Table 7 Data on measurement properties of instruments

BPS tool

BPS tool

Brouwers

Cronbach’s alpha = 0.90

Construct validity: interobserver variance between BPS-oriented physicians and biomed oriented physicians: range: 23.2–59.3 (p < 0.0001)

Burgoon and Hale Relational Communication Scale for Observational Measurement (Adapted version)

RCS-O

Ekman

Inter-rater-reliability (Cronbach ´s alpha): Immediacy/affection = 0.62; Similarity/depth = 0.51; Receptivity/trust = 0.72; Composure = 0.69; Formality = 0.02; Dominance = 0.34. Internal consistency (Cronbach ´s alpha): Immediacy/affection = 0.95; Similarity/depth = 0.84; Receptivity/trust = 0.94; Composure = 0.98; Formality = 0.92; Dominance = 0.60. Inter-rater-agreement (within group agreement coefficient): Immediacy/affection = 0.65; Similarity/depth = 0.72; Receptivity/trust = 0.86; Composure = 0.74; Formality = 0.58; Dominance = 0.78. N interactions: 20, N raters: 3

Concurrent validity: correlation with other measure (Interview Rating Scale): Immediacy/affection = 0.65; Similarity/depth = 0.50; Receptivity/trust = 0.76; Composure = 0.62; Formality =  − 0.31; Dominance =  − 0.26

CARES Observational tool

COT

Ekman

Inter-rater reliability: ICC = 0.77

N interactions: 5, N raters: 5

Face validity: PI with input from scientific advisors reviewed Content validity: panel of several interdisciplinary experts

Client-Centred Care Questionnaire

CCCQ

Koberich

Cronbach’s alpha: 0.94

Structural validity (EFA): One factor, Factor explains 58% of the variance. Hypothesis-testing Validity with known groups: Differences between clients of three organizations (P = 0.08). Differences between clients of two organizations (P = 0.049). Convergent validity: Correlation ‘client-centredness’ – ‘overall satisfaction’: r = 0.81

Common Ground

CG

Brouwers

Internal consistency: Pearson’s r = 0.91 and 0.95 (for raters 1 and 2, respectively)

Intra-rater reliability: rater 1: Pearson’s r = 0.63 (overall case rating), 0.69 (overall case percentage score); rater 2: Pearson’s r = 0.87 (overall case rating), 0.78 (overall case percentage score)

Inter-rater reliability: global rating overall case: Pearson’s r = 0.85, checklist percentage score overall case: r = 0.92

Construct validity: interobserver variance between year 3 students intensive and minimal curriculum + (p < 0.001); Concurrent validity (expert versus rater): Pearson’s r = 0.84 (overall performance). Criterion validity: Correlation of overall performance between expert and rater: 0.84

Components of Primary Care Instrument

CPCI

Hudon

Internal consistency: Cronbach’s α ranging from .68 to .79. Accumulated knowledge (7/7, α = .88), interpersonal communication (6/ 6, α = .75), advocacy (2/9, α = .88), family context(2/3, α = .82) and community context (2/2, α not available)

Content validity: A panel of experts evaluated the relevance of the items to the component they proposed to measure and assessed the items for clarity and conciseness. Predictive validity: CPCI was related with patient satisfaction. Interpersonal communication was associated with being more up to date on screening

Consultation and Relational Empathy

CARE

Hudon & Brouwers

Internal consistency: Cronbach’s alpha = 0.93

Face and content validity: Feedback from patients interviewed, the general practitioners, and the expert researchers led to a number of modifications. Based on earlier studies on theoretical concept of empathy and compared with BLESS. Patient and colleague GP interviews based on grounded theory approach, experts’ advice. Criterion validity: Pearson’s r = 0.85, p < 0.001 with RES; Pearson’s r = 0.84, p < 0.001 with BLESS. Predictive validity: General practitioner empathy is associated with patient enablement at contact consultation and a prospective relationship between patient enablement and changes in main complaint and well-being at 1 month. Concurrent validity: Strong correlations with the Reynolds Empathy Scale (RES) and the Barret-Lennard Empathy Subscale (BLESS)

Davis Observation Code (modified version)

