Interpersonal Communication from the Patient Perspective: Comparison of Primary Healthcare Evaluation Instruments La communication interpersonnelle du point de vue du patient : comparaison entre instruments d’évaluation des soins de santé primaires

The operational definition of interpersonal communication is “the ability of the provider to elicit and understand patient concerns, to explain healthcare issues and to engage in shared decision-making if desired.” Objective: To examine how well interpersonal communication is captured in validated instruments that evaluate primary healthcare from the patient’s perspective. Method: 645 adults with at least one healthcare contact in the previous 12 months responded to instruments that evaluate primary healthcare. Eight subscales measure interpersonal communication: the Primary Care Assessment survey (PCAs, two subscales); the Components of Primary Care Index (CPCI, one subscale); the first version of the EuROPEP (EuROPEP-I); and the Interpersonal Processes of Care survey, version II (IPC-II, four subscales). scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation) factor analysis examined fit to operational definition, and item response theory analysis examined item performance. Results: Items not pertaining to interpersonal communication were removed from the EuROPEP-I. most subscales are skewed positively. Normalized mean scores are similar across subscales except for IPC-II Patient-Centred decision-making and IPC-II Hurried Communication. All subscales load reasonably well on a single factor, presumed to be interpersonal communication. The best model has three underlying factors corresponding to eliciting (eigenvalue = 26.56), explaining (eigenvalue = 2.45) and decision-making (eigenvalue = 1.34). Both the PCAs Communication and the EuROPEP-I Clinical Behaviour subscales capture all three dimensions. Individual subscales within IPC-II measure each sub-dimension. Conclusion: The operational definition is well reflected in the available measures, although shared decision-making is poorly represented. These subscales can be used with confidence in the Canadian context to measure this crucial aspect of patient-centred care. Résumé La définition opérationnelle de la communication interpersonnelle est la « capacité du clinicien à obtenir et à comprendre les inquiétudes du patient, à expliquer les problèmes concernant les soins de santé et à procéder à des prises de décisions communes s’il y a lieu. » Objectif : Examiner à quel point les instruments validés, qui servent à évaluer les soins primaires du point de vue du patient, font état de la communication interpersonnelle. Méthode : 645 adultes, ayant vécu au moins un contact avec les services de santé au cours des 12 mois antérieurs, ont répondu à des instruments utilisés pour l’évaluation des soins de santé primaires. Huit sous-échelles ont servi à mesurer la communication interpersonnelle :