Patient involvement in assessing consultation quality: validation of patient enablement instrument (PEI) in Lithuanian general practice

Aelita Skarbalienė,Eva Lena Strandberg,Arnoldas Jurgutis,Teresa Pawlikowska

doi:10.1186/s12875-019-1061-1

Aelita Skarbalienė, Eva Lena Strandberg + Show 2 more

Open Access

https://doi.org/10.1186/s12875-019-1061-1

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Abstract

BackgroundThe Patient Enablement Instrument (PEI) was designed to encapsulate consultation outcome from the perspective that increasing their understanding and coping ability would underpin a positive consultation outcome for patients. The objective of the study was the validation of the PEI in Lithuanian general practice and comparison of Lithuanian patients’ enablement with previous studies in Europe to see if factors associated with patient enablement in Lithuania were reflective of those in the previous studies.MethodsThe Patient Enablement Instrument was translated into Lithuanian and included in the questionnaire along with the questions about a person’s health, reasons for visiting the doctor and feeling about the consultation. Practices from 4 different municipalities that are situated in different geographical regions which have both town and rural areas were sampled randomly. Patients scheduled consecutively aged 18 years or more were the subjects of the study. The data analyses focused on internal reliability and concept validity.ResultsThe overall mean patient enablement score was 6.43. Enablement scores declined with increasing patient age, and female patients were more enabled. Patients with biomedical problems had the highest enablement results, while patients with complex problems had the lower results. Enablement was positively related to receiving a prescription and knowing a doctor, and negatively related to wish having consultation with another doctor.ConclusionsThis study substantiates the rationality of using PEI in assessing primary care consultations in Lithuania. The correlations of enablement largely reflect the situation in Western and Central Europe: longer consultation and access to the same physician increases patient enablement.

Highlights

The Patient Enablement Instrument (PEI) was designed to encapsulate consultation outcome from the perspective that increasing their understanding and coping ability would underpin a positive consultation outcome for patients
Patient-doctor consultations are pivotal to the delivery of high quality patient care, nowhere more so than in the first contact care that is family practice characterized by people presenting with undifferentiated problems
Sample size was estimated from prior works [3, 9] to ensure that we captured the expected diversity 50 consultations were sampled per doctor and 50 doctors participated in the research

Summary

Introduction

The Patient Enablement Instrument (PEI) was designed to encapsulate consultation outcome from the perspective that increasing their understanding and coping ability would underpin a positive consultation outcome for patients. The essence of primary care has been characterized as being holistic and patient – centered, and measures have been developed to capture this: one of the earliest, Skarbalienė et al BMC Family Practice (2019) 20:167 provider and is expected to be associated with behaviours like treatment adherence and self-care and indicators of quality of care [2]. PEI was designed to encapsulate consultation outcome from the perspective that increasing their understanding and coping ability would underpin a positive consultation outcome for patients [3]. Health needs and culture have been shown to relate to PEI outcome, there is some inconsistency [3, 4, 6]

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