DOC

Ekman

NR

NR

Detail of Essential Elements and Participants in Shared Decision Making

DEEP-SDM

Ekman

NR

NR

Four Habits Coding Scheme

4HCS

Ekman

Inter-rater reliability (Pearson correlation): Habit 1 = 0.70, Habit 2 = 0.80, Habit 3 = 0.71, Habit 4 = 0.69, Overall 0.72. Internal consistency reliability (Cronbach ´s alpha): Habit 1 = 0.71, Habit 2 = 0.51, Habit 3 = 0.81 and Habit 4 = 0.61. N interactions: 13, N raters: 2

Concurrent validity: correlation with other measure (RIAS). Habit 1 =  − 0.07–0.28, Habit 2 = 0.08–0.37, Habit 3 =  − 0.01–0.37, Habit 4 = 0.01–0.21

General Practice Assessment Survey

GPAS

Hudon

Internal consistency: All Cronbach’s alpha’s were above 0.70 (except for the trust scale = 0.69)

Test–retest reliability: All 7 of the multi-item scales had test–retest correlations greater than the 0.70. access: 0.81; technical care: 0.89; communication: 0.85; inter-personal care: 0.83; trust: 0.83; knowledge of patient: 0.87; nursing care: 0.92). Communication (2/4, α = .90), interpersonal care (3/3, α = .93), trust (2/4, α = .69) and knowledge of patient (3/3, α = .91)

Discriminant validity: Respondents who were extremely satisfied scored significantly higher than those who were not

Henbest and Stewart instrument

Henbest & Stewart

Ekman

Inter-rater reliability: Spearman correlation = 0.91 Intra-rater reliability: Spearman correlation = 0.88 (after 2 weeks) and 0.63 (after 6 weeks)

N interactions: 18 (inter-rater); 8 (intra-rater, 2 weeks); 12 (intra-rater, 12 weeks) N raters: 2

NR

Individualized Care Scale (4th version) – English version (Canada) (Petroz et al. 2011)

ICS

Koberich

ICS-A: 0.94

ICS-B: 0.94

Structural validity (EFA): Three factor for ICS-A and two factors for ICS-B. Factors accountable for 69.2% of the variance in ICS-A and 63.6% of the variance in ICS-B. Convergent validity: Schmidt Perception of Nursing Care Survey (SPNCS) was used (measuring patient satisfaction) Spearman’s Rho: SPNCS vs. ICS-A: 0.76 (95% CI: 0.72, 0.80); SPNCS vs. ICS-B: 0.80 (95% CI: 0.77, 0.83)

Individualized Care Scale (4th version) – Finnish, Greek, Swedish and English version (Suhonen et al. 2010)

ICS

Koberich

Finnish version: ICS-A: 0.92; ICS-B: 0.90; ClinB: 0.88; PersB: 0.78; DecB: 0.77 Greek version: ICS-A: 0.97; ClinA: 0.96; PersA: 0.90; DecA: 0.92 ICS-B: 0.97; ClinB: 0.96; PersB: 0.87; DecB: 0.89. Swedish version: ICS-A: 0.93; ClinA: 0.88; PersA: 0.84; DecA: 0.89 ICS-B: 0.92; ClinB: 0.88; PersB: 0.80; DecB: 0.84. UK version: ICS-A: 0.97; ClinA: 0.93; PersA: 0.86; DecA: 0.94 ICS-B: 0.95; ClinB: 0.94; PersB: 0.80; DecB: 0.85. USA version: ICS-A: 0.94; ClinA: 0.86; PersA: 0.88; DecA: 0.88 ICS-B: 0.93; ClinB: 0.90; PersB: 0.78; DecB: 0.78

Structural validity (EFA): Three factor for ICS-A and ICS-B, Factors accountable for n % of the variance 1) Finnish version: ICS-A: 61.9%; ICS-B: 58.2% 2) Greek version: ICS-A: 73.9%; ICS-B: 68.8% 3) Swedish version:ICS-A: 65.6%; ICS-B: 62.1% 4) UK version: ICS-A: 79.7%; ICS-B: 79.7% Cross-cultural validity (Rasch-Analysis): Measurement of invariance between the ICS versions of four countries: general congruence in item calibration patterns, but slight differences in the rank order

Individualized Care Scale (4th version) – Turkish version (Acaroglu et al. 2011)

ICS

Koberich

ICS-A: 0.92; ClinA: 0.86; PersA: 0.72; DecA: 0.83 ICS-B: 0.93; ClinB: 0.89; PersB: 0.80; DecB: 0.84

Structural validity (EFA): Three factor for ICS-A and ICS-B. Factors accountable for 65% of the variance in ICS-A and 62% of the variance in ICS-B

