title: Patient communication competence: development of a German questionnaire and correlates of competent patient behavior.
abstract: OBJECTIVE
  The aim of our study was to design and psychometrically test a patient questionnaire to capture patient communication competence in the context of patient-provider interaction (CoCo questionnaire). We also aimed to determine patient characteristics associated with competent patient behavior.
  
  
  METHODS
  To assure content validity, we initially conducted 17 focus groups (n=97) made up of patients and providers. In the main study n=1.264 patients with chronic back pain, chronic-ischemic heart disease or breast cancer who underwent inpatient rehabilitation were surveyed at the end of rehabilitation.
  
  
  RESULTS
  The CoCo questionnaire contains four scales (patient adherence in communication, critical and participative communication, communication about personal circumstances, active disease-related communication) and 28 items addressing competent patient behavior. We provide evidence of unidimensionality, local independence, reliability, a Rasch-Model fit, the absence of differential item functioning, and signs of construct validity. The most important correlates of communication competence are health literacy and communication self-efficacy.
  
  
  CONCLUSIONS
  The CoCo questionnaire has good psychometric properties in German. Future research should examine CoCo's responsiveness and analyze criterion validity by means of observation data.
  
  
  CONCLUSIONS
  The CoCo questionnaire can be recommended for use in evaluating patient communication training programs.
authors: Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany. Electronic address: erik.farin@uniklinik-freiburg.de.
authors: Erik
authors: E
authors: Farin
authors: Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany.
authors: Erika
authors: E
authors: Schmidt
authors: Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany.
authors: Lukas
authors: L
authors: Gramm
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000534:rehabilitation; D001943:Breast Neoplasms / Q000534:rehabilitation; D003142:Communication; D005260:Female; D015438:Health Behavior; D057220:Health Literacy; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000534:rehabilitation; D011369:Professional-Patient Relations; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Breast cancer; Chronic back pain; Chronic ischemic heart disease; Patient communication competence; Patient–provider communication; Questionnaire development