Development and testing of an observation-based instrument that measures the degree of person-centred care – GDOT-PCC (Gothenburg Direct Observation Tool – Person-Centred Care)
Short description
Person-centred care (PCC) is widely considered to be integral to high quality healthcare. A common strategy for assessing PCC in clinician-patient interactions is the use of direct-observation methods, where clinicians are observed and rated while they interact with patients. Although there are a number of existing direct-observation tools, many are repurposed, lack comprehensive psychometric evaluation, require extensive rater training, fail to specify how PCC is conceptualized, and have not involved patients in their development. The overall aim of this doctoral project is to develop and test a new observation-based method aimed to effectively, efficiently and reliably assess PCC in clinicians’ interpersonal interactions with patients. This tool is envisioned to contribute to implementation efforts and clinician training and evaluation.
Development of the measurement instrument
An observation-based measurement instrument, GDOT-PCC (Gothenburg Direct Observation Tool – Person-Centred Care), where the degree of person-centred care can be assessed, has been developed in the following steps:
1) A systematic literature review, where 16 observation-based methods were identified and analyzed.
Ekman N, Taft C, Moons P, Mäkitalo Å, Boström E, Fors A. A state-of-the-art review of direct observation tools for assessing competency in person-centred care. Int J Nurs Stud. 2020 Sep;109:103634. doi: 10.1016/j.ijnurstu.2020.103634. Epub 2020 May 11. PMID: 32531569.
2) Patients and staff were interviewed, who had either received or worked with PCV, about what person-centred care actions are and how they can be observed.
Ekman N, Moons P, Taft C, Boström E, Fors A. Observable indicators of person-centred care: an interview study with patients, relatives and professionals. BMJ Open. 2022 Apr 20;12(4):e059308. doi: 10.1136/bmjopen-2021-059308. PMID: 35443963; PMCID: PMC9021806.
3) Instrument development. Through a “think aloud” method, patients and healthcare professionals are allowed to test the newly developed measurement instrument.
Ekman N, Fors A, Moons P, Boström E, Taft C. Are the content and usability of a new direct observation tool adequate for assessing competency in delivering person-centred care: a think-aloud study with patients and healthcare professionals in Sweden. BMJ Open. 2024 Jul 1;14(6):e085198. doi: 10.1136/bmjopen-2024-085198. PMID: 38950999; PMCID: PMC11328633.
4) Testing the measuring instrument.
Ekman N, Fors A, Moons P, Taft C. Gothenburg direct observation tool for assessing person-centred care (GDOT-PCC): evaluation of inter-rater reliability. BMJ Open. 2025 Apr 17;15(4):e096576. doi: 10.1136/bmjopen-2024-096576. PMID: 40246569; PMCID: PMC12007047.
Continued testing
The instrument is now being tested further at the Medical Department at Sahlgrenska University Hospital (SU)/Östra during the spring of 2025.
Researchers
Nina Ekman, Phd, The Institute of Health and Care 91̽s, Sahlgrenska Academy, University 91̽
Charles Taft, Associate Professor, The Institute of Health and Care 91̽s, Sahlgrenska Academy, University 91̽
Personal
Mahboubeh Goudarzi, Registered Specialist Nurse, Research Nurse, Co-ordinator, Sahlgrenska University Hospital (SU)/Östra
Hengameh Henny Kazemi, Registered Nurse, Research Nurse, Sahlgrenska University Hospital (SU)/Östra