Informed Decision Making instrument

IDM

Ekman

Inter-rater reliability: Agreement = 77%. N interactions: 20, N raters: 3

NR

Instrument on Doctor-Patient Communication Skills

IDPCS

Hudon

Internal consistency: Cronbach’s α for the patient questionnaire was .69

Face validity: The initial instruments were administered to 4 specialists and 3 family doctors who, along with their patients, provided feedback. Factor analysis: For patients, 60% of the variance was explained by the first factor (process of communication) and 6% by the second (content of communication)

Interpersonal Processes of Care

IPC

Hudon

Internal consistency: Cronbach’s α coefficients ranging from .65 to .90. Hurried communication (5/5, α = .65), elicited concerns, responded (3/3, α = .80), explained results, medication (4/4, α = .81), patient-centered decision-making (3/3, α = .75) and compassionate, respectful (5/5, α = .71)

Interpersonal Skills Rating Scale

IPS

Brouwers

Reliability coefficient: medical students 0.72 (range: 0.68–0.76), foreign medical graduates 0.83 (range: 0.68–0.93); internal medicine residents: 0.48 and 0.42

Construct validity: correlation other instrument (patient rating form) and IPS = 0.95 (p < 0.0001). Factor 1 (communication of information and patient participation) explained 62% of variance; factor 2 (empathy and jargon free communication) explained 10% of variance

Little instrument

CCM

Hudon

Communication and partnership (11/11, α = .96), personal relationship (3/3, α = .89), health promotion (2/2, α = .87), positive and clear approach to problem (3/3, α = .84) and interest in effect on life (2/2, α = .89)

Satisfaction was related to communication and partnership and positive approach. Enablement was more significantly related with interest in effect on life, health promotion, and positive approach. Positive approach was associated with reduced symptom burden at 1 month. Referrals were fewer if patients felt they had a personal relationship with their doctor

Little instrument

Little instrument

Hudon & Brouwers

Internal consistency: Cronbach’s alpha = 0.96 (communication and partnership), 0.89 (personal relationship), 0.87 (health promotion), 0.84 (positive and clear approach to the problem), 0.89 (interest in effect on life)

Four factors explained 93% of variance

Measure of Patient-Centered Communication (Modified version)

MPCC

Ekman

Inter-coder reliability: Krippendorff’s α for process categories = 0.86. Internal consistency reliability: Cronbach ‘s alpha = 0.48. N interactions: 56, N raters: NR

Content validity: Panel of radiation therapists and PCC researchers. Concurrent validity: Comparison with other measure (Patient-perceived patient centeredness), Pearson correlation = 0.01

Medical Communication Competence Scale

MCCS

Hudon

No subscale (24/40, α = .79 for information giving, α = .76 for information seeking, α = .85 for information verifying, and α = .92 for socioemotional communication

Nonverbal Accommodation Analysis System

NAAS

Ekman

Inter-rater reliability (Pearson correlation): paraverbal = 0.81–0.96; nonverbal = 0.85–0.93. Intra-rater reliability (Pearson correlation): paraverbal = 0.82–1.0; non-verbal = 0.89–0.94. N interactions: 10, N raters: 2

Concurrent validity: correlation with other measure (MIPS): physician eye contact = 0.45; patient eye contact = 0.62

North Worcestershire Vocational Training Scheme Patient Satisfaction Questionnaire

NWVTS-PSC

Brouwers

Internal consistency: Cronbach’s alpha = 0.84

Content validity: Association with general satisfaction with the consultation Spearman’s r = 0.61 (exploring patient understanding), 0.54 (ease of problem sharing), 0.52 (sufficient time in consultation)

Observing Patient Involvement

OPTION

Ekman

Inter-rater reliability: ICC = 0.62; Cohen´s kappa = 0.71; Generalisability coefficient = 0.68. Intra-rater reliability: Generalisability coefficient = 0.66. Internal consistency reliability: Cronbach ´s alpha = 0.79. N interactions: 186, N raters: 2

Content validity: items formulated from existing literature. Known groups validity: scores influenced by patient age (negative); sex of clinician (positive in favour of female); qualification of clinician (positive), and clinical equipoise (positive)

Oncology Patients’ Perceptions of the Quality of Nursing Care Scale

OPPQNCS

Koberich

Internal consistency: Total scale: 0.99 (Short form: 0.97), Responsiveness: 0.99 (Short form: 0.95), Individualization: 0.97 (Short form: 0.93), Coordination: 0.87 (Short form: 0.87), Proficiency: 0.95 (Short form: 0.95)

