Provider behaviors or consumer participation: How should we measure person-centered care?

Abstract

Current research has found that higher rates of person-centered care (PCC) are associated with greater treatment adherence and positive treatment outcomes. However, the instruments used to access PCC primarily collect data on provider behavior, rather than consumer participation in PCC, despite the necessary co-equal and collaborative nature of PCC interactions. The objective of the current study was to test the hypotheses that: (1) the Perceived Involvement in Care Scale (PICS) consumer information subscale and the consumer decision making subscale are not correlated with the PPPC subscales and, (2) consumer perceptions of person-centeredness and of consumer involvement in care are significant independent explanatory variables for the theoretically or quantitatively grounded outcomes of therapeutic alliance, treatment adherence, and mental health care system mistrust. Cross-sectional survey data was collected from 82 mental health care consumers receiving services at two Veterans Health Administration (VHA) facilities. Participants completed surveys on perceptions of PCC, consumer involvement in care, therapeutic alliance, medication adherence, and mental health care system mistrust. Significant correlation between the consumer participation and PCC subscales was mixed. Higher levels of PCC were associated with greater therapeutic alliance, less suspicion of mental health care systems, less perception of lack of support from providers, and less beliefs about group disparities in care. Consumer involvement was only significantly related to suspicion of mental health care systems. These findings may be a function of the locus of each outcome variable. When conducting PCC research investigators should consider how the outcomes they are examining inform the method through which they measure patient-centeredness.