Measuring patient-centredness: a comparison of three observation-based instruments

Area of Science:

• Medical Education
• Health Services Research
• Qualitative Research Methods

Background:

• Patient-centredness is a key quality indicator in healthcare.
• Accurate measurement of patient-centredness is crucial for research and quality improvement.
• Existing observation-based measures vary in their operationalization of patient-centredness.

Purpose of the Study:

• To evaluate the reliability and validity of three distinct observation-based instruments for measuring patient-centredness.
• To compare the performance of these measures in the context of general practitioner (GP) consultations.
• To identify factors influencing the reliability and validity of these measurement tools.

Main Methods:

• Utilized 55 videotaped GP consultations for analysis.
• Applied three distinct, face-valid, observation-based instruments to measure patient-centredness.
• Examined associations between measurement outcomes and consultation input/process variables.

Main Results:

• Inter-rater reliability varied across the three measures, correlating with training intensity.
• Significant differences in construct validity were observed among the instruments.
• Concurrent validity of the measures was generally low.
• Measurement reliability was found to be proportional to the training requirements for the observers.

Conclusions:

• Researchers must carefully select patient-centredness measurement tools due to differing operationalizations.
• Enhanced conceptual clarity and simplification are needed for reliable and meaningful measurement of patient-centredness.
• Findings have implications for research design and the assessment of interpersonal care quality in clinical practice.