IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v61y2005i7p1516-1528.html
   My bibliography  Save this article

Measuring patient-centered communication in Patient-Physician consultations: Theoretical and practical issues

Author

Listed:
  • Epstein, Ronald M.
  • Franks, Peter
  • Fiscella, Kevin
  • Shields, Cleveland G.
  • Meldrum, Sean C.
  • Kravitz, Richard L.
  • Duberstein, Paul R.

Abstract

The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and how to measure it. PCC includes four communication domains: the patient's perspective, the psychosocial context, shared understanding, and sharing power and responsibility. Problems in measuring PCC include lack of theoretical and conceptual clarity, unexamined assumptions, lack of adequate control for patient characteristics and social contexts, modest correlations between survey and observational measures, and overlap of PCC with other constructs. We outline problems in operationalizing PCC, choosing tools for assessing PCC, choosing data sources, identifying mediators of PCC, and clarifying outcomes of PCC. We propose nine areas for improvement: (1) developing theory-based operational definitions of PCC; (2) clarifying what is being measured; (3) accounting for the communication behaviors of each individual in the encounter as well as interactions among them; (4) accounting for context; (5) validating of instruments; (6) interpreting patient ratings of their physicians; (7) doing longitudinal studies; (8) examining pathways and mediators of links between PCC and outcomes; and (9) dealing with the complexity of the construct of PCC. We discuss the use of observational and survey measures, multi-method and mixed-method research, and standardized patients. The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues.

