Staff-based measurement instruments of person-centredness in settings of care for older people: A systematic review

Background

Person-centred care is widely endorsed as a promising approach for delivering high-quality care to older people. However, the multitude of existing definitions and measurement tools, coupled with the continuous emergence of new tools, can create confusion and hinder precision in assessing this concept. This review was undertaken with a recognition of the crucial role that assessment quality plays in evaluations and improvements, particularly within the context of person-centred care for older people.

Objectives

This study aimed to systematically review staff-based measures of person-centredness in settings of care for older people. More specifically, the objectives were to provide description, methodological evaluation and synthesis of diverse conceptual understandings of person-centredness encapsulated in these measurement tools.

Methods

We systematically searched the Cinahl, PsycInfo, PubMed, Scopus and Web of Science databases for English peer-reviewed journal articles between 2000 and 2021. These articles discussed the creation of staff-based questionnaires designed to assess the extent of person-centred care. We excluded questionnaires meant for clients, patients or families, as well as non-questionnaire scales. The measures were described, and their interpretations of person-centred care were synthesised through a critical interpretive synthesis method. We evaluated methodological quality using a condensed COSMIN risk of bias checklist and adhered to PRISMA guidelines.

Results

The review identified a total of 14 staff-based measures. These measures exhibited varying levels of comprehensiveness, encompassing anywhere between 2 and 17 components. Furthermore, the number of items within the measures ranged from 11 to 62, and the sample sizes exhibited significant diversity, spanning from 58 to 1428. In terms of the components scrutinised by the scales regarding person-centred care, our synthesis revealed the emergence of four distinct conceptual categories: care process, supportive care environment, relations and communication, and knowledge and attitudes. As for the methodological quality of the scales, it exhibited a notable degree of variation (i.e. from inadequate to very good).

Conclusions

Diverse measures of person-centredness vary in terms of comprehensiveness, aspects covered and methodological quality. Synthesising the concept through staff-based measures offers a novel approach for researchers and practitioners, illuminating nuanced perspectives in person-centred care.

Implications for practice

The synthesis enriches academic discussions and practical applications by dissecting components, ultimately enhancing care quality assessment and improvement. Further, this review is a valuable resource for unit managers and quality coordinators working in settings of care for older people, empowering them to make informed decisions tailored to their specific needs from a diverse array of available person-centred care measures.