<p><strong>Introduction:</strong> Client-Centred Care (CCC) is emerging as a best practice in health care organizations around the world. Partnerships between patient, family, and health professionals in planning and delivery of health care services are known to improve outcomes and satisfaction with care. Studies report lack of understanding of the elements involved in creating this partnership, and identify the need for valid and reliable measures of client-centredness for adults</p> <p><strong>Objectives:</strong> 1) To explore the historical evolution and current state of CCC as these were used in adult health care settings; 2) to evaluate the performance of the adapted MPOC for Adults (MPOC-A) and MPOC-SP (A) as measures of client-centredness from the perspectives of adult clients and their HCPs, respectively; and 3) to develop an in-depth understanding of health professionals’ and clients’ experiences of engaging in CCC.</p> <p><strong>Methods: </strong>A narrative review was completed to explore the development and conceptualization of CCC. Two validation studies looked at psychometric properties of the Measure of Processes of Care for Adults (MPOC-A) in orthopedic surgery and in-patient neurological rehabilitation settings, and the Measure of Processes of Care for Service Providers working with Adults (MPOC-SP (A)) in in-patient neurological rehabilitation programs. A qualitative study using Grounded Theory methodology explored experiences of CCC, barriers, and supports to developing successful partnerships from patients’, families’, and health care professionals’ perspectives.</p> <p><strong>Results: </strong>The narrative review presented theoretical conceptualizations and definitions of CCC and identified areas that needed further development, e.g., clinical implementation of CCC principles into adult health care, development of valid and reliable outcome measures for adult clients, etc. In the validation studies, good to excellent internal consistency and moderate to good correlations between domains supported internal reliability of the tools. Results of confirmatory factor analysis of MPOC-SP (A) supported the original multi-dimensional structure of the tool.</p> <p>Being on common ground was the main category identified by both clients and HCPs in the qualitative study. All participants repeatedly highlighted the importance of good communication and information flow among all the parties.</p> <p><strong>Conclusions: </strong>The MPOC-A and MPOC-SP (A) will be useful in assisting with program evaluation and quality control. The qualitative components of this study will help to improve our understanding of attributes of programs and health professionals that clients consider important for good quality care, and will provide some practical recommendations for clinicians on implementation of CCC into practice.</p> / Doctor of Rehabilitation (RhD)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/13852 |
| Date | 04 1900 |
| Creators | Bamm, Elena L. |
| Contributors | Rosenbaum, Peter, Wilkins, Seanne, Stratford, Paul, Rehabilitation Science |
| Source Sets | McMaster University |
| Detected Language | English |
| Type | thesis |
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