Brian Mavis1, Margaret Holmes Rovner2, Sarah Jorgenson3, John Coffey4, Nandita Anand5, Emi Bulica5, Carolyn Marie Gaulden5, Jacob Peacock5, Alycia Ernst5. 1. Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA. 2. Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University, East Lansing, MI, USA. 3. Center for Advancing Health, Washington, DC, USA. 4. Michigan State University Libraries, East Lansing, MI, USA. 5. College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Abstract
BACKGROUND: There is evidence suggesting that active participation of patients in their health care can improve the quality of care and decrease health-care costs. Further, patient reports of their health-care experience are increasingly used to monitor health-care quality. OBJECTIVE: This paper describes a systematic review of peer-reviewed studies to identify measures of patients' active participation in their encounters with health-care providers. METHODS: A systematic literature review was conducted for publications indexed from 1975 to 2011. Of interest were self-reported measures of patient participation that were not limited to a specific health concern. All abstracts were reviewed independently by two authors, and the full paper was considered for those meeting inclusion criteria. MAIN RESULTS: From a review of 4528 citations, ten measures were identified. The approaches to development of the measures varied considerably, as did their study samples and their psychometric quality. DISCUSSION: These measures represented three conceptual frameworks: empowerment and self-efficacy, therapeutic alliance, and consumerism/satisfaction. They provide a more comprehensive perspective of patients' experiences of their provider encounters, and a better understanding patient behaviour enhanced the quality of health-care delivery or improved health outcomes. These measures underscore the continuing challenge of defining patient participation and the multiple theoretical approaches that underlie this form of patient behaviour. CONCLUSIONS: Current interest in quality-related physician report cards gives significant weight to patients' self-reported experiences as one dimension of physician performance. It is critical to identify the specific focus and quality of measures selected for this and research purposes.
BACKGROUND: There is evidence suggesting that active participation of patients in their health care can improve the quality of care and decrease health-care costs. Further, patient reports of their health-care experience are increasingly used to monitor health-care quality. OBJECTIVE: This paper describes a systematic review of peer-reviewed studies to identify measures of patients' active participation in their encounters with health-care providers. METHODS: A systematic literature review was conducted for publications indexed from 1975 to 2011. Of interest were self-reported measures of patient participation that were not limited to a specific health concern. All abstracts were reviewed independently by two authors, and the full paper was considered for those meeting inclusion criteria. MAIN RESULTS: From a review of 4528 citations, ten measures were identified. The approaches to development of the measures varied considerably, as did their study samples and their psychometric quality. DISCUSSION: These measures represented three conceptual frameworks: empowerment and self-efficacy, therapeutic alliance, and consumerism/satisfaction. They provide a more comprehensive perspective of patients' experiences of their provider encounters, and a better understanding patient behaviour enhanced the quality of health-care delivery or improved health outcomes. These measures underscore the continuing challenge of defining patient participation and the multiple theoretical approaches that underlie this form of patient behaviour. CONCLUSIONS: Current interest in quality-related physician report cards gives significant weight to patients' self-reported experiences as one dimension of physician performance. It is critical to identify the specific focus and quality of measures selected for this and research purposes.
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Authors: Kate Breckenridge; Hillary L Bekker; Elizabeth Gibbons; Sabine N van der Veer; Denise Abbott; Serge Briançon; Ron Cullen; Liliana Garneata; Kitty J Jager; Kjersti Lønning; Wendy Metcalfe; Rachael L Morton; Fliss E M Murtagh; Karl Prutz; Susan Robertson; Ivan Rychlik; Steffan Schon; Linda Sharp; Elodie Speyer; Francesca Tentori; Fergus J Caskey Journal: Nephrol Dial Transplant Date: 2015-05-16 Impact factor: 5.992