Self-Awareness of Performing Patient-Centered Medicine in General Practice / Family Medicine: Development of a Measurement Scale

Authors

  • Luiz Miguel Santiago Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Centro de Estudos e Investigação em Saúde. Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • José Augusto Simões Centro de Estudos e Investigação em Saúde. Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • Martinha Vale Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • Elleni de Faria Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • Pedro Lopes Ferreira Centro de Estudos e Investigação em Saúde. Universidade de Coimbra. Coimbra.
  • Inês Rosendo Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Coimbra. Coimbra.

DOI:

https://doi.org/10.20344/amp.11742

Keywords:

Clinical Method Focused on the Person, Doctor-Patient Relationship, General and Family Medicine, Person-Centered Medicine, Primary health care, Questionnaire, Reliability

Abstract

Introduction: Patient Centred Medicine is a method and a model of practicing allowing gains for both the doctor and the patient. Its practice must be evaluated for purposes of continuous professional development and continuous medical education. The aim of this study was to create an instrument focused in measuring the practice based on person centered medicine in general and family medicine, as well as in determining its reliability and validity.
Material and Methods: A first version of a questionnaire according to the four dimensions of the patient- centred clinical method was revised in a focus group providing the content validity. The final questionnaire includes 22 items, using a Likert scale with four response options. Factorial analysis made it possible to confirm the dimensions defined by Moira Stewart, and internal consistency, test-retest reproducibility and item-total correlations were determined. The online implementation of the questionnaire to a sample of 905 family doctors guaranteed the construct and criterion validities.
Results: The measurement instrument includes four dimensions: (i) exploring health, disease and the illness experience; (ii) investing in the doctor-patient relationship; (iii) seeking understanding; and (iv) understanding the whole person. The internal consistency was demonstrated with a global Cronbach’s alpha of 0.892, varying between 0.783 and 0.844 for all dimensions. The test-retest reproducibility obtained an intraclass correlation value between 0.678 and 1.000. The item-total correlations varied between 0.457 and 0.870. Women doctors are more aware than their colleagues about seeking understanding with the person, and young doctors are more susceptible to approach the disease through history and to seek understanding with the patient. Specialist physicians have shown to be more careful with the history and with viewing the patient as a whole and the professionals who work in a Family Health Unit are those who seek a better understanding with the person. Finally, specific training about person centered medicine and about consultation in person centered medicine demonstrated a positive impact in all dimensions of the person-centred medicine and this is acknowledged by professionals.
Discussion: The assessment of self-perception of person-centred medicine is now possible.
Conclusion: The questionnaire presents good reliability and validity, thus allowing doctors to assess their main weaknesses, as well as enabling the development of specific training.

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Author Biographies

Luiz Miguel Santiago, Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Centro de Estudos e Investigação em Saúde. Faculdade de Medicina. Universidade de Coimbra. Coimbra.

Licenciado em Medicina pela Universidade de Coimbra desde 1979, Mestre em Saúde Pública pela Universidade de Coimbra desde 2006 e Doutorado por unanimidade com distinção e louvor, pela Universidade de Coimbra, na Especialidade de Sociologia Médica, ramo de Medicina Preventiva e Comunitária desde 11/11/2009. É desde1/7/2017 Professor Associado da Faculdade de Medicina da Universidade de Coimbra, regendo as Unidades Curriculares de MISP IV, 3º Ano e de Medicina Geral e Familiar, 5º Ano. Em Janeiro de 2018 obtém o título de Gregado em Provas Públicas. Médico, especialista em Medicina Geral e Familiar, é Consultor com o Grau de Assistente Graduado Sénior da Carreira de Medicina Geral e Familiar desde 2002, sendo orientador no Internato Complementar de Medicina Geral e Familiar desde 2006, tendo exercido na Unidade de Saúde Familiar Topázio em Coimbra, onde ainda continua actividade clínica, agora reduzida. Professor Associado Convidado da Universidade da Beira Interior, onde é regente das cadeiras de CSP I, II e III entre 2011 e 2017. Desde 2014 até 2017 foi Professor Adjunto Convidado da Coimbra Health Scholl lecionando Patologia Geral. Membro da Academia Europeia de Professores em Medicina Geral e Familiar (EURACT) é orientador de Teses de Mestrado Integrado e de Mestrado Pré-Bolonha bem como de Doutoramento, na Universidade de Coimbra (2) e na Universidade da Beira Interior (6). É membro da Comissão de Ética da ARS do Centro. Tem vasta bibliografia publicada individualmente e em co-autoria em revistas nacionais e internacionais com “revisores-par” e indexadas (27 artigos). Desde março de 2017 é membro investigador do CEISUC, FEUC. Em Novembro de 2017 é eleito sócio correspondente da Academia Nacional de Medicina. Aguarda a marcação de Provas de Agregação a serem prestadas na Universidade da Beira Interior. Membro da direção do CEISUC desde 2018.

Orcid:  https://orcid.org/0000-0002-9343-2827

Researcher - ID: P-9545-2018

Scopus Author - ID: 7006027550

Pedro Lopes Ferreira, Centro de Estudos e Investigação em Saúde. Universidade de Coimbra. Coimbra.

Professor Catedrático da Universidade de Coimbra

Direção do Centro de Estudos e Investigação em Saúde da Universidade de Coimbra

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Published

2020-06-01

How to Cite

1.
Santiago LM, Simões JA, Vale M, de Faria E, Ferreira PL, Rosendo I. Self-Awareness of Performing Patient-Centered Medicine in General Practice / Family Medicine: Development of a Measurement Scale. Acta Med Port [Internet]. 2020 Jun. 1 [cited 2024 Nov. 22];33(6):407-14. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11742

Issue

Vol. 33 No. 6 (2020): June

Section

Original

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