Structural validity, EFA: Four factors: (1) Responsiveness, (2) Individualization, (3) Coordination, (4) Proficiency. Four factors explain 80.5% of the variance

Oncology Patients’ Perceptions of the Quality of Nursing Care Scale—Finnish version (Suhonen et al. 2007a,b)

OPPQNCS

Koberich

Internal consistency: Total scale: 0.94, Responsiveness: 0.91, Individualization: 0.87, Coordination: 0.85, Proficiency: 0.90

Convergent validity (Pearsons r): Correlation of OPPQNCS subscales assessing individualized care with ICS subscales assessing individualized care: r = 0.64/0.66. Correlation of OPPQNCS subscales assessing individualized care with Schmidt Perception of Nursing Care Survey subscales assessing individualized care: r = 0.67. Divergent validity (Pearsons r): Correlation of OPPQNCS subscales not assessing individualized care with ICS subscales assessing individualized care: r = 0.51–0.60. Correlation of OPPQNCS subscales not assessing individualized care with Schmidt Perception of Nursing Care Survey subscales assessing individualized

care: r = 0.53–0.62

Oncology Patients’ Perceptions of the Quality of Nursing Care Scale—Short form – Turkish version (Can et al. 2008)

OPPQNCS

Koberich

Total scale: 0.91, Responsiveness: 0.74, Individualization: 0.79, Coordination: 0.66, Proficiency: 0.87

NA

Patient Feedback Questionnaire on Communication Skills

PFC

Brouwers

Internal consistency: Cronbach’s alpha = 0.89, item–total correlations ranged from 0.45 (question 11) to 0.67 (questions 9 and 13)

Construct validity: correlation original construct (translated PPPC) and new construct (PFC): 0.97. One factor explained 55.64% of variance

Patient Perception of Patient Centeredness

PPPC

Hudon

Alpha = .71

The PPPC showed significant correlations with better recovery from discomfort, alleviation of concerns, and better emotional health 2 months after the initial visit, and with use of fewer diagnostic tests and referrals. Patients’ perception of patient-centered behaviors was strongly associated with patients’ satisfaction with information

Patient Perception of Patient Centeredness (14 items)

PPPC

Brouwers

Internal consistency: Cronbach’s alpha = 0.71

Criterion validity: Pearson’s r = 0.16, p < 0.01 with MPCC

Patient Perception of Patient Centeredness (9 item)

PPPC

Brouwers

Internal consistency: Cronbach’s alpha = 0.80 (patient questionnaire), 0.79 (physician questionnaire)

Patient Perception of Quality

PPQ

Hudon

Internal consistency: Cronbach’s α coefficients ranging from .83 to .94. Interpersonal aspects of care (5/5, α = .91) and technical aspects of care (5/12, α = .91)

Discriminant validity: Indices developed are potentially discriminating. Factor analysis: The 3 factors explained 60% of the total variance

Patient Reactions Assessment

PRA

Hudon

Overall Cronbach’s α of .91. Patient information index (2/5, α = .87), patient communication index (1/5, α = .91) and patient affective index (5/5, α = .90)

Face validity: An initial pool of 56 items was evaluated for face validity by 4 oncologist nurses and 13 counselling students. Discriminant validity: PRA was able to differentiate a group of providers who were perceived by counselling professionals as having more effective relationships with patients from a group who were perceived as having less effective patient relationship. Factor analysis: The 3-factor oblique model seemed

to provide the best fit to the data

Patient-Centred Behaviour Coding instrument

PBCI

Ekman

Inter-rater reliability (ICC); Relative agreement: facilitating = 0.93, inhibiting = 0.53; Absolute agreement: facilitating = 0.92, inhibiting = 0.53. Internal consistency reliability (Cronbach ´s alpha): facilitating = 0.64, inhibiting = 0.50. N interactions: 323, N raters: 4

Concurrent validity: Correlation with other measure (Euro communication): facilitating (r = 0.28 and inhibiting (r =  − 0.29)

Patient-Centred Observation Form

PCOF

Brouwers & Ekman

Overall inter-rater reliability Cronbach’s alpha = 0.67. N interactions: 13, N raters: 4. clinician’s inter-rater reliability: 0.45; social scientist’s inter-rater reliability: 0.62

NR

Perceived Involvement in Care Scale

PICS

Hudon

Internal consistency: Overall Cronbach’s α of .73. Doctor facilitation (5/5, α = .60-.73)

