Healthcare provider person-centred practice: relationships between prerequisites, care environment and care processes using structural equation modelling

Nur Zahirah Balqis-Ali; Pui San Saw; Jailani Anis-Syakira; Weng Hong Fun; Sondi Sararaks; Shaun Wen Huey Lee; Mokhtar Abdullah

doi:10.1186/s12913-022-07917-3

Healthcare provider person-centred practice: relationships between prerequisites, care environment and care processes using structural equation modelling

BMC Health Serv Res. 2022 Apr 29;22(1):576. doi: 10.1186/s12913-022-07917-3.

Authors

Nur Zahirah Balqis-Ali^#¹, Pui San Saw^#^{2

3}, Jailani Anis-Syakira⁴, Weng Hong Fun⁴, Sondi Sararaks⁴, Shaun Wen Huey Lee^{2

5}, Mokhtar Abdullah⁶

Affiliations

¹ Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia. dr.nurbalqis@moh.gov.my.
² School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
³ Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
⁴ Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
⁵ School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
⁶ MERITUS University, 49, The Boulevard, Mid Valley City, Lingkaran Syed Putra, 59200, Kuala Lumpur, Malaysia.

^# Contributed equally.

Abstract

Background: The translation of person-centred care concepts into practice requires fulfilment of necessary components, including person-centred values and practice held by the employees and having a supportive system. The objectives of this study were multifold: firstly, to evaluate the measurement model, secondly, to examine the roles of prerequisite or attributes of healthcare providers and care environment and how they affect delivery of person-centred processes; and finally, to examine the mediating effect of care environment towards the relationship between prerequisite and care processes.

Methods: A cross sectional study was conducted among healthcare providers working in primary care facilities in a state in Malaysia. The Person-centred Practice Inventory-Staff instrument (PCPI-S) was distributed and completed by respondents. The instrument structure, reliability and validity were assessed through confirmatory factor analysis, while the framework's unidirectional hypothesis and the mediation path hypothesis were analysed using structural equation modelling.

Results: The overall goodness of fit verifies the original Person-centred Practice Framework, allowing some correlation errors. There were significant relationships between prerequisites of healthcare providers and care environment (β = 0.826, p < 0.001), as well as between care environment and care processes (β = 0.785, p < 0.001). This analysis also proved that care environment plays a partial mediating role in the relationship between prerequisites and care processes.

Conclusions: In order to successfully move towards delivering person-centred practice, it is imperative to equip healthcare providers with person-centred values and beliefs, while at the same time transform current work culture to align with person-centred care. This will allow successful delivery of person-centred processes.

Trial registration: NMRR-18-309-40,447.

Keywords: Healthcare provider; Person-centred; Person-centred practice inventory-staff; Primary care; Structural equation modelling.

MeSH terms

Cross-Sectional Studies
Health Personnel*
Humans
Latent Class Analysis
Patient-Centered Care*
Reproducibility of Results