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Crompvoets PI, Nieboer AP, van Rossum EFC, Cramm JM. Perceived weight stigma in healthcare settings among adults living with obesity: A cross-sectional investigation of the relationship with patient characteristics and person-centred care. Health Expect 2024; 27:e13954. [PMID: 39102661 PMCID: PMC10790109 DOI: 10.1111/hex.13954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Patients living with obesity often experience weight stigma in healthcare settings, which has worrying consequences for their healthcare experiences. This cross-sectional study aimed to: (1) provide an overview of stigmatising experiences in healthcare settings reported by adults living with varying classes of obesity, (2) identify associations among patient characteristics and perceived weight stigma and (3) investigate the association between perceived weight stigma and person-centred care (PCC). METHODS Dutch adults living with obesity classes I (body mass index [BMI]: 30 to <35 kg/m2; n = 426), II (BMI: 35 to <40 kg/m2; n = 124) and III (BMI: ≥40 kg/m2; n = 40) completed measures of perceived weight stigma in healthcare settings and PCC. Descriptive, correlational and multivariate analyses were conducted. RESULTS Of patients living with classes I, II and III obesity, 41%, 59% and 80%, respectively reported experiences of weight stigma in healthcare settings. Younger age, greater obesity severity and the presence of chronic illnesses were associated with greater perceived weight stigma. Greater perceived weight stigma was associated with lower PCC. CONCLUSION The results of this study emphasise the significant role of weight stigma in the healthcare experiences of patients living with obesity. Reducing weight stigma is expected to improve PCC and the overall quality of care for these patients. Minimising weight stigma will require efforts across various healthcare domains, including increasing awareness among healthcare professionals about sensitive communication in weight-related discussions. PATIENT CONTRIBUTION Our sample consisted of patients living with obesity. Additionally, patients were involved in the pilot testing and refinement of the PCC instrument.
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Affiliation(s)
- Paige I. Crompvoets
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
| | - Anna P. Nieboer
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
| | - Elisabeth F. C. van Rossum
- Department of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Obesity Center CGGErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Jane M. Cramm
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
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Kim YJ, Lee G, Choi S. Validation of the Korean Version of Patient-Centered Care Tool: For Outpatients. Patient Prefer Adherence 2023; 17:1525-1540. [PMID: 37405193 PMCID: PMC10317544 DOI: 10.2147/ppa.s411109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/03/2023] [Indexed: 07/06/2023] Open
Abstract
Aim The objective of this study was to assess the validity and reliability of the Korean version of the patient-centered care (K-PCC) instrument for outpatients. The study was conducted due to the absence of a measurement tool specifically designed to evaluate patient-centered care for outpatients. Design This study is a methodological study to verify the validity and reliability of the Korean version of Patient-Centered Care (K-PCC) to measure patient-centeredness for outpatients. Methods As a first step for the evaluation of the tool, the content validity was verified by expert panel. Then, a total of 400 outpatients were recruited, and construct validity was verified through confirmatory factor analysis (CFA) as the second step for the evaluation of the tool. The convergent and discriminant validity of the tool was verified by calculating the standardized factor loads, construct reliability (CR), and average variance extracted (AVE), and calculating the correlation square between the factors as the third and fourth steps for the evaluation of the tool. And as a fifth step for the evaluation of the tool, criterion validity was evaluated by comparing the correlation with the patient-centeredness measurement tool for inpatients (PEx-inpatient). In estimating reliability, internal consistency reliability coefficients were calculated. Results The confirmatory factor analysis supported good fit for the Korean patient-centered care instrument (K-PCC), and the eight-factor structure was validated. The scale comprises 21 items across eight factors: patient preferences (4 items), physical comfort (2 items), coordination of care (2 items), continuity and transition (3 items), emotional support (2 items), access to medical care (3 items), information and education (2 items), and family and friends (3 items). The Cronbach's alphas ranging between 0.73 and 0.88. Conclusion The Korean patient-centered primary care instrument is a valid and reliable scale to measure patient-centered care for outpatients in the Korean medical environment.
