MEASURING PERSON-CENTREDNESS: THE DEVELOPMENT OF A NEW CARE QUALITY SCALE FOR OLDER PEOPLE'S COMMUNITY MENTAL HEALTH AND SOCIAL CARE SERVICES

Abstract

Background: Person-centredness is a ubiquitous term used across the health and social care system to signal services that align with the unique perspectives, needs and values of each individual. However, measures of person-centredness are under-developed. Researchers often turn to proxy indicators or ad-hoc satisfaction instruments, which are found to be inadequate for the task. Aims: This research aimed to develop and test a new multi-item measure of person-centredness for use in research and as a quality improvement instrument in the community support of older people with mental health problems. Methods: The aims were met using a mixed-methods approach. Two literature reviews defined the key attributes of person-centredness and appraised existing measures. New questionnaire items were sourced from two concept mapping groups held in the North West of England with White British and South Asian participants. Cognitive interviews tested and refined these items through face-to-face interviews with 14 service users and carers. A questionnaire was then tested in a postal mailing with older people using community mental health services in five regions of England. Rasch analysis and confirmatory factor modelling was used to form a short scale. All research activities were conducted between 2014-2016. Results: Person-centredness was defined through the concept synthesis as spanning three key themes: understanding the person; engagement in decision-making; and promoting the care relationship. Concept mapping groups identified 132 statements describing the care experience, and cognitive interviews concluded with 30 items for psychometric testing. The postal questionnaire achieved 633 returns (a response rate of 29 per cent), with 101 also completing a retest questionnaire. Psychometric analyses constructed a 12-item scale (the PERson Centred Care Instrument - PERCCI) with encouraging psychometric properties. The PERCCI has an essentially unidimensional factor structure and met Rasch criteria for interval-level measurement. Construct validity was supported by testing a priori hypotheses and through correlations with other experience measures. A test-retest analysis suggested excellent reliability. Conclusions: The twelve-item PERCCI has encouraging measurement properties, although further research is recommended before its use in high-stakes research. Comparisons need to be made with a wider range of validated instruments, and whether the PERCCI is sufficiently sensitive to capture meaningful change in quality needs to be established.

Date of Award	31 Dec 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Christopher Roberts (Supervisor), David Challis (Supervisor), Linda Davies (Supervisor) & Michael Kelly (Supervisor)