4.7 Article Proceedings Paper

Measuring patient-centered communication in patient-physician consultations: Theoretical and practical issues

期刊

SOCIAL SCIENCE & MEDICINE
卷 61, 期 7, 页码 1516-1528

出版社

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2005.02.001

关键词

patient-centered; communication; measurement; doctor-patient communication

资金

  1. AHRQ HHS [R01-HS1610-01A1] Funding Source: Medline

向作者/读者索取更多资源

The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and how to measure it. PCC includes four communication domains: the patient's perspective, the psychosocial context, shared understanding, and sharing power and responsibility. Problems in measuring PCC include lack of theoretical and conceptual clarity, unexamined assumptions, lack of adequate control for patient characteristics and social contexts, modest correlations between survey and observational measures, and overlap of PCC with other constructs. We outline problems in operationalizing PCC, choosing tools for assessing PCC, choosing data sources, identifying mediators of PCC, and clarifying outcomes of PCC. We propose nine areas for improvement: (1) developing theory-based operational definitions of PCC (2) clarifying what is being measured; (3) accounting for the communication behaviors of each individual in the encounter as well as interactions among them; (4) accounting for context; (5) validating of instruments; (6) interpreting patient ratings of their physicians; (7) doing longitudinal studies; (8) examining pathways and mediators of links between PCC and outcomes; and (9) dealing with the complexity of the construct of PCC. We discuss the use of observational and survey measures, multi-method and mixed-method research, and standardized patients. The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues. (c) 2005 Elsevier Ltd. All rights reserved.

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