science Abstracts, EBSCO, and ISI Web of Science from 1990 to 2016 for empirical studies addressing the active participation of patients, caregivers, or families in the design, delivery and evaluation of health services to improve quality of care. Thematic analysis was used to identify (1) strategies and contextual factors that enable optimal engagement of patients, (2) outcomes of patient engagement, and (3) patients' experiences of being engaged. Forty-eight studies were included. Strategies and contextual factors that enable patient engagement were thematically grouped and related to techniques to enhance design, recruitment, involvement and leadership action, and those aimed to creating a receptive context. Reported outcomes ranged from educational or t...
Measuring patients’ experiences with individual primary care physicians
Journal of General Internal Medicine, 2006
BACKGROUND: Measuring and reporting patients’ experiences with health plans has been routine for several years. There is now substantial interest in measuring patients’ experiences with individual physicians, but numerous concerns remain. OBJECTIVE: The Massachusetts Ambulatory Care Experiences Survey Project was a statewide demonstration project designed to test the feasibility and value of measuring patients’ experiences with individual primary care physicians and their practices. DESIGN: Cross-sectional survey administered to a statewide sample by mail and telephone (May–August 2002). PATIENTS: Adult patients from 5 commercial health plans and Medicaid sampled from the panels of 215 generalist physicians at 67 practice sites (n=9,625). MEASUREMENTS: Ambulatory Care Experiences Survey produces 11 summary measures of patients’ experiences across 2 domains: quality of physician-patient interactions and organizational features of care. Physician-level reliability was computed for all measures, and variance components analysis was used to determine the influence of each level of the system (physician, site, network organization, plan) on each measure. Risk of misclassifying individual physicians was evaluated under varying reporting frameworks. RESULTS: All measures except 2 achieved physician-level reliability of at least 0.70 with samples of 45 patients per physician, and several exceeded 0.80. Physicians and sites accounted for the majority of system-related variance on all measures, with physicians accounting for the majority on all “interaction quality” measures (range: 61.7% to 83.9%) and sites accounting for the largest share on “organizational” measures (range: 44.8% to 81.1%). Health plans accounted for neglible variance (<3%) on all measures. Reporting frameworks and principles for assuring misclassification risk ≤ 2.5% were identified. CONCLUSIONS: With considerable national attention on the importance of patient-centered care, this project demonstrates the feasibility of obtaining highly reliable measures of patients’ experiences with individual physicians and practices. The analytic findings underscore the validity and importance of looking beyond health plans to individual physicians and sites as we seek to improve health care quality.
Examining the role of patient experience surveys in measuring health care quality
Medical care research and review : MCRR, 2014
Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization. Patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
Patient-perceived dimensions of total quality service in healthcare
Benchmarking: An …, 2008
Purpose -This research paper aims to identify dimensions of patient-perceived total quality service (TQS) in the healthcare sector. Further, the impact of the dimensions of patient-perceived TQS on patient satisfaction is examined. Design/methodology/approach -A questionnaire has been developed based on an extensive literature review of research in service quality and based on responses of the pilot survey among patients recently discharged from hospital. The instrument thus developed has been examined for its psychometric properties using tests of reliability and validity. Multiple regression analysis has been used to examine the impact of the dimensions of patient-perceived quality on patient satisfaction. Findings -Findings highlight seven distinct dimensions of patient-perceived TQS and the relationships among them. Positive and significant relationships among the dimensions and patient satisfaction have been found. Research limitations/implications -Contribution to research on healthcare services by the development of a comprehensive instrument of patient-perceived healthcare quality. Practical implications -This instrument would enable patients to provide feedback to hospitals regarding the quality of healthcare received by them. Hospitals could use this feedback to analyze their performance, gauge patient satisfaction and benchmark their performance against competitive hospitals. Originality/value -This paper illustrates a comprehensive instrument of patient-perceived healthcare quality.
“Patient participation” and related concepts: A scoping review on their dimensional composition
Patient Education and Counseling, 2019
Objectives Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, "patient participation" and related concepts were studied by focusing on the dimensions that compose them. This review follows two objectives: (1) to produce a detailed and comprehensive overview of the "patient participation" dimensions; (2) to identify differences and similarities between the related concepts. Methods A scoping review was performed to synthesize knowledge into a conceptual framework. An electronic protocol driven search was conducted in two bibliographic databases and a thematic analysis was used to analyse the data. Results The search process returned 39 articles after exclusion for full data extraction and analysis. Through the thematic analysis, the dimensions, influencing factors and expected outcomes of "patient participation" were determined. Finally, differences between the included concepts were identified. Conclusion This global vision of "patient participation" allows us to go beyond the distinctions between the existing concepts and reveals their common goal to include the patient in the healthcare system. Practice implications This scoping review provides useful information to propose a conceptual model of "patient participation", which could impact clinical practice and medical training programs.
A brief instrument to measure patients’ overall satisfaction with primary care physicians
Family medicine
A brief and psychometrically sound scale to measure patients' overall satisfaction with their primary care physicians would be useful in studies where a longer instrument is impractical. The purpose of this study was to develop and examine the psychometrics of a brief instrument to measure patients' overall satisfaction with their primary care physicians. Research participants included 535 outpatients (between 18--75 years old, 66% female) who completed a mailed survey that included 10 items for measuring overall satisfaction with their primary care physician who was named on the survey. Patients were also asked about their perceptions of physician empathy, preventive tests recommended by the physician (colonoscopy, mammogram, and prostate-specific antigen (PSA) for age and gender appropriate patients) and demographic information. Factor analysis of the patient satisfaction items resulted in one prominent component. Corrected item-total score correlations of the patient sati...
Research Square (Research Square), 2023
Background Strategies aimed at promoting patient involvement vary in purpose across different healthcare settings and are assessed using a wide range of outcomes. However, there is no consensus on the most appropriate measurement tools or ways to evaluate patient involvement initiatives. This qualitative study aimed to explore the perspectives of stakeholders from micro, meso, and macro levels within the Danish healthcare system on patient involvement and its measurement. MethodsThis descriptive, explorative study employed semi-structured interviews with open-ended questions to elicit participants' views and experiences of patient involvement and measurement tools. A purposeful sample of participants was identi ed, to include decision makers, researchers, and health professionals (n=20) with experiences of patient involvement in healthcare at micro, meso, and macro levels across Danish organizations. Data underwent re exive thematic analysis. Results Three main themes were identi ed: 1) Determining the purpose of patient involvement and measurement alignment; 2) Re ecting on the qualities, t, and usefulness of measures; 3) Recognizing con icting stakeholder paradigms. Despite the interest in and positive attitudes toward patient involvement, views on the meaning and value of evaluating involvement and innovating varied; in part, this was attributable to challenges in selecting criteria, methods, and measures for evaluation. Conclusion The ndings indicate the need to integrate the perspectives of all key stakeholders in designing the evaluation of patient involvement initiatives. The application of a multiple stakeholder approach and co-production of a multidimensional evaluation may provide some common ground for selecting evaluation criteria and measurement tools in the healthcare setting.