Abstract
Background
Patient-Centred Care is a globally recognized model for high-quality patient care, emphasizing respect and responsiveness to patients' needs, preferences, and values. It focuses on treating each patient as a unique individual and encourages open communication, involving patients in their care. The Patient-Practitioner Orientation Scale (PPOS) traditionally assesses the patient-practitioner relationship and has demonstrated reliability in various studies. However, it has shown inconsistencies in low socioeconomic environments, like a study on chiropractic students at the University of Johannesburg. In response, a 2022 study adapted the PPOS to the South African context. This current study serves as a secondary analysis to evaluate the success of this adaptation by comparing pre- and post-adaptation items within the PPOS. It seeks to provide insights into the effectiveness of tailoring the PPOS to better measure patient-practitioner relationships in the South African setting.
Aim
The aim of this study is to evaluate the impact of adapting the PPOS on the distribution of responses and internal consistency of caring and sharing dimensions in patient-centred care. It conducts a secondary analysis of two studies, one published and one unpublished, involving chiropractic students in South Africa.
Research Methodology
This study involved a secondary analysis of existing data from two primary studies that used both the original and adapted versions of the PPOS. It examined the extent to which the distribution of responses to caring and sharing statements differs between the original and adapted PPOS. Any significant changes were evaluated to determine if they resulted from wording alterations. The study assessed the internal consistency coefficients for the caring and sharing dimensions in both PPOS versions using Cronbach alpha. It explored the factor structures derived from each questionnaire through confirmatory and exploratory factor analyses. These analyses aimed to establish the validity and reliability of the PPOS instruments. Based on the findings from the above the study draws conclusions about the level of patient-centred care reported by chiropractic students. Overall, this research sought to provide insights into the impact of adapting the PPOS and its implications for measuring patient-centred care among chiropractic students, considering both validity and reliability.
Results and Discussion
From the crosstabulation of the original and adapted versions of the PPOS, we see that while the change
vii
in wording affected the distributions to some of the responses to items, it did not affect the distributions to others. Both the original version and adapted version of the PPOS lacked internal consistency, producing Cronbach alpha values of 0,528 and 0,563, respectively. These are below the acceptable values of 0,6 – 0,7. An exploratory factor analysis was conducted on the adapted PPOS which should produce 2 factors, a sharing and a caring, however it was found that 7 factors exist within the scale.
Conclusions and Recommendations
The adapted PPOS overall produced better results than using the original version of the PPOS in the South African context. However, the results did not meet satisfactory standards for internal consistency. Future studies should utilise an assessment for patient-centred care with less ambiguity.