Assessing attitudes of patient-centered care among chiropractic students at a South African university.

Fatima Ismail,Christopher Yelverton,Tamaryn Schafer,Cynthia Peterson

doi:10.7899/jce-21-2

Abstract

Patient-centered care (PCC) is acknowledged globally as a foundation of quality patient care and key to doctor-patient rapport. Student attitudes toward PCC have been assessed in some health professions and some international chiropractic institutions but is lacking in the South African chiropractic student context. This study explores this concept and compares these attitudes to other student groups. A cross-sectional survey was conducted on chiropractic students (years 1, 3, 5, and 6) at a South African institution. The 18-item Patient-Practitioner Orientation Scale (PPOS), with scoring 1-6 on a Likert scale, was used to evaluate the attitude toward PCC by students. Higher scores were representative of more patient-centeredness. Variables were analyzed to assess for associations between variables. Mean PPOS scores were calculated, and reliability and validity were tested using Cronbach α and factor analysis. There were 100 respondents (68% response rate). The PPOS showed unsatisfactory reliability in our sample. The mean scores for the overall PPOS were 3.64 (SD = 0.46), the sharing subscale was 2.99 (SD = 0.61), and the caring subscale was 4.29 (SD = 0.58). There were small but suggestive trends noticed in PPOS scores based on age, sex, and year of study. Chiropractic students from our university showed a general positive tendency toward PCC with no association between age and year of study. Sex showed some suggestive descriptive trends contrary to findings in other studies. The PPOS showed poor reliability in this study, warranting consideration with its use in similar contexts.

Highlights

The quality and effectiveness of health care is fundamentally reliant on evidence-based practice[1] (EBP), which has been widely accepted as good clinical practice.[2]
Patient-centered care (PCC), a second model, refers to an approach to the planning, delivery, and evaluation of health care grounded in equitable partnerships between health care providers, patients, and their families.[10]
There were no statistically significant differences found across the sample to the overall Patient–Practitioner Orientation Scale (PPOS), some statistically significant differences were noted in the sharing subscales with female students scoring less in the sharing subscale than male students

Summary

Introduction

The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.’’8 Following reproach from primary health care practitioners, ‘‘patient values’’ were included into the EBP decision-making process.[9]. This has created the need for the inception of yet another trend, Evidence-Based Patient Choice, which aims to merge the EBP and PCC practices allowing the patient the lead role in making informed decisions based on current best evidence.[3,16,17]

Results

Discussion

Conclusion