Abstract
Background
Patient-centred care (PCC) is recognized worldwide as a fundamental base for quality patient care. PCC involves treating patients as unique individuals and considers a patient's beliefs, expectations, circumstances, and values when making decisions based on their healthcare. The Patient-Practitioner- Orientation scale (PPOS) is an instrument used to measure PCC across the globe; however, in some countries, including South Africa, results show that the PPOS is inconsistent and unreliable. PCC holds a valuable and essential role in the health care system, but there are insufficient methods to measure whether chiropractic care in South Africa aligns with PCC.
Aim
The aim of this study was two-fold in that it would adapt and then validate the PPOS in the South African context to better assess the attitudes toward patient-centred care among chiropractic students at the University of Johannesburg. The adaptation of the PPOS may allow better reliability and validity by possibly improving internal consistency.
Research Methodology
This study was a cross-sectional, quantitative, evaluative study, which was carried out in two parts, namely, an adaptation process and a validation process. In the adaptative process, a focus group was recruited to discuss and adapt the original 18-item PPOS to better suit the South African population. In the validation process, the adapted online and anonymous survey was distributed amongst BHSc and MHSc students at the University of Johannesburg, using Google forms, which took approximately 10 minutes to complete.
Results and Discussion
The overall mean PPOS score was 4.08 , with the mean score for the caring subscale (4.4) being higher than the mean score (3.8) for the sharing subscale. Cronbach’s alpha values were 0.562 and 0.286 for the sharing and caring subscales, respectively, with an overall value of 0.562. These values were below the acceptable range of 0.6 – 0.7, which indicate that the adapted PPOS did not succeed in producing consistent and valid results. The PPOS measures 2 components to PCC (sharing and caring), but exploratory analyses found that 7 components exist within the PPOS.
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Conclusion and Recommendations
In the context of South Africa, the items of the PPOS did not accurately measure attitudes to patient-centred care. Results showed poor Cronbach alpha values, indicating poor internal inconsistency. The PPOS thus could not appropriately measure its intended sharing or caring subcategory, as items are not specific enough and share more than one underlying construct.