Abstract
BackgroundPatient centeredness is an important component of patient care and healthcare quality. Several scales exist to measure patient centeredness, and previous literature provides a critical appraisal of their measurement properties. However, limited knowledge exists regarding the content of the various scales in terms of what type of patient centeredness they represent and how they can be used for quality improvement. The aim of this study was to explore the measurement properties of patient centeredness scales and their content with a special focus on patient involvement, and assess whether and how they can be used for quality improvement.MethodsA systematic review of patient centeredness scales was conducted in Medline, CINAHL, Embase, and SCOPUS in April and May 2017. Inclusion criteria were limited to articles written in English published from 2005 to 2017. Eligible studies were critically appraised in terms of internal consistency and reliability, as well as their content, structural, and cross-cultural validity. Type of studies included were scale-development articles and validation studies of relevant scales, with healthcare personnel as respondents. We used directed content analysis to categorize the scales and items according to Tritter’s conceptual framework for patient and public involvement.ResultsEleven scales reported in 22 articles were included. Most scales represented individual, indirect, and reactive patient involvement. Most scales included items that did not reflect patient centeredness directly, but rather organizational preconditions for patient centered practices. None of the scales included items explicitly reflecting the use of patient experiences of quality improvement.ConclusionsThere is a lack of patient centeredness scales focusing on direct and proactive involvement of patients in quality improvement. It would be useful to develop such instruments to further study the role of patient involvement in quality improvement in healthcare. Furthermore, they could be used as important tools in quality improvement interventions.
Highlights
Patient centeredness is an important component of patient care and healthcare quality
The aims of this study were to 1) conduct a quality appraisal focusing on the measurement properties of patient centeredness scales for healthcare professionals, 2) explore the content of the scales in terms of whether and how patient involvement is represented according to the Patient and Public Involvement (PPI) conceptual framework, and 3) explore whether the scales reflect patient involvement in quality improvement practices
Data extraction and critical appraisal For the critical appraisal of the methodological quality of the 22 included studies, we evaluated the quality of measurement properties using five of the seven criteria applied by Wilberforce et al [13]
Summary
Patient centeredness is an important component of patient care and healthcare quality. The aim of this study was to explore the measurement properties of patient centeredness scales and their content with a special focus on patient involvement, and assess whether and how they can be used for quality improvement. The Institute of Medicine regards patient centered care and patient experiences as one of six dimensions of healthcare quality [1], and it is extensively addressed in the research literature [2]. The concept of patient centered care has received widespread attention in the scientific arena since the mid-1950s [3] It became embedded in healthcare policies and regulations in several developed countries only at the turn of the millennium [4,5,6,7]. We consider patient involvement an important dimension of patient centeredness, and scales addressing the latter should include some aspects of patient involvement
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