Patient-centered care in physical therapy: definition, operationalization, and outcome measures

Abstract

Background: The term patient-centered care (PCC) is increasingly used in health care with the intent of improving outcomes. How PCC is defined and operationalized in the physical therapy literature and its outcome measures have not been systematically explored. Such knowledge is needed in the interest of designing studies and comparing their findings.Objectives: (1) to describe how the term PCC is conceptualized in the physical therapy literature, and operationalized and implemented in research; and (2) to describe the measures used to evaluate its effectiveness.Methods: CINAHL, Medline, PsycINFO, PubMed, and SportDiscus databases were searched from databases’ inceptions to April 2015, using a combination of keywords. Two investigators performed title, abstract, and full-text screening. Study protocols and expert opinion were excluded. Definitions of PCC and modes of implementation were extracted from the eligible articles and synthesized along with study characteristics and outcome measures.Results: One thousand four hundred and seventy-five articles were retrieved; 8 met inclusion criteria. The term PCC was defined variably. Frequently, no definitions were provided, even though implementation and clinical implications were described. Mixed associations were observed between PCC and outcomes. Most articles had low levels of evidence.Conclusion: Although PCC is considered integral to physical therapy practice, there is no commonly accepted definition; thus, description of its implementation and outcomes has been non-specific and varied. We reviewed PCC in the physical therapy context. Further, the degree to which PCC is truly PCC in the absence of an inter-professional team needs to be reconciled. The findings of this exploratory review generated research questions for subsequent systematic review.