Variance components of ratings of physician-patient communication: A generalizability theory analysis.

<h4>Background</h4>The ratings of physician-patient communication are an important indicator of the quality of health care delivery and provide guidance for many important decisions in the health care setting and in health research. But there is no gold standard to assess physician-patie...

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Autores principales:	Nicole Röttele, Christian Schlett, Mirjam Körner, Erik Farin-Glattacker, Andrea C Schöpf-Lazzarino, Sebastian Voigt-Radloff, Markus A Wirtz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fb0b1797483749998d96344d7045ed8e
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spelling	oai:doaj.org-article:fb0b1797483749998d96344d7045ed8e2021-12-02T20:10:48ZVariance components of ratings of physician-patient communication: A generalizability theory analysis.1932-620310.1371/journal.pone.0252968https://doaj.org/article/fb0b1797483749998d96344d7045ed8e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252968https://doaj.org/toc/1932-6203<h4>Background</h4>The ratings of physician-patient communication are an important indicator of the quality of health care delivery and provide guidance for many important decisions in the health care setting and in health research. But there is no gold standard to assess physician-patient communication. Thus, depending on the specific measurement condition, multiple sources of variance may contribute to the total score variance of ratings of physician-patient communication. This may systematically impair the validity of conclusions drawn from rating data.<h4>Objective</h4>To examine the extent to which different measurement conditions and rater perspectives, respectively contribute to the variance of physician-patient communication ratings.<h4>Methods</h4>Variance components of ratings of physician-patient communication gained from 32 general practitioners and 252 patients from 25 family practices in Germany were analyzed using generalizability theory. The communication dimensions "shared decision making", "effective and open communication" and "satisfaction" were considered.<h4>Results</h4>Physician-patient communication ratings most substantially reflect unique rater-perspective and communication dimension combinations (32.7% interaction effect). The ratings also represented unique physician and rater-perspective combinations (16.3% interaction effect). However, physicians' communication behavior and the observed communication dimensions revealed only a low extent of score variance (1% physician effect; 3.7% communication dimension effect). Approximately half of the variance remained unexplained (46.2% three-way interaction, confounded with error).<h4>Conclusion</h4>The ratings of physician-patient communication minimally reflect physician communication skills in general. Instead, these ratings exhibit primarily differences among physicians and patients in their tendency to perceive shared decision making and effective and open communication and to be satisfied with communication, regardless of the communication behavior of physicians. Rater training and assessing low inferential ratings of physician-patient communication dimensions should be considered when subjective aspects of rater perspectives are not of interest.Nicole RötteleChristian SchlettMirjam KörnerErik Farin-GlattackerAndrea C Schöpf-LazzarinoSebastian Voigt-RadloffMarkus A WirtzPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252968 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nicole Röttele Christian Schlett Mirjam Körner Erik Farin-Glattacker Andrea C Schöpf-Lazzarino Sebastian Voigt-Radloff Markus A Wirtz Variance components of ratings of physician-patient communication: A generalizability theory analysis.
description	<h4>Background</h4>The ratings of physician-patient communication are an important indicator of the quality of health care delivery and provide guidance for many important decisions in the health care setting and in health research. But there is no gold standard to assess physician-patient communication. Thus, depending on the specific measurement condition, multiple sources of variance may contribute to the total score variance of ratings of physician-patient communication. This may systematically impair the validity of conclusions drawn from rating data.<h4>Objective</h4>To examine the extent to which different measurement conditions and rater perspectives, respectively contribute to the variance of physician-patient communication ratings.<h4>Methods</h4>Variance components of ratings of physician-patient communication gained from 32 general practitioners and 252 patients from 25 family practices in Germany were analyzed using generalizability theory. The communication dimensions "shared decision making", "effective and open communication" and "satisfaction" were considered.<h4>Results</h4>Physician-patient communication ratings most substantially reflect unique rater-perspective and communication dimension combinations (32.7% interaction effect). The ratings also represented unique physician and rater-perspective combinations (16.3% interaction effect). However, physicians' communication behavior and the observed communication dimensions revealed only a low extent of score variance (1% physician effect; 3.7% communication dimension effect). Approximately half of the variance remained unexplained (46.2% three-way interaction, confounded with error).<h4>Conclusion</h4>The ratings of physician-patient communication minimally reflect physician communication skills in general. Instead, these ratings exhibit primarily differences among physicians and patients in their tendency to perceive shared decision making and effective and open communication and to be satisfied with communication, regardless of the communication behavior of physicians. Rater training and assessing low inferential ratings of physician-patient communication dimensions should be considered when subjective aspects of rater perspectives are not of interest.
format	article
author	Nicole Röttele Christian Schlett Mirjam Körner Erik Farin-Glattacker Andrea C Schöpf-Lazzarino Sebastian Voigt-Radloff Markus A Wirtz
author_facet	Nicole Röttele Christian Schlett Mirjam Körner Erik Farin-Glattacker Andrea C Schöpf-Lazzarino Sebastian Voigt-Radloff Markus A Wirtz
author_sort	Nicole Röttele
title	Variance components of ratings of physician-patient communication: A generalizability theory analysis.
title_short	Variance components of ratings of physician-patient communication: A generalizability theory analysis.
title_full	Variance components of ratings of physician-patient communication: A generalizability theory analysis.
title_fullStr	Variance components of ratings of physician-patient communication: A generalizability theory analysis.
title_full_unstemmed	Variance components of ratings of physician-patient communication: A generalizability theory analysis.
title_sort	variance components of ratings of physician-patient communication: a generalizability theory analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fb0b1797483749998d96344d7045ed8e
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Variance components of ratings of physician-patient communication: A generalizability theory analysis.

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