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Affiliation(s)
- Yeo Ju Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
- Inje University Ilsan-Paik Hospital, Goyang, Gyeonggi-do, South Korea
| | - Gunjeong Lee
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Sunyeob Choi
- College of Nursing, Ewha Womans University, Seoul, South Korea
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Moroz G, Kutch T, Tkachuk I, Sokoluk A, Tkalenko O. PATIENT-CENTERED CARE AND SELF-MANAGEMENT: OPINION OF MILITARY PERSONNEL WITH CORONARY ARTERY DISEASE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1594-1599. [PMID: 37622502 DOI: 10.36740/wlek202307112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim: Тo determin attitude of military personnel with coronary artery disease to implementation of the principles of patient- centered care and self-assessment of adherence to treatment. PATIENTS AND METHODS Materials and methods: 72 military personnel (male aged 30-58 years) with coronary artery disease, who visited the general practitioners at the Outpatient Care Clinic of the National Military Medical Clinical «Main Military Clinical Hospital» were interviewed anonymously, using the specially designed questionnaire. The patients were divided into two groups: the 1st group with individuals of 49 years old and younger (39 military personnel, mean age 42,8«5,0) and the 2nd group who is 50 years and older (33 military personnel, mean age 53,2«2,4 years). RESULTS Results: The results of a sociological survey showed that the majority of military personnel with coronary artery disease believe that doctors do not always provide them with enough information about their health (61,1%) and they do not always provide emotional support to solve their health problems (66,7 %). It has been indicated a mismatch between patients' willingness to participate in shared decision-making regarding a treatment (84,7 % of them) and adher¬ence to treatment - 55,6% of surveyed patients rated adherence to treatment by three points or less on a five-point scale. There is no statistically significant difference between military personnel of the 1st and 2nd groups. CONCLUSION Conclusions: The results of the study showed the interest and readiness of surveyed military personnel with coronary artery disease to implementation of the principles of patient-centered medical care.
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Affiliation(s)
- Galina Moroz
- UKRAINIAN MILITARY MEDICAL ACADEMY, KYIV, UKRAINE
| | - Taras Kutch
- UKRAINIAN MILITARY MEDICAL ACADEMY, KYIV, UKRAINE
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Ewunetu M, Temesgen W, Zewdu D, Andargie A, Kebede M, Lidetu T. Patients' Perception of Patient-Centered Care and Associated Factors Among Patients Admitted in Private and Public Hospitals: A Comparative Cross-Sectional Study. Patient Prefer Adherence 2023; 17:1035-1047. [PMID: 37090181 PMCID: PMC10120812 DOI: 10.2147/ppa.s402262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/05/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction The provision of patient-centered care is challenging around the globe, including in Ethiopia. There is a scarcity of information on this issue. Therefore, this study aimed to assess patients' perceptions of patient-centered care and associated factors among patients admitted to public and private hospitals in Bahir Dar city. Methods A facility-based comparative cross-sectional study was conducted from May 8-June 15, 2022. Using a multistage sampling approach, the study participants were selected. An interviewer was used to collect the data. Bi-variable and multivariable logistic regressions were used to analyze the data. Statistical significance was declared using a p value< 0.05. Results Overall, 53.7% of patients reported poor patient-centered care. And it was higher among public hospitals (66.3%) than private hospitals (40.3%). Length of stay (AOR = 4.2; 95% CI [1.1, 15.3] and AOR = 4.3; 95% CI [1.4, 13]), intimacy with providers (AOR = 2.4; 95% CI [1.2, 4.6] and AOR = 3.9; 95% CI [1.1-9.6]), privacy during care (AOR = 4.2; 95% CI [1.93, 8.9]and AOR=3.3;95% CI: [1.5-7]), easy access to service (AOR=2.76;95% CI [1.33, 5.74] and AOR=3.8;95% CI [1.15, 12.7]) were associated with patient-centered care in public and private hospitals respectively. Awareness of the disease (AOR = 2.3; 95% CI [1.12, 4.8]), information on plans of care (AOR = 4.6; 95% CI [1.9, 10]), and being involved in decisions (AOR = 2.7; 95% CI [1.28, 5.9]) were associated factors in private hospitals. The following factors were associated with the practice of patient-centered care only in public hospitals: residence (AOR = 2.9; 95% CI [1.4, 5.5]), medication information (AOR = 2.88; 95% CI [1.34, 6.2]), and external appearance of hospital (AOR = 2.27; 95% CI [1.04, 4.97]). Conclusion This study showed that the practice of patient-centered care in public hospitals was poor compared to that in private hospitals. Hence, hospitals should train their staff regarding a culture of patient-centered care in order to deliver high-quality and safer care.
