Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases
Abstract Background The aim of this study was to measure the patient’s perception of patient centeredness in their consultations for non-communicable diseases (NCDs). We also measured consultation length and patient enablement. Method A cross-sectional study was conducted over 2 months at four prima...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-023-02149-8 |
| _version_ | 1797451958344220672 |
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| author | Reisa R Rahaman M Shastri Motilal Raveed Khan Rohan G Maharaj |
| author_facet | Reisa R Rahaman M Shastri Motilal Raveed Khan Rohan G Maharaj |
| author_sort | Reisa R Rahaman |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to measure the patient’s perception of patient centeredness in their consultations for non-communicable diseases (NCDs). We also measured consultation length and patient enablement. Method A cross-sectional study was conducted over 2 months at four primary care clinics at the St. Joseph cluster of the North Central Regional Health Authority (NCRHA) in Trinidad and Tobago. Interviewers timed the consultation and completed post-consultation questionnaires using the Patient Perception of Patient-Centeredness (PPPC) questionnaire and the Patient Enablement Index (PEI). The PPPC is a 14-item (each scored 1–4) Likert-scaled instrument. The total score is averaged and a PPPC score of 4 is the maximum. The PEI measures the ability of the patient to cope with life and their disease. The PEI consists of 6 questions scored 0–2, with a maximum score of 12. Results There were 180 respondents (response rate = 82.5%). Participants were female (75.6%), aged over 65 years (50.6%), married (51.1%), Indo-Trinidadian (52.2%), and Christian (60.6%). Half achieved a primary school education, and 37.2% secondary. The consultation length ranged between 1.32 and 31.22 min. The average, median and mode of the consultation length were 8.5, 7.74 and 10 min, respectively. The average, median and mode of the measures of patient-centeredness were PPPC (3.67, 3.86 and 4) and PEI score (5.93, 6 and 6). The PPPC average was lower in patients with a stroke (p = 0.022), and higher among those with more than 2 consultation interruptions (p = 0.015) and those who knew the doctor very well (p = 0.015). The PEI score was lower in patients with heart disease (p = 0.022). The consultation length was longer in those with tertiary education (p = 0.044) and those with two consultation interruptions (p = 0.032). PPPC Average and PEI Score correlated well (ρ = 0.408, p < 0.001). The consultation length correlated with the PPPC Average (ρ = 0.168,p = 0.025). Conclusion Primary Care consultations in this cluster of health centres in NCRHA in Trinidad were often patient centered. The consultation length, patient-centeredness, measured with the PPPC instrument, and patient enablement scores, measured with the PEI instrument, in consultations for NCDs in Trinidad compare favourably with international reports. |
| first_indexed | 2024-03-09T15:00:54Z |
| format | Article |
| id | doaj.art-494db54185374957a8bb8ddeed648352 |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-03-09T15:00:54Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-494db54185374957a8bb8ddeed6483522023-11-26T13:53:29ZengBMCBMC Primary Care2731-45532023-10-0124111310.1186/s12875-023-02149-8Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseasesReisa R Rahaman0M Shastri Motilal1Raveed Khan2Rohan G Maharaj3Faculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West IndiesFaculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West IndiesFaculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West IndiesFaculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West IndiesAbstract Background The aim of this study was to measure the patient’s perception of patient centeredness in their consultations for non-communicable diseases (NCDs). We also measured consultation length and patient enablement. Method A cross-sectional study was conducted over 2 months at four primary care clinics at the St. Joseph cluster of the North Central Regional Health Authority (NCRHA) in Trinidad and Tobago. Interviewers timed the consultation and completed post-consultation questionnaires using the Patient Perception of Patient-Centeredness (PPPC) questionnaire and the Patient Enablement Index (PEI). The PPPC is a 14-item (each scored 1–4) Likert-scaled instrument. The total score is averaged and a PPPC score of 4 is the maximum. The PEI measures the ability of the patient to cope with life and their disease. The PEI consists of 6 questions scored 0–2, with a maximum score of 12. Results There were 180 respondents (response rate = 82.5%). Participants were female (75.6%), aged over 65 years (50.6%), married (51.1%), Indo-Trinidadian (52.2%), and Christian (60.6%). Half achieved a primary school education, and 37.2% secondary. The consultation length ranged between 1.32 and 31.22 min. The average, median and mode of the consultation length were 8.5, 7.74 and 10 min, respectively. The average, median and mode of the measures of patient-centeredness were PPPC (3.67, 3.86 and 4) and PEI score (5.93, 6 and 6). The PPPC average was lower in patients with a stroke (p = 0.022), and higher among those with more than 2 consultation interruptions (p = 0.015) and those who knew the doctor very well (p = 0.015). The PEI score was lower in patients with heart disease (p = 0.022). The consultation length was longer in those with tertiary education (p = 0.044) and those with two consultation interruptions (p = 0.032). PPPC Average and PEI Score correlated well (ρ = 0.408, p < 0.001). The consultation length correlated with the PPPC Average (ρ = 0.168,p = 0.025). Conclusion Primary Care consultations in this cluster of health centres in NCRHA in Trinidad were often patient centered. The consultation length, patient-centeredness, measured with the PPPC instrument, and patient enablement scores, measured with the PEI instrument, in consultations for NCDs in Trinidad compare favourably with international reports.https://doi.org/10.1186/s12875-023-02149-8Patient-centered careConsultationNon-communicable diseaseQualityTrinidad |
| spellingShingle | Reisa R Rahaman M Shastri Motilal Raveed Khan Rohan G Maharaj Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases BMC Primary Care Patient-centered care Consultation Non-communicable disease Quality Trinidad |
| title | Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases |
| title_full | Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases |
| title_fullStr | Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases |
| title_full_unstemmed | Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases |
| title_short | Are primary care consultations in Trinidad patient-centered? A cross-sectional study of patients with non-communicable diseases |
| title_sort | are primary care consultations in trinidad patient centered a cross sectional study of patients with non communicable diseases |
| topic | Patient-centered care Consultation Non-communicable disease Quality Trinidad |
| url | https://doi.org/10.1186/s12875-023-02149-8 |
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