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Person‐centred care in nurse‐led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument
Author(s) -
Bala SidonaValentina,
Forslind Kristina,
Fridlund Bengt,
Samuelson Karin,
Svensson Björn,
Hagell Peter
Publication year - 2018
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1233
Subject(s) - operationalization , medicine , conceptualization , outpatient clinic , content validity , rheum (plant) , personalization , empowerment , family medicine , nursing , alternative medicine , psychometrics , clinical psychology , philosophy , epistemology , pathology , artificial intelligence , world wide web , computer science , political science , law
Background Person‐centred care (PCC) is considered a key component of effective illness management and high‐quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient‐perceived PCC in nurse‐led outpatient rheumatology clinics. Methods A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person‐centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse‐led outpatient clinic. Results The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision‐making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87–1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24‐item questionnaire. Conclusions A conceptual outpatient PCC framework and a 24‐item questionnaire intended to measure PCC in nurse‐led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.