• Margaret F Clayton, Seth Latimer, Todd W Dunn, and Leonard Haas.
• University of Utah, College of Nursing, Salt Lake City, UT, USA. Margaret.clayton@nurs.utah.edu
• Patient Educ Couns. 2011 Sep 1; 84 (3): 294-302.

ObjectiveThis study evaluated variables thought to influence patient's perceptions of patient-centeredness. We also compared results from two coding schemes that purport to evaluate patient-centeredness, the Measure of Patient-Centered Communication (MPCC) and the 4 Habits Coding Scheme (4HCS).Methods174 videotaped family practice office visits, and patient self-report measures were analyzed.ResultsPatient factors contributing to positive perceptions of patient-centeredness were successful negotiation of decision-making roles and lower post-visit uncertainty. MPCC coding found visits were on average 59% patient-centered (range 12-85%). 4HCS coding showed an average of 83 points (maximum possible 115). However, patients felt their visits were highly patient-centered (mean 3.7, range 1.9-4; maximum possible 4). There was a weak correlation between coding schemes, but no association between coding results and patient variables (number of pre-visit concerns, attainment of desired decision-making role, post-visit uncertainty, patients' perception of patient-centeredness).ConclusionsCoder inter-rater reliability was lower than expected; convergent and divergent validity were not supported. The 4HCS and MPCC operationalize patient-centeredness differently, illustrating a lack of conceptual clarity.Practice ImplicationsThe patient's perspective is important. Family practice providers can facilitate a more positive patient perception of patient-centeredness by addressing patient concerns to help reduce patient uncertainty, and by negotiating decision-making roles.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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