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Affiliation(s)
- Mengistu Ewunetu
- Department of Adult Health Nursing, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
- Correspondence: Mengistu Ewunetu, Debre Tabor University, P.O.Box Address: 272, Debre Tabor, Ethiopia, Tel +251945575289, Email
| | - Worku Temesgen
- Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dagmawit Zewdu
- Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Astewle Andargie
- Department of Adult Health Nursing, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulu Kebede
- Department of Adult Health Nursing, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadios Lidetu
- Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Mahdavi M, Parsaeian M, Borzouei S, Majdzadeh R. Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran. BMC Health Serv Res 2021; 21:896. [PMID: 34461877 PMCID: PMC8406836 DOI: 10.1186/s12913-021-06932-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/24/2021] [Indexed: 12/05/2022] Open
Abstract
Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. Methods We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. Results After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). Conclusions Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06932-0.
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Affiliation(s)
- Mahdi Mahdavi
- The Bernard Lown Scholar in Cardiovascular Health, Harvard T.H. Chan School of Public Health, Boston, USA. .,National Institute for Health Research, Tehran University of Medical Sciences, Postal address: No 70, Bozorgmehr st, Tehran, Iran.
| | - Mahboubeh Parsaeian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shiva Borzouei
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Reza Majdzadeh
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Knowledge Utilization Research Center and Community-Based Participatory-Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Kuipers SJ, Nieboer AP, Cramm JM. Making care more patient centered; experiences of healthcare professionals and patients with multimorbidity in the primary care setting. BMC FAMILY PRACTICE 2021; 22:70. [PMID: 33836652 PMCID: PMC8035730 DOI: 10.1186/s12875-021-01420-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/23/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The present study describes how primary care can be improved for patients with multimorbidity, based on the evaluation of a patient-centered care (PCC) improvement program designed to foster the eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, coordination of care, continuity and transition, emotional support, and family and friends). This study characterizes the interventions implemented in practice as part of the PCC improvement program and describes the experiences of healthcare professionals and patients with the resulting PCC delivery. METHODS This study employed a mixed-methods design. Semi-structured interviews were conducted with nine general practitioners and nurse practitioners from seven primary care practices in Noord-Brabant, the Netherlands, that participated in the program (which included interventions and workshops). The qualitative interview data were examined using thematic analysis. A longitudinal survey was conducted with 138 patients with multimorbidity from these practices to assess perceived improvements in PCC and its underlying dimensions. Paired sample t tests were performed to compare survey responses obtained at a 1-year interval corresponding to program implementation. RESULTS The PCC improvement program is described, and themes necessary for PCC improvement according to healthcare professionals were generated [e.g. Aligning information to patients' needs and backgrounds, adapting a coaching role]. PCC experiences of patients with multimorbidity improved significantly during the year in which the PCC interventions were implemented (t = 2.66, p = 0.005). CONCLUSION This study revealed how primary PCC can be improved for patients with multimorbidity. It emphasizes the importance of investing in PCC improvement programs to tailor care delivery to heterogenous patients with multimorbidity with diverse care needs. This study generates new perspectives on care delivery and highlights opportunities for its improvement according to the eight dimensions of PCC for patients with multimorbidity in a primary care setting.
