Characteristics of Instruments Measuring Patient-Centered Care
| Instrument | Origin | Conceptual Base | Description | Subscale (Items) |
|---|---|---|---|---|
| Patient Perception of Patient-Centeredness (PPPC) | Existing literature and empirical studies on the doctor-patient relationship and the Stewart et al model | Stewart et al model | 14 Items, 4-point Likert scale (completely to not at all) | No subscale (14/14, α= .71) |
| Consultation Care Measure (CCM) | Existing literature and empirical studies on the doctor-patient relationship, the Stewart et al model, and patient interviews | Stewart et al model | 21 Items, 4-point Likert scale (very strongly agree to neutral/disagree) | Communication and partnership (11/11, α = .96), personal relationship (3/3, α= .89), health promotion (2/2, α = .87), positive and clear approach to problem (3/3, α= .84) and interest in effect on life (2/2, α= .89) |
| Patient Reactions Assessment (PRA) | Existing instruments, existing literature and empirical studies on the physician-patient relationship, interviews with patients and caregivers, and clinical experiences of the research team | Dimensions of the physician-patient medical relationship | 15 Items, 7-point Likert scale (very strongly disagree to very strongly agree) | Patient information index (2/5, α = .87), patient communication index (1/5, α=.91) and patient affective index (5/5, α=.90) Excluded: Patient information index (3/5) and patient communication (4/5) |
| Perceived Involvement in Care Scale (PICS) | Existing literature and empirical studies on patient participation in medical care, observations of the principal researcher, expert consultations | Dimensions of patient participation | 13 Items, dichotomous scale (yes/no) | Doctor facilitation (5/5, α=.60–.73) Excluded: Patient information (4/4) and patient decision making (4/4) |
| Component of Primary Care Instrument (CPCI) | Interim report by the Institute of Medicine (IOM) in 1994 defining primary care and its components | IOM’s definition of primary care and dimensions of primary care | 52 Items, 6-point Likert scale (strongly disagree to strongly agree) | Accumulated knowledge (7/7, α = .88), interpersonal communication (6/6, α=.75), advocacy (2/9, α=.88), family context(2/3, α = .82) and community context (2/2, α not available) Excluded: Comprehensive care (6/6), preference for regular physician (4/4), coordination of care (6/6), family context (1/3), duration of relationship (2/2) and continuity (3/3) |
| Medical Communication Competence Scale (MCCS) | Existing literature and empirical studies on doctor-patient communication | Dimensions of medical communication | 40 Items (patient’s version), 7-point Likert scale strongly agree to strongly disagree) | No subscale (24/40, α = .79 for information giving, α = .76 for information seeking, α = .85 for information verifying, and α =.92 for socioemotional communication) Excluded: Patients’ self-competence items (16/40) |
| Primary Care Assessment Survey (PCAS) | Interim report by the Institute of Medicine (IOM) in 1994 defining primary care and its components | IOM’s definition of primary care | 51 Items, 6-point Likert scale (very poor to excellent) | Contextual knowledge of patient (5/5, α=.92), communication (6/6, α=.95), interpersonal treatment (4/5, α = .95) and trust (5/8, α=.86) Excluded: Organizational access (6/6), financial access (2/2), longitudinal continuity (1/1) and visit-based continuity (2/2), preventive counseling (7/7), integration (6/6), interpersonal treatment (1/5), thoroughness of physical examination (1/1), trust (3/8), screener items (2/2) |
| Interpersonal Processes of Care (IPC) | Focus group, existing literature and empirical studies on the doctor-patient relationship and the quality of care, Stewart et al model and cognitive interviews | Dimensions of interpersonal care processes | 29 Items, 5-point Likert scale (never to always) | Hurried communication (5/5, α = .65), elicited concerns, responded (3/3, α=.80), explained results, medication (4/4, α = .81), patient-centered decision-making (3/3, α = .75) and compassionate, respectful (5/5, α=.71) Excluded: Discrimination (4/4) and disrespectful office staff (5/5) |
| General Practice Assessment Survey (GPAS) | PCAS | Dimensions of primary care | 30 Items, 6-point Likert scale (very poor to excellent) | Communication (2/4, α = .90), interpersonal care (3/3, α=.93), trust (2/4, α=.69) and knowledge of patient (3/3, α=.91) Excluded: Accessibility (8/8), technical care (5/5), communication (2/4), trust (2/4) and nursing care (3/3) |
| Patient Perception of Quality (PPQ) | Existing instruments, existing literature and empirical studies on quality of care, patient interviews and expert consultations | Dimensions of quality of care | 22 Items, 5-point Likert scale (negative to positive) | Interpersonal aspects of care (5/5, α = .91) and technical aspects of care (5/12, α=.91) Excluded: Technical aspects of care (7/12) and outcomes of care (5/5) |
| Priamry Care Assessment Tool– Adult (PCAT–A) | Primary Care Assessment Tool–Child, expert consultations | Dimensions of primary care | 74 Items, 4-point Likert scale (definitely not to definitely) | Ongoing care (12/20, α=.92) Excluded: First-contact accessibility (4/4), first contact utilization (3/3), ongoing care (8/20) coordination of services (8/8), comprehensiveness services available (21/21), comprehensive service received (13/13) and community orientation (5/5) |
| Colsultation and Relational Empathy (CARE) | Existing literature and empirical studies on empathy and in-depth qualitative work on patient’s views on holistic care | Dimensions of empathy | 10 Items, 5-point Likert scale (poor to excellent) | No subscale (10/10, α=.92) |
| Instrument on Doctor-Patient Communication Skills (IDPCS) | Existing instruments (PPPC and Core Competency of Interpersonal and Communication Skills), revised conceptual framework adapted from the Calgary–Cambridge guide and expert consultations | The Stewart et al model and communication theories | 19 items, 5-point Likert scale (strongly disagree to strongly agree) | No subscale (19/19, α=.69) |