Patient perspectives of patient-centeredness in medical rehabilitation.

Abstract

OBJECTIVE: Achieving patient-centeredness requires a paradigm shift in the provider-patient interaction. Participation, information, communication, and interaction are essential indicators in this area. The study examined the evaluation and implementation of indicators of patient-centeredness for chronically ill patients and center-specific differences in this regard. METHODS: This cross-sectional study with mixed-method design combined focus groups and a questionnaire survey at 5 rehabilitation centers. The analysis included a qualitative component with summarizing content analysis and a descriptive-exploratory quantitative component. RESULTS: Patients (N=32) rated the indicators of patient-centeredness favorably to very favorably (on a scale of 1=very good to 6=unsatisfactory). The centers exhibited significant differences in "patient participation" (p<.05). Dominant topics voiced in the focus groups were the desire for more individualized treatment (n=30) and more specific and rapid feedback on treatment goals (n=13). CONCLUSION: Considerable between-center differences exist, particularly in patients' opportunity to participate in treatment planning, which can be a starting point for improvements. PRACTICE IMPLICATIONS: Rehabilitation centers should ask patients to evaluate indicators of patient-centeredness and develop targeted actions for improvement. The patient survey shows that patients would like improvements in patient-centeredness in the overall rehabilitation system, particularly regarding patient participation, and training in this area is recommended.