Further validation of the Patient-Practitioner Orientation Scale (PPOS) from recorded visits for back pain

Abstract

ObjectiveMore patient-centered communication is associated with improved patient satisfaction and health status, fewer malpractice complaints, and increased adherence. In a study of medical encounters for acute low back pain (LBP), we conducted a secondary analysis to assess the validity of the Patient Practitioner Orientation Scale (PPOS), a measure of patient-centeredness. MethodsFourteen clinicians and 89 of their patients with acute LBP completed the PPOS and agreed to have verbal exchanges recorded and coded using the Roter Interaction Analysis System (RIAS). We examined correlations between the PPOS and counts of patient and provider utterances within 8 RIAS verbal exchange categories. ResultsProviders with a more patient-centered orientation asked fewer biomedical questions, posed more lifestyle questions, gave more lifestyle advice, and did more rapport-building. Their patients shared more lifestyle information and made more attempts at rapport building and provider engagement. In contrast, the patient-centered orientation of patients showed no effect on communication. ConclusionThe PPOS scores of providers, but not patients, predicted significant and meaningful differences in the verbal exchanges of patients and providers. Practice implicationsThe results support the validity of the PPOS measure and provide further evidence of the extent to which provider orientation influences patient communication and exchange.