title: Assessing patient-centered communication in a family practice setting: how do we measure it, and whose opinion matters?
abstract: OBJECTIVE
  This study evaluated variables thought to influence patient's perceptions of patient-centeredness. We also compared results from two coding schemes that purport to evaluate patient-centeredness, the Measure of Patient-Centered Communication (MPCC) and the 4 Habits Coding Scheme (4HCS).
  
  
  METHODS
  174 videotaped family practice office visits, and patient self-report measures were analyzed.
  
  
  RESULTS
  Patient factors contributing to positive perceptions of patient-centeredness were successful negotiation of decision-making roles and lower post-visit uncertainty. MPCC coding found visits were on average 59% patient-centered (range 12-85%). 4HCS coding showed an average of 83 points (maximum possible 115). However, patients felt their visits were highly patient-centered (mean 3.7, range 1.9-4; maximum possible 4). There was a weak correlation between coding schemes, but no association between coding results and patient variables (number of pre-visit concerns, attainment of desired decision-making role, post-visit uncertainty, patients' perception of patient-centeredness).
  
  
  CONCLUSIONS
  Coder inter-rater reliability was lower than expected; convergent and divergent validity were not supported. The 4HCS and MPCC operationalize patient-centeredness differently, illustrating a lack of conceptual clarity.
  
  
  CONCLUSIONS
  The patient's perspective is important. Family practice providers can facilitate a more positive patient perception of patient-centeredness by addressing patient concerns to help reduce patient uncertainty, and by negotiating decision-making roles.
authors: University of Utah, College of Nursing, Salt Lake City, UT, USA. Margaret.clayton@nurs.utah.edu
authors: Margaret F
authors: MF
authors: Clayton
authors: Seth
authors: S
authors: Latimer
authors: Todd W
authors: TW
authors: Dunn
authors: Leonard
authors: L
authors: Haas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003657:Decision Making; D005104:Expert Testimony; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods*; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D013223:Statistics as Topic; D013997:Time Factors; D035501:Uncertainty; D014705:Verbal Behavior; D014743:Videotape Recording; D055815:Young Adult