title: Development of a measure to assess healthcare providers' implementation of patient-centered care.
abstract: BACKGROUND
  Patient-centered care (PCC) is a vaguely defined element of high-quality care, which precludes its consistent and precise operationalization. A conceptualization of PCC was derived from the literature and guided the development of an instrument to assess implementation of PCC by healthcare providers. The items of the instrument capture specific activities that reflect three components of PCC: holistic, collaborative, and responsive care. This paper reports on the measure's content and construct validity and reliability.
  
  
  METHODS
  Content validity was evaluated in a sample of 11 nurse practitioners who rated the relevance of each items' content in reflecting the respective component of PCC. The content validity index (CVI) was estimated. Construct validity and internal consistency reliability were examined in a survey of 149 nurse practitioners employed in acute care institutions, using factor analysis and the KR-20 coefficient, respectively.
  
  
  RESULTS
  The CVIs were 100% for the three subscales assessing the holistic, collaborative, and responsive care components of PCC. The items in each subscale loaded on one factor. The KR-20 coefficients were .66, .70, and .42, respectively. Overall, the majority (>70%) of respondents indicated performance of the activities comprising the three components of PCC.
  
  
  CONCLUSIONS
  The PCC measure demonstrated acceptable psychometric properties. The low variance in responses, which is anticipated for instruments assessing fidelity of intervention implementation, accounts for the low reliability coefficients. Additional testing of the measure's psychometric properties in different groups of healthcare providers is warranted. The measure can be used to monitor healthcare providers' implementation of PCC in their usual practice.
authors.affiliation: Professor and Canada Research Chair, Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada.
authors.forename: Souraya
authors.initials: S
authors.lastname: Sidani
authors.forename: Laura
authors.initials: L
authors.lastname: Collins
authors.forename: Patti
authors.initials: P
authors.lastname: Harbman
authors.forename: Kathleen
authors.initials: K
authors.lastname: MacMillan
authors.forename: Scott
authors.initials: S
authors.lastname: Reeves
authors.forename: Christina
authors.initials: C
authors.lastname: Hurlock-Chorostecki
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Patti
authors.initials: P
authors.lastname: Staples
authors.forename: Mary
authors.initials: M
authors.lastname: van Soeren
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000458:organization & administration / Q000706:statistics & numerical data; D018939:Holistic Nursing / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D009864:Ontario; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011159:Population Surveillance; D016730:Program Development; D011594:Psychometrics / Q000295:instrumentation*; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: collaborative care; conceptualization; content validation; holistic care; implementation fidelity; measure; nurse practitioners; patient-centered care; reliability; responsive care