Abstract
BackgroundPresent models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions.MethodA two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria.Results105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment.Discussion11 out of the 15 dimensions have been validated through experts’ ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy.
Highlights
Patient-centeredness is an internationally widely discussed topic in high-quality health care and modern medicine [1,2,3,4,5]
In 2003, Health Canada highlighted the essential meaning of patient-centeredness in health care by creating the initiative Interdisciplinary Education for Collaborative Patient-Centered Practice (IECPCP) [8]
In Australia, patient-centered care is supported by the Australian Charter of Healthcare Rights, which ensures the provision of safe and high-quality care and by the National Safety and Quality Framework for health care, which was developed in 2009 to improve the healthcare system [9]
Summary
Patient-centeredness is an internationally widely discussed topic in high-quality health care and modern medicine [1,2,3,4,5]. In Australia, patient-centered care is supported by the Australian Charter of Healthcare Rights, which ensures the provision of safe and high-quality care and by the National Safety and Quality Framework for health care, which was developed in 2009 to improve the healthcare system [9]. In the UK, patient-centeredness is a core concept in professional medical guidance [10]. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions
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