Literature DB >> 23205039

Interpersonal communication from the patient perspective: comparison of primary healthcare evaluation instruments.

Marie-Dominique Beaulieu1, Jeannie L Haggerty, Christine Beaulieu, Fatima Bouharaoui, Jean-Frédéric Lévesque, Raynald Pineault, Frederick Burge, Darcy A Santor.   

Abstract

UNLABELLED: The operational definition of interpersonal communication is "the ability of the provider to elicit and understand patient concerns, to explain healthcare issues and to engage in shared decision-making if desired."
OBJECTIVE: To examine how well interpersonal communication is captured in validated instruments that evaluate primary healthcare from the patient's perspective.
METHOD: 645 adults with at least one healthcare contact in the previous 12 months responded to instruments that evaluate primary healthcare. Eight subscales measure interpersonal communication: the Primary Care Assessment Survey (PCAS, two subscales); the Components of Primary Care Index (CPCI, one subscale); the first version of the EUROPEP (EUROPEP-I); and the Interpersonal Processes of Care Survey, version II (IPC-II, four subscales). Scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation) factor analysis examined fit to operational definition, and item response theory analysis examined item performance.
RESULTS: Items not pertaining to interpersonal communication were removed from the EUROPEP-I. Most subscales are skewed positively. Normalized mean scores are similar across subscales except for IPC-II Patient-Centred Decision-Making and IPC-II Hurried Communication. All subscales load reasonably well on a single factor, presumed to be interpersonal communication. The best model has three underlying factors corresponding to eliciting (eigenvalue = 26.56), explaining (eigenvalue = 2.45) and decision-making (eigenvalue = 1.34). Both the PCAS Communication and the EUROPEP-I Clinical Behaviour subscales capture all three dimensions. Individual subscales within IPC-II measure each sub-dimension.
CONCLUSION: The operational definition is well reflected in the available measures, although shared decision-making is poorly represented. These subscales can be used with confidence in the Canadian context to measure this crucial aspect of patient-centred care.

Entities:  

Year:  2011        PMID: 23205039      PMCID: PMC3399440     

Source DB:  PubMed          Journal:  Healthc Policy        ISSN: 1715-6572


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