RESEARCH ARTICLE
Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument
Sidona-Valentina Bala,
Kristina Forslind,
Bengt Fridlund,
Karin Samuelson,
Björn Svensson,
Peter Hagell,
Corresponding Author
Sidona-Valentina Bala
Department of Health Sciences, Lund University, Lund, Sweden
Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, Sweden
Correspondence
Sidona-Valentina Bala, Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, SE-251 87 Helsingborg, Sweden.
Email: [email protected]
Search for more papers by this authorKristina Forslind
Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, Sweden
Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund University, Lund, Sweden
Search for more papers by this authorBengt Fridlund
School of Health and Welfare, Jönköping University, Jönköping, Sweden
Search for more papers by this authorKarin Samuelson
Department of Health Sciences, Lund University, Lund, Sweden
Search for more papers by this authorBjörn Svensson
Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund University, Lund, Sweden
Search for more papers by this authorPeter Hagell
The PRO-CARE Group, School of Health & Society, Kristianstad University, Kristianstad, Sweden
Search for more papers by this authorSidona-Valentina Bala,
Kristina Forslind,
Bengt Fridlund,
Karin Samuelson,
Björn Svensson,
Peter Hagell,
Corresponding Author
Sidona-Valentina Bala
Department of Health Sciences, Lund University, Lund, Sweden
Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, Sweden
Correspondence
Sidona-Valentina Bala, Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, SE-251 87 Helsingborg, Sweden.
Email: [email protected]
Search for more papers by this authorKristina Forslind
Section of Rheumatology, Department of Medicine, Helsingborg Central Hospital, Sweden
Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund University, Lund, Sweden
Search for more papers by this authorBengt Fridlund
School of Health and Welfare, Jönköping University, Jönköping, Sweden
Search for more papers by this authorKarin Samuelson
Department of Health Sciences, Lund University, Lund, Sweden
Search for more papers by this authorBjörn Svensson
Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund University, Lund, Sweden
Search for more papers by this authorPeter Hagell
The PRO-CARE Group, School of Health & Society, Kristianstad University, Kristianstad, Sweden
Search for more papers by this authorAbstract
Background
Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.
Methods
A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic.
Results
The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87–1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire.
Conclusions
A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.
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