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Affiliation(s)
- Sanne Jannick Kuipers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Kuipers SJ, Nieboer AP, Cramm JM. Views of patients with multi-morbidity on what is important for patient-centered care in the primary care setting. BMC FAMILY PRACTICE 2020; 21:71. [PMID: 32336277 PMCID: PMC7184691 DOI: 10.1186/s12875-020-01144-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/15/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patient-centered care (PCC) has been proposed as the way forward in improving primary care for patients with multi-morbidity. However, it is not clear what PCC exactly looks like in practice for patients with multi-morbidity. A better understanding of multi-morbid patients' views on what PCC should look like and which elements are most important may help to improve care delivery for this vulnerable population. The present study thus aimed to identify views of patients with multi-morbidity on the relative importance of PCC aspects in a Dutch primary care setting. METHODS Interviews were conducted with 16 patients with multi-morbidity using Q-methodology, which combines quantitative and qualitative analyses. The participants ranked 28 statements about the eight dimensions of PCC (patients' preferences, information and education, access to care, emotional support, family and friends, continuity and transition, physical comfort, and coordination of care) by relative importance. By-person factor analysis using centroid factor extraction and varimax rotation were used to reveal factors that represent viewpoints. Qualitative interview data were used to interpret the viewpoints. RESULTS The analyses revealed three factors representing three distinct viewpoints of patients with multi-morbidity on what is important for patient-centered care in the primary care setting. Patients with viewpoint 1 are prepared proactive patients who seem to be well-off and want to be in charge of their own care. To do so, they seek medical information and prefer to be supported by a strongly coordinated multidisciplinary team of healthcare professionals. Patients with viewpoint 2 are everyday patients who visit GPs and require well-coordinated, respectful, and supportive care. Patients with viewpoint 3 are vulnerable patients who are less resourceful in terms of communication skills and finances, and thus require accessible care and professionals taking the lead while treating them with dignity and respect. CONCLUSION The findings of this study suggest that not all patients with multi-morbidity require the same type of care delivery, and that not all aspects of PCC delivery are equally important to all patients.
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Affiliation(s)
- Sanne Jannick Kuipers
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jane Murray Cramm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Cramm JM, Nieboer AP. Validation of an instrument to assess informal caregivers' perceptions about the delivery of patient-centred care to people with intellectual disabilities in residential settings. BMC Health Serv Res 2019; 19:518. [PMID: 31340813 PMCID: PMC6657207 DOI: 10.1186/s12913-019-4358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Validated instruments are needed to assess the delivery of patient-centred care (PCC) to people with intellectual disabilities (PWIDs) needing 24-h care in residential settings. Eight dimensions of PCC have been identified: taking patients' preferences into account; access to care; emotional support; physical comfort; information and education; involvement of family and friends; coordination of care; and continuity and secure transition. Objective of this study is to validate an instrument to assess these eight PCC dimensions among informal caregivers of PWIDs in residential settings (institutional settings as well as group homes in the community). The original 24-item instrument was developed and validated among professionals providing care to PWIDs. METHODS This study was conducted in a disability care centre in the Netherlands. All informal caregivers of PWIDs living in institutional settings or group homes in the community in need of 24-h care were invited to participate (n = 941). The response rate was 31% (n = 289). We tested the instrument using structural equation modelling, and examined its validity and reliability. RESULTS Confirmatory factor analyses revealed good indices of fit and overall internal consistency, as represented by Cronbach's alpha values. All eight dimensions of PCC were related positively to satisfaction with care (all p ≤ 0.001). As expected, informal caregivers were less critical of PCC and its underlying dimensions, except for information and education, than were professionals working in the same disability care centre. CONCLUSIONS The psychometric properties of the 24-item PCC instrument for informal caregivers (PCC-IC) were satisfactory, indicating that the PCC-IC is valid and reliable for the assessment of the eight dimensions of PCC among informal caregivers of PWIDs in residential settings.