Predictive validity: Doctor facilitation and patient decision making were related with patient satisfaction with care. Doctor facilitation and information exchange was related with patients’ control over illness, and expectations for improvement in functioning. Doctor facilitation scale was related with patient participation Factor analysis: 3 relatively independent factors

Perceived Involvement in Care Scale (Modified version)

M-PICS

Brouwers

Internal consistency: Cronbach’s alpha = 0.87 (ranges: 0.79–0.89 (English), 0.76–0.86 (Spanish))

Convergent validity: Pearson’s r = -0.302, p < 0.01 (patient decision making and age); r = -0.314, p < 0.01 (facilitation and Latina status); r = 0.363, p < 0.001 (health care provider info and Latina); r = 0.0376, p < 0.001 (health care provider info and SES). Factor 1 (health care provider info) explained 32.01%, factor 2 (patient info) explained 16.42%, factor 3 (patient decision making) explained 9.45%, factor 4 (health care provider facilitation) explained 7.32%; total variance explained: 65.2%

Primary Care Assessment Survey

PCAS

Hudon

Internal consistency: Cronbach’s α ranging from .81 to .95. Contextual knowledge of patient (5/5, α = .92), communication (6/6, α = .95), interpersonal treatment (4/5, α = .95) and trust (5/8, α = .86)

Primary Care Assessment Tool (adult edition)

PCAT-A

Hudon

Internal consistency: Cronbach’s α ranging from .64 to .95. Ongoing care (12/20, α = .92)

Content validity: 9 expert were asked to rate the appropriateness and representativeness of the primary care domain items. Factor analysis: 7 factors explained 88% of the total variance

Process of Interactional Sensitivity Coding in Healthcare

PISCH

Ekman

Inter-rater reliability: Cohen ´s kappa = 0.46–0.72; Scotts ´s pi = 0.44–0.72. N interactions: 50, N raters: NR

Face validity: review by panel of experts

Quality of Communication

QoC

Brouwers

Internal consistency: Cronbach’s alpha = 0.50

Convergent validity: Spearman’s r = 0.738 with overall quality of doctor’s communication and r = 0.432 with overall quality of discussions of end-of-life care (both p ≤ 0.000)

Questionnaire on the Quality of Physician–Patient Interaction

QQPPI

Brouwers

Internal consistency: Cronbach’s alpha = 0.95, Test–retest reliability: Pearson’s r = 0.59

Content: +  + (adequate). Structural: PICS-A and SWD: r = 0.64 and 0.59 (n = 147), QHC and PICS-B: r = 0.54 and 0.52 (n = 147), PSHC: r = 0.38 (n = 147). One factor explained 60.11% of variance

Revised Patient-Centred Communication and Interpersonal Skills Scale

RUCIS

Brouwers

NA (tested using IRT—Rasch model)

NA (tested using IRT—Rasch model)

Rochester Participatory Decision-Making Scale

RPAD

Ekman

Inter-rater reliability: ICC = 0.72. N interactions: 193, N raters: NR

Concurrent validity: correlation with other measure (MPCC, dimension finding common ground) r = 0.19. Correlation with standardized patient perceptions (r = 0.32–0.36) and patient survey measures (r = 0.06–0.07)

Roter Interaction Analysis System (Modified version)

ARCS(RIAS)

Ekman

Inter-rater reliability (Cohen ´s kappa): 0.52. N interactions: 145, N raters: 5

Concurrent validity: correlation with other measure (RIAS). No misclassification between RIAS codes and ARCS codes

Sherbrooke Observation Scale of Patient-Centered Care

SOS-PCC

Ekman

Inter-rater reliability: ICC = 0.93. Internal consistency reliability: Cronbach ´s alpha = 0.88. N interactions: 42, N raters: 3

Content validity: 7 interdisciplinary experts in the health care field

Smoliner scale

Smoliner scale

Koberich

Total scale: n/a. Preferences: 0.84, Experiences: 0.86

Hypothesis-testing. Validity with known-groups: Group 1: experience with decision making = preference of decision-making; Group 2: experience with decision making ≠ preference of decision-making. Groups differ in overall satisfaction with decision-making (P < 0.001). Convergent validity: Correlation ‘experiences’ – ‘patient satisfaction with information process’: r = 0.673. Correlation ‘preferences’ – ‘patient satisfaction with information process’: r = 0.358