Suggested Citation

  • Epstein, Ronald M. & Franks, Peter & Fiscella, Kevin & Shields, Cleveland G. & Meldrum, Sean C. & Kravitz, Richard L. & Duberstein, Paul R., 2005. "Measuring patient-centered communication in Patient-Physician consultations: Theoretical and practical issues," Social Science & Medicine, Elsevier, vol. 61(7), pages 1516-1528, October.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1516-1528
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00083-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ford, Sarah & Fallowfield, Lesley & Lewis, Shôn, 1996. "Doctor-patient interactions in oncology," Social Science & Medicine, Elsevier, vol. 42(11), pages 1511-1519, June.
    2. Arora, Neeraj K., 2003. "Interacting with cancer patients: the significance of physicians' communication behavior," Social Science & Medicine, Elsevier, vol. 57(5), pages 791-806, September.
    3. Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
    4. Roter, Debra & Frankel, Richard, 1992. "Quantitative and qualitative approaches to the evaluation of the medical dialogue," Social Science & Medicine, Elsevier, vol. 34(10), pages 1097-1103, May.
    5. Helman, Cecil G., 1985. "Communication in primary care: The role of patient and practitioner explanatory models," Social Science & Medicine, Elsevier, vol. 20(9), pages 923-931, January.
    6. Ware, John E. & Snyder, Mary K. & Wright, W. Russell & Davies, Allyson R., 1983. "Defining and measuring patient satisfaction with medical care," Evaluation and Program Planning, Elsevier, vol. 6(3-4), pages 247-263, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Adepeju M. Lateef & Euphemia M. Mhlongo, 2020. "Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(6), pages 1-73, May.
    2. Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    3. Ishikawa, Hirono & Hashimoto, Hideki & Kiuchi, Takahiro, 2013. "The evolving concept of “patient-centeredness” in patient–physician communication research," Social Science & Medicine, Elsevier, vol. 96(C), pages 147-153.
    4. Timmermans, Stefan & Tietbohl, Caroline, 2018. "Fifty years of sociological leadership at Social Science and Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 209-215.
    5. Hyojung Tak & Gregory Ruhnke & Ya-Chen Shih, 2015. "The Association between Patient-Centered Attributes of Care and Patient Satisfaction," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 187-197, April.
    6. Sohail, Mohammad, 2005. "Accessibility and Quality of Government Primary Health Care: Achievement and Constraints," Bangladesh Development Studies, Bangladesh Institute of Development Studies (BIDS), vol. 31(3-4), pages 63-98, Sept-Dec.
    7. Rathert, Cheryl & Mittler, Jessica N. & Vogus, Timothy J. & Lee, Yuna S.H., 2023. "Better outcomes through patient – Provider therapeutic connections? An exploratory study of proposed mediating variables," Social Science & Medicine, Elsevier, vol. 338(C).
    8. Mitchell, Ellen M.H. & Kwizera, Amata & Usta, Momade & Gebreselassie, Hailemichael, 2010. "Choosing early pregnancy termination methods in Urban Mozambique," Social Science & Medicine, Elsevier, vol. 71(1), pages 62-70, July.
    9. Beach, Wayne A. & Easter, David W. & Good, Jeffrey S. & Pigeron, Elisa, 2005. "Disclosing and responding to cancer "fears" during oncology interviews," Social Science & Medicine, Elsevier, vol. 60(4), pages 893-910, February.
    10. Runtang Meng & Jingjing Li & Yunquan Zhang & Yong Yu & Yi Luo & Xiaohan Liu & Yanxia Zhao & Yuantao Hao & Ying Hu & Chuanhua Yu, 2018. "Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals," IJERPH, MDPI, vol. 15(4), pages 1-17, April.
    11. Waleed Al Nadabi & Mohammed A Mohammed, 2019. "Arabic Language Surveys Measuring Mothers’ Satisfaction During Childbirth: A Review," Global Journal of Health Science, Canadian Center of Science and Education, vol. 11(6), pages 169-169, June.
    12. Margaret Gerteis & Rosemary Borck, "undated". "Shared Decision-Making in Practice: Lessons from Implementation Efforts," Mathematica Policy Research Reports f802e52b8442486594ecda927, Mathematica Policy Research.
    13. Nor Azmaniza Azizam & Siti Noorsuriani Maon & Leny Suzana & Nor Intan Shamimi Abdul Aziz, 2018. "Factors Influencing Selected Health Outcome among Patients Attending Universiti Teknologi MARA Medical Centre," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 8(7), pages 500-511, July.
    14. Fenton, Anny T. & Elliott, Marc N. & Schwebel, David C. & Berkowitz, Zahava & Liddon, Nicole C. & Tortolero, Susan R. & Cuccaro, Paula M. & Davies, Suzy L. & Schuster, Mark A., 2018. "Unequal interactions: Examining the role of patient-centered care in reducing inequitable diffusion of a medical innovation, the human papillomavirus (HPV) vaccine," Social Science & Medicine, Elsevier, vol. 200(C), pages 238-248.
    15. Eissens van der Laan, M.R. & van Offenbeek, M.A.G. & Broekhuis, H. & Slaets, J.P.J., 2014. "A person-centred segmentation study in elderly care: Towards efficient demand-driven care," Social Science & Medicine, Elsevier, vol. 113(C), pages 68-76.
    16. Catherine Fullwood & Anne Kennedy & Anne Rogers & Martin Eden & Caroline Gardner & Joanne Protheroe & David Reeves, 2013. "Patients’ Experiences of Shared Decision Making in Primary Care Practices in the United Kingdom," Medical Decision Making, , vol. 33(1), pages 26-36, January.
    17. Mario Alexander Pfannstiel, 2016. "Bayreuth Productivity Analysis—a method for ascertaining and improving the holistic service productivity of acute care hospitals," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(1), pages 65-86, January.
    18. Kreuzer, Maria & Cado, Vesna & Raïes, Karine, 2020. "Moments of care: How interpersonal interactions contribute to luxury experiences of healthcare consumers," Journal of Business Research, Elsevier, vol. 116(C), pages 482-490.
    19. Janice Gandy & Erika Metzler Sawin & Sharon Zook & Lynne Eggert, 2019. "Improving Adherence to Mental Health Treatment in a Low-Income Clinic," SAGE Open, , vol. 9(2), pages 21582440198, May.
    20. Murdoch, Jamie & Salter, Charlotte & Ford, John & Lenaghan, Elizabeth & Shiner, Alice & Steel, Nicholas, 2020. "The “unknown territory” of goal-setting: Negotiating a novel interactional activity within primary care doctor-patient consultations for patients with multiple chronic conditions," Social Science & Medicine, Elsevier, vol. 256(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1516-1528. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.