Cited by 1,211Patient-Provider Communication in HealthcarePatient Satisfaction in HealthcareEmpathy and Medical Education

Measuring patient-centered communication in Patient–Physician consultations: Theoretical and practical issues

Epstein, Ronald M., Franks, Peter, Fiscella, Kevin, Shields, Cleveland G., Meldrum, Sean C., Kravitz, Richard L., Duberstein, Paul R.·2005·Social Science & Medicine

Abstract

The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and how to measure it. PCC includes four communication domains: the patient's perspective, the psychosocial context, shared understanding, and sharing power and responsibility. Problems in measuring PCC include lack of theoretical and conceptual clarity, unexamined assumptions, lack of adequate control for patient characteristics and social contexts, modest correlations between survey and observational measures, and overlap of PCC with other constructs. We outline problems in operationalizing PCC, choosing tools for assessing PCC, choosing data sources, identifying mediators of PCC, and clarifying outcomes of PCC. We propose nine areas for improvement: (1) developing theory-based operational definitions of PCC; (2) clarifying what is being measured; (3) accounting for the communication behaviors of each individual in the encounter as well as interactions among them; (4) accounting for context; (5) validating of instruments; (6) interpreting patient ratings of their physicians; (7) doing longitudinal studies; (8) examining pathways and mediators of links between PCC and outcomes; and (9) dealing with the complexity of the construct of PCC. We discuss the use of observational and survey measures, multi-method and mixed-method research, and standardized patients. The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues.

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Crossref · 10.1016/j.socscimed.2005.02.001

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  • Motivational interviewing, originally developed to treat alcohol abuse, is a specific form of patient-centered counseling that has also been applied successfully to foster health behavior changes.

    “Motivational interviewing, originally developed to treat alcohol abuse, is a specific form of patient-centered counseling that has also been applied successfully to foster health behavior changes.54–57”

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Authors
Epstein, R. M., Franks, P., Fiscella, K., Shields, C. G., Meldrum, S. C., Kravitz, R. L., & Duberstein, P. R.
Affiliations
  • University of Rochester Medicine (US)
  • University of California, Davis (US)
Corresponding author
Epstein, Ronald M.
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2005-10
Volume
61
Issue
7
Pages
1516-1528
ISSN
0277-9536 (ISSN-L)
OpenAlex
W1990480169
Cited by
1,211
References
92
Citations by year
2026: 39 · 2025: 47 · 2024: 49 · 2023: 59 · 2022: 65 · 2021: 71 · 2020: 87 · 2019: 72 · 2018: 65 · 2017: 117 · 2016: 63 · 2015: 65 · 2014: 77 · 2013: 75 · 2012: 53
FWCI
41.98
Type
journal article
Language
en
Open access
closed
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
Agency for Healthcare Research and Quality (R01-HS1610-01A1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Keywords
patient-centered communication, patient-physician communication, operational definitions, shared decision-making, patient satisfaction survey, observational measures, standardized patients, psychosocial environment, mutual understanding, patient participation in care, quality of care evaluation, medical education
MeSH terms
Communication, Data Collection, Humans, Models, Theoretical, Physician-Patient Relations, Quality Assurance, Health Care, Quality of Health Care, Referral and Consultation, United States, Patient-Centered Care

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