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Affiliation(s)
- Jane Murray Cramm
- Erasmus School of Health Policy and Management, Department of Socio-Medical Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anna Petra Nieboer
- Erasmus School of Health Policy and Management, Department of Socio-Medical Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Hakobyan L, Nieboer AP, Finkenflügel H, Cramm JM. The Significance of Person‐Centered Care for Satisfaction With Care and Well‐Being Among Informal Caregivers of Persons With Severe Intellectual Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Liana Hakobyan
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Anna P. Nieboer
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Harry Finkenflügel
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Jane M. Cramm
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
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Kuipers SJ, Cramm JM, Nieboer AP. The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Serv Res 2019; 19:13. [PMID: 30621688 PMCID: PMC6323728 DOI: 10.1186/s12913-018-3818-y] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 12/14/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Patients with multi-morbidity have complex care needs that often make healthcare delivery difficult and costly to manage. Current healthcare delivery is not tailored to the needs of patients with multi-morbidity, although multi-morbidity poses a heavy burden on patients and is related to adverse outcomes. Patient-centered care and co-creation of care are expected to improve outcomes, but the relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care among patients with multi-morbidity are not known. METHODS In 2017, a cross-sectional survey was conducted among 216 (of 394 eligible participants; 55% response rate) patients with multi-morbidity from eight primary care practices in Noord-Brabant, the Netherlands. Correlation and regression analyses were performed to identify relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care. RESULTS The mean age of the patients was 74.46 ± 10.64 (range, 47-94) years. Less than half (40.8%) of the patients were male, 43.3% were single, and 39.3% were less educated. Patient-centered care and co-creation of care were correlated significantly with patients' physical well-being, social well-being, and satisfaction with care (all p ≤ 0.001). Patient-centered care was associated with social well-being (B = 0.387, p ≤ 0.001), physical well-being (B = 0.368, p ≤ 0.001) and satisfaction with care (B = 0.425, p ≤ 0.001). Co-creation of care was associated with social well-being (B = 0.112, p = 0.006) and satisfaction with care (B = 0.119, p = 0.007). CONCLUSIONS Patient-centered care and co-creation of care were associated positively with satisfaction with care and the physical and social well-being of patients with multi-morbidity in the primary care setting. Making care more tailored to the needs of patients with multi-morbidity by paying attention to patient-centered care and co-creation of care may contribute to better outcomes.
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Affiliation(s)
- Sanne Jannick Kuipers
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane Murray Cramm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Cramm JM, Nieboer AP. Validation of an instrument for the assessment of patient-centred care among patients with multimorbidity in the primary care setting: the 36-item patient-centred primary care instrument. BMC FAMILY PRACTICE 2018; 19:143. [PMID: 30153809 PMCID: PMC6114899 DOI: 10.1186/s12875-018-0832-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022]
Abstract
Background Validated instruments are needed to assess the delivery of patient-centred care (PCC) to patients with multimorbidity in the primary care setting. Eight dimensions of PCC have been identified: respect for patients’ preferences, access to care, emotional support, information and education, involvement of family and friends, continuity and secure transition between health care settings, physical comfort, and coordination of care. The main objective of this study was to validate an instrument for the assessment of PCC among patients with multimorbidity in the primary care setting: the 36-item patient-centred primary care (PCPC) instrument. Methods We included patients with multimorbidity from seven health care practices in the region of Tilburg, the Netherlands. All patients enrolled in at least two chronic care programmes (involving diagnosis of and treatment for combinations of diabetes, asthma and/or chronic obstructive pulmonary disease, cardiovascular diseases and conditions, and age-related frailty) were selected from the practices’ data registries and included as eligible participants. A total of 216 patients with multimorbidity filled in the study questionnaire (55% response rate). We tested the instrument using structural equation modelling, and examined its validity and reliability. Results Confirmatory factor analyses revealed good indices of fit and overall internal consistency, as represented by Cronbach’s alpha values. All eight dimensions of PCC were related positively to satisfaction with care (all p ≤ 0.001). Patients with multimorbidity who experienced joint decision making and responsibility taking in the primary care setting also had significantly higher scores for all eight PCC dimensions, indicating the instrument’s construct validity. Conclusions We conclude that the psychometric properties of the 36-item PCPC instrument are good. Based on these results the PCPC instrument seems a promising tool for the assessment of PCC among patients with multimorbidity in the primary care setting.
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Affiliation(s)
- Jane Murray Cramm
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands.
| | - Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
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