Development of observational rating scales for evaluating patient-centered communication within a whole health approach to care |
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| Institution: | 1. US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Affairs Medical Center, 200 Springs Road, Bedford, MA 01730, United States;2. Boston University School of Public Health, Department of Health Law, Policy, and Management, 715 Albany Street, Boston, MA 02118, United States;3. Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA 02453, United States;4. US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Jamaica Plain Campus, Building 9, Boston, MA 02130, United States;5. University of Maine, Department of Psychology, 301 Little Hall, Orono, ME 04469, United States;6. University of Massachusetts Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation Street, Worcester, MA 01605, United States;1. Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;2. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;1. Chung-Yeon Korean Medicine Hospital, 64 Sangmujungang-ro, Seo-gu, Gwangju 61949, Republic of Korea;2. College of Korean Medicine, Wonkwang University, 460, Iksan-daero, Iksan, Jeonbuk 54538, Republic of Korea;3. Research and Development Institute, CY Pharma Co., Gangnam-gu, Seoul 06227, Republic of Korea;4. Research Center of Traditional Korean Medicine, Wonkwang University, 460, Iksan-daero, Sin-dong, Iksan, Jeollabuk-do 54538, Republic of Korea;5. Chung-Yeon Central Institute, 64 Sangmujungang-ro, Seo-gu, Gwangju 61949, Republic of Korea;1. School of Health & Human Sciences, Southern Cross University, Lismore, Australia;2. College of Health & Biomedicine, Victoria University, PO Box 14428, Melbourne, VIC 3000, Australia;3. Department of Medical Education, University of Melbourne, Melbourne, Australia;1. Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany;2. Medical Section, School of Spiritual Science/Goetheanum, 4134Dornach, Switzerland;3. Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089Berlin, Germany;4. Clinic for Rehabilitative Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625Hannover, Germany;5. Society for Clinical Research, Hardenbergstraße 20, 10623Berlin, Germany;6. Institute for Integrative Medicine, University Witten/Herdecke, Gerhard Kienle Weg 8, 58313Herdecke, Germany;7. Hospital Arlesheim, Research Department, Pfeffinger Weg 1, 4144Arlesheim, Switzerland |
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| Abstract: | ContextTeaching and evaluating patient-centered communication (PCC) skills that incorporate holistic approaches are increasingly relevant.ObjectiveThis study describes the development of the Observational Whole Health Measure (OWHM) for evaluating the extent to which primary care providers in the Veterans Health Administration engaged in PCC in the context of a holistic approach to care known as “Whole Health.”Design and SettingObservational rating scales were created based on content from a national whole health clinical education program in the VA and refined from audio recordings of patient-provider interactions in primary care clinical encounters. Unpaired t-tests and Cohen's d were conducted to measure overall quality of what really matters and whole health goal setting and plan development.Participants65 clinical encounters across 8 providers before and after participating in the training were included for analysis.InterventionThe intervention used for creating rating scales is a 2.5 day whole health clinical education program designed to teach providers PCC skills to identify what matters most for the patients and develop a patient-centered health plan that incorporates integrative health approaches to care.Main outcome measureQuality scores (0–4) were used to measure number of instances and extent to which providers explored what matters most to patients, dimensions of whole health, and development of a whole health plan tailored to patient's goals.ResultsWe developed the Observational Whole Health Measure (OWHM) that captures changes in provider communication. Significant differences in overall quality of whole health goal setting and plan development were detected between pre- and post-encounters, demonstrating a sensitivity to change. With the rise of integrative health approaches being adopted across clinical settings, the observational rating scales created in this study are likely to have increasing relevance. |
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