gms | German Medical Science

Background and current state of (inter)national research: Patient-centeredness (PCC) became increasingly important in health care policy and research. To overcome inconsistencies in the definition of patient-centeredness, an integrative model consisting of 15 dimensions of PC was developed. However, little is known how patients value the different dimensions of PC. Furthermore, there is a lack of psychometrically sound measures to assess PC in German language.

Research questions and objectives:

1.

To assess the relevance of different dimensions of PC from patients’ perspectives;

2.

to develop and psychometrically test a core set of German patient-reported experience measures (PREMs) to assess different dimensions of PC; and

3.

to investigate the feasibility of implementation of the developed core set of PREMs in routine health care.

Methods or hypothesis: The study uses a prospective mixed-methods approach, and targets patients from different chronic disease groups that are recruited through community-based strategies and through healthcare institutions. In Phase 1 a Delphi study was conducted to assess the relevance and perceived implementation of dimensions of PC from patients’ perspective. In Phase 2 a preliminary item core set was developed based on focus groups, key informant interviews and a literature review on PREMs. Items were selected through a content validity rating by key stakeholders and comprehensibility was tested in cognitive interviews with patients. The resulting item core set is currently undergoing psychometric evaluation in a large patient sample (n=2,000). In Phase 3, the feasibility of implementation of the developed measure will be assessed and discussed in a subsequent national expert workshop.

Results: Phase 1: 226 patients participated in the 1^st and 214 in the 2^nd round of the Delphi study In both rounds, all dimensions of PC were rated highly relevant, but currently insufficiently implemented. The dimensions ‘patient safety’, ‘access to care’ and ‘patient information’ were considered most relevant.

Phase 2: A total of 152 items were derived from data gathered in 6 focus groups with n=40 patients, n=10 key informant interviews, and a review of 36 existing measures. The content validity rating was conducted by n=32 stakeholders and led to the deletion of 27 items and addition of 4 items. Cognitive interviews with n=34 patients showed good comprehensibility of the items and led to the revision of the response scale. Preliminary results of the psychometric testing will be presented at the conference. Phase 3 will only start in 2021.

Discussion: The Delphi study extends the integrative model of PC with the patients’ perspective. The developed item set showed high content validity and is based on extensive data and feedback of the target users. The final core set of PREMs will enable a comprehensive assessment of PC in German.

Practical implications: The results from the Delphi study can help to set priorities in designing intervention to foster PC. The resulting core set of PREMs can be used as a performance, benchmarking or quality improvement measure. The last project phase will generate important insights into how to best implement it into routine practice.