title: Interpersonal communication from the patient perspective: comparison of primary healthcare evaluation instruments.
abstract: The operational definition of interpersonal communication is "the ability of the provider to elicit and understand patient concerns, to explain healthcare issues and to engage in shared decision-making if desired."
  
  
  OBJECTIVE
  To examine how well interpersonal communication is captured in validated instruments that evaluate primary healthcare from the patient's perspective.
  
  
  METHODS
  645 adults with at least one healthcare contact in the previous 12 months responded to instruments that evaluate primary healthcare. Eight subscales measure interpersonal communication: the Primary Care Assessment Survey (PCAS, two subscales); the Components of Primary Care Index (CPCI, one subscale); the first version of the EUROPEP (EUROPEP-I); and the Interpersonal Processes of Care Survey, version II (IPC-II, four subscales). Scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation) factor analysis examined fit to operational definition, and item response theory analysis examined item performance.
  
  
  RESULTS
  Items not pertaining to interpersonal communication were removed from the EUROPEP-I. Most subscales are skewed positively. Normalized mean scores are similar across subscales except for IPC-II Patient-Centred Decision-Making and IPC-II Hurried Communication. All subscales load reasonably well on a single factor, presumed to be interpersonal communication. The best model has three underlying factors corresponding to eliciting (eigenvalue = 26.56), explaining (eigenvalue = 2.45) and decision-making (eigenvalue = 1.34). Both the PCAS Communication and the EUROPEP-I Clinical Behaviour subscales capture all three dimensions. Individual subscales within IPC-II measure each sub-dimension.
  
  
  CONCLUSIONS
  The operational definition is well reflected in the available measures, although shared decision-making is poorly represented. These subscales can be used with confidence in the Canadian context to measure this crucial aspect of patient-centred care.
authors.affiliation: Chaire Dr Sadok Besrour en médecine familiale, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Beaulieu
authors.forename: Jeannie L
authors.initials: JL
authors.lastname: Haggerty
authors.forename: Christine
authors.initials: C
authors.lastname: Beaulieu
authors.forename: Fatima
authors.initials: F
authors.lastname: Bouharaoui
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Lévesque
authors.forename: Raynald
authors.initials: R
authors.lastname: Pineault
authors.forename: Frederick
authors.initials: F
authors.lastname: Burge
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Santor