The doctor and the Patient-Centered Medicine practice: cultural adaptation and validation of a retrospective self-assessment instrument

Authors

  • Luiz Miguel Santiago Faculdade de Medicina da Universidade de Coimbra Clínica Universitária de Medicina Geral e Familiar da Faculdade de Medicina da Universidade de Coimbra USF Topázio, ACES Baixo Mondego http://orcid.org/0000-0002-9343-2827
  • Mariana Ramalho MD. Faculdade de Medicina da Universidade de Coimbra. Coimbra, Portugal.
  • Pedro Lopes Ferreira PhD. Faculdade de Economia da Universidade de Coimbra. Coimbra, Portugal. | Centro de Estudo e Investigação em Saúde da Universidade de Coimbra. Coimbra, Portugal.

DOI:

https://doi.org/10.32385/rpmgf.v39i6.13701

Keywords:

Patient-centered medicine, General practice, Self-assessment, Concurrent validation study

Abstract

Introduction: The general practitioner’s evaluation of his/her performance in Patient-Centered Medicine (MCP), must be explored to improve it.

Aim: To perform the cultural adaptation and concurrent validation of an English questionnaire by Moira Stewart for doctor self-assessment of MCP practice.

Methods: After authorization by the author and ethical approval, the translation into European Portuguese, back-translation into English, and linguistic and cultural adaptation were conducted. Concurrent validity analysis was performed with a dimension of the Sobrecarga da Gestão da Multimorbilidade em Medicina Geral e Familiar (SoGeMM-MGF), applying it to interns and specialists of general practice/family medicine (GP/FM) in a representative, multicentric, convenience sample.

Results: The questionnaire showed strong internal consistency (Cronbach’s alpha=0.895), and intraclass correlation coefficient for average measures of 2.5; p<0.001, one only factor explaining 56.51% of the variance with a self-fulfillment time of 72±37 seconds. The mean global score was 31.3±4.0 [9 to 36], with males significantly scoring higher, p=0.039; by GP/FM unit of work, significant differences were found, p=0.001 between USF A and B and p=0.002 between USF A and UCSP, USF A scoring higher followed by USF B. A Pearson ρ=0.491; p<0.001 correlation was found between both questionnaires.

Discussion: This questionnaire is an opportunity for improvement of the doctor’s performance, ameliorating the health care provided and the doctor’s satisfaction.

Conclusion: The adaptation and validation for European spoken Portuguese of the questionnaire by Moira Stewart was possible for retrospective evaluation of the GP/FM doctor MCP performance.

Downloads

Download data is not yet available.

Author Biographies

  • Luiz Miguel Santiago, Faculdade de Medicina da Universidade de Coimbra Clínica Universitária de Medicina Geral e Familiar da Faculdade de Medicina da Universidade de Coimbra USF Topázio, ACES Baixo Mondego

    Luiz Miguel de Mendonça Soares Santiago é 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.

    Desde 30 de Janeiro de 2018 tem o título de "Agregado".

    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.

  • Pedro Lopes Ferreira, PhD. Faculdade de Economia da Universidade de Coimbra. Coimbra, Portugal. | Centro de Estudo e Investigação em Saúde da Universidade de Coimbra. Coimbra, Portugal.

    Professor Catdrático da Universidade de Coimbra.

    Fundador do Centro de Estudo e Investigação em Saúde da Universidade de Coimbra

References

Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR. Medicina centrada na pessoa, transformando o método clínico. e-book. 3ª ed. (Tradução da edição inglesa), Porto Alegre, Artmed, 2017. cited 2022 Jan 3. eBook ISBN 9781846195662.

Hudon C, Fortin M, Haggerty JL, Lambert M, Poitras ME. Measuring patients’ perceptions of patient-centered care: A systematic review of tools for family medicine. Ann Farm Med. 2011;9(2):155-164. https://www.annfammed.org/content/9/2/155

Reis AF, Santiago LM, Botas P. Medicina centrada no paciente e capacitação do consulente em medicina geral e familiar. RevADSO. 2015;5:19-32. https://revista.adso.com.pt/revadso/article/view/30

Hojat M, DeSantis J, Gonnella JS. Patient perceptions of clinician’s empathy: Measurement and psychometrics. Journal of Patient Experience. 2017;4(2):78-83. https://pubmed.ncbi.nlm.nih.gov/28725866/

West CA, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388:2272-81. https://pubmed.ncbi.nlm.nih.gov/27692469/

de Oliveira GS, Chang R, Fitzgerald PC, Almeida MD, Castro-Alves LS, Ahmad S, et al. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg. 2013;117:182-93. https://pubmed.ncbi.nlm.nih.gov/23687232/

Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91:42231. https://pubmed.ncbi.nlm.nih.gov/27046522/

Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med. 2003;114:513-9. https://pubmed.ncbi.nlm.nih.gov/12727590/

Mercer SW, Reynolds WJ. Empathy and quality of care. British Journal of General Practice. 2002;52:S9-13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1316134/

Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Evaluation & The Health Professions. 2004;27(3):237-251. https://pubmed.ncbi.nlm.nih.gov/15312283/

Prazeres F, Santiago LM, Pereira PM, Santos PM, Cortinhal T. Multimorbilidade em Medicina Geral e Familiar: Construção e Validação do Questionário de Avaliação da Sobrecarga da gestão da Multimorbilidade em Medicina Geral e Familiar (SoGeMM-MGF). Gazeta Médica. 2019; 4 (6):221-7.

https://www.gazetamedica.pt/index.php/gazeta/article/view/272

Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714-21. https://pubmed.ncbi.nlm.nih.gov/19914516/

Dewa CS, Jacobs P, Thanh NX, Loong D. An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada. BMC Health Serv Res. 2014;14:254. https://pubmed.ncbi.nlm.nih.gov/24927847/

Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C, et al. Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Intern Med. 2017;177:195205. https://pubmed.ncbi.nlm.nih.gov/27918798/

Santiago LM, Simões JA, Vale M, de Faria E, Ferreira PL, Rosendo I. Autoperceção do desempenho da medicina centrada na pessoa em medicina geral e familiar: Criação de um questionário de medição. Acta Med Port. 2020;33(6):407-414. https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11742

Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR.- Patient-centered medicine: transforming the clinical method e-book. 3rd ed. London: Radcliffe Publishing Ltd, 2013. cited 2022 Jan 3. https://doi.org/10.1201/b20740. eBook ISBN 9780429083730.

Scientific Advisory Committee of the Medical Outcomes Trust. Assessing health status and quality of life instruments: Attributes and review criteria. Quality of Life Research. 2002;11(3):193-205. https://pubmed.ncbi.nlm.nih.gov/12074258/

Comrey AL, Lee HB (eds). A first course in factor analysis. Hillsdale, NJ: Lawrence Erlbaum associates. 1992.

Bryman A, Cramer D. Análise de dados em Ciências Sociais - Introdução às Técnicas Utilizando o SPSS. Oeiras, Portugal: Celta, 2003.

Magalhães AR, Penetra J, Pereira C, Carvalho R, Neto MG, Santiago LM. Caracterização dos Grandes Utilizadores de uma Unidade de Saúde Familiar. RevADSO. 2016;6:15-21. https://revista.adso.com.pt/index.php/revadso/article/view/54

Van Ham I, Verhoeven AAH, Groenier KH, Groothoff JW, De Haan J. Job satisfaction among general practitioners: A systematic literature review. The Eur J Gen Practice. 2006;12:4,174-180. https://pubmed.ncbi.nlm.nih.gov/17127604/

Stobbe EJ, Groenewegen PP, Schaffer W. Job satisfaction of general practitioners: A cross-sectional survey in 34 countries. Hum Resour Health. 2021,19:57. https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-021-00604-0

Mercer SW, Watt GCM, Reilly D. Empathy is important for enablement. BJM. 2001;322:865. https://pubmed.ncbi.nlm.nih.gov/11321018/

Derksen FAWM, Hartman TO, Bensing J, Lagro-Janssen A. Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians. Family Practice. 2018;35(2):203-8. https://pubmed.ncbi.nlm.nih.gov/28973531/

Purvanova RK, Muros JP. Gender differences in burnout: A meta-analysis. J Vocacional Behavior. 2010;77:168-85.

https://www.sciencedirect.com/science/article/abs/pii/S0001879110000771

Coelho B, Santiago LM. Medicina centrada na pessoa: validação populacional de um instrumento de medida pela pessoa. Rev Port Med Geral Fam 2022, 38:247-56 DOI: 10.32385/rpmgf.v38i3.13218

Downloads

Published

2023-12-22

Issue

Vol. 39 No. 6 (2023): Revista Portuguesa de Medicina Geral e Familiar

Section

Original Research

License

Copyright (c) 2023 Portuguese Journal of Family Medicine and General Practice

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The authors will assign to the RPMGF the sole right to publish and distribute the content of the manuscript specified in this declaration via physical, electronic, broadcasting or any other medium that may come into existence. They also grant the RPMGF the right to use and exploit this manuscript, in particular by assigning, selling or licensing its content. This permission is permanent and takes effect from the moment the manuscript is submitted, has the maximum duration allowed by applicable Portuguese or international law and is of worldwide scope. The authors further declare that this assignment is made free of charge. If the RPMGF informs the authors that it is not going to publish their manuscript, the exclusive assignment of rights ceases forthwith.

The authors authorise the RPMGF (or any entity it may appoint) to act on their behalf when it believes that copyright may have been infringed.

 

How to Cite

The doctor and the Patient-Centered Medicine practice: cultural adaptation and validation of a retrospective self-assessment instrument. (2023). Portuguese Journal of Family Medicine and General Practice, 39(6), 523-32. https://doi.org/10.32385/rpmgf.v39i6.13701

Most read articles by the same author(s)

1 2 3 4 5 6 > >>