title: Patient participation in clinical encounters: a systematic review to identify self-report measures.
abstract: BACKGROUND
  There is evidence suggesting that active participation of patients in their health care can improve the quality of care and decrease health-care costs. Further, patient reports of their health-care experience are increasingly used to monitor health-care quality.
  
  
  OBJECTIVE
  This paper describes a systematic review of peer-reviewed studies to identify measures of patients' active participation in their encounters with health-care providers.
  
  
  METHODS
  A systematic literature review was conducted for publications indexed from 1975 to 2011. Of interest were self-reported measures of patient participation that were not limited to a specific health concern. All abstracts were reviewed independently by two authors, and the full paper was considered for those meeting inclusion criteria.
  
  
  RESULTS
  From a review of 4528 citations, ten measures were identified. The approaches to development of the measures varied considerably, as did their study samples and their psychometric quality.
  
  
  CONCLUSIONS
  These measures represented three conceptual frameworks: empowerment and self-efficacy, therapeutic alliance, and consumerism/satisfaction. They provide a more comprehensive perspective of patients' experiences of their provider encounters, and a better understanding patient behaviour enhanced the quality of health-care delivery or improved health outcomes. These measures underscore the continuing challenge of defining patient participation and the multiple theoretical approaches that underlie this form of patient behaviour.
  
  
  CONCLUSIONS
  Current interest in quality-related physician report cards gives significant weight to patients' self-reported experiences as one dimension of physician performance. It is critical to identify the specific focus and quality of measures selected for this and research purposes.
authors.affiliation: Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Mavis
authors.affiliation: Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Holmes Rovner
authors.affiliation: Center for Advancing Health, Washington, DC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jorgenson
authors.affiliation: Michigan State University Libraries, East Lansing, MI, USA.
authors.forename: John
authors.initials: J
authors.lastname: Coffey
authors.affiliation: College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Anand
authors.affiliation: College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Emi
authors.initials: E
authors.lastname: Bulica
authors.affiliation: College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Carolyn Marie
authors.initials: CM
authors.lastname: Gaulden
authors.affiliation: College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Peacock
authors.affiliation: College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Alycia
authors.initials: A
authors.lastname: Ernst
mesh_terms: D006801:Humans; D010358:Patient Participation / Q000523:psychology; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D020377:Self Efficacy; D057566:Self Report
keywords: patient involvement; patient participation; questionnaire; review