Measuring person-centred care in nurse-led outpatient rheumatology clinics

Sidona-Valentina Bala; Kristina Forslind; Bengt Fridlund; Peter Hagell

doi:10.1002/msc.1234

Measuring person-centred care in nurse-led outpatient rheumatology clinics

Musculoskeletal Care. 2018 Jun;16(2):296-304. doi: 10.1002/msc.1234. Epub 2018 Feb 27.

Authors

Sidona-Valentina Bala^{1

2}, Kristina Forslind^{2

3}, Bengt Fridlund⁴, Peter Hagell⁵

Affiliations

¹ Department of Health Sciences, Lund University, Lund, Sweden.
² Section of Rheumatology, Department of Medicine, Helsingborg Hospital, Helsingborg, Sweden.
³ Department of Clinical Science, Section of Rheumatology, Faculty och Medicine, Lund University, Lund, Sweden.
⁴ School of Health and Welfare, Jönköping University, Jönköping, Sweden.
⁵ The PRO-CARE Group, School of Health & Society, Kristianstad University, Kristianstad, Sweden.

PMID: 29484828
DOI: 10.1002/msc.1234

Abstract

Background: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

Objective: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

Methods: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

Results: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

Conclusion: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

Keywords: measurement; nurse-led rheumatology clinics; outpatient; person-centred care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Arthritis, Rheumatoid / therapy*
Female
Humans
Male
Middle Aged
Patient Outcome Assessment*
Patient-Centered Care*
Practice Patterns, Nurses'
Reproducibility of Results
Rheumatology