Self-Determination Theory to observe healthcare professionals' counselling in chronic care encounters: Development of the COUNSEL-CCE tool

Objective: To develop and psychometrically evaluate an observation tool to rate healthcare professionals' engagement in need-supportive and need-thwarting counselling in chronic care encounters. Methods: The observation tool was developed through three stages (January 2018-June 2019). First, a set of items was developed according to essential components of need-supportive and need-thwarting counselling as identified in Self-Determination Theory. Second, content validation by five experts. Third, ecological validation using video-recorded real-life consultations. For the psychometric evaluation (June-October 2019), the tool was used by three observers to code 55 units of real-life encounters. Results: The Coding and Observing Need-Supportive Counselling in Chronic Care Encounters (COUNSELCCE) consists of 44 items clustered into nine theoretically underpinned behavioural approaches. Psychometric testing indicated acceptable to good consistency in scoring between observers and strong consistency within observers. Conclusion: The COUNSEL-CCE captures person-oriented alongside process-oriented aspects during chronic care encounters. A person-oriented approach expresses counselling that is responsive to individual preferences and needs, whereas a process-oriented approach indicates the necessity to support competency building within patients, and is more instrumental of nature. Practice implications: COUNSEL-CCE is a valuable observation tool to assess (graduate) healthcare professionals' counselling style and address if, and how, counselling evolves as a result of professional training. (c) 2020 Elsevier B.V. All rights reserved.

Automated summary

The study developed and evaluated an observation tool to assess healthcare professionals' engagement in need-supportive and need-thwarting counselling in chronic care encounters. The tool demonstrated good consistency in scoring between observers and strong consistency within observers. This tool can be valuable for assessing and addressing healthcare professionals' counselling style and evolution through professional training.