What is patient-centered care according to QSEN?

  1. World Health Organization. Primary health care: now more than ever. 2008.

    Google Scholar 

  2. van Oostrom SH, Picavet HSJ, van Gelder BM, Lemmens LC, Hoeymans N, van Dijk CE, et al. Multimorbidity and comorbidity in the Dutch population: data from general practices. BMC Public Health. 2012;12(1):715.

    Article  Google Scholar 

  3. Navickas R, Petric VK, Feigl AB, Seychell M. Multimorbidity: what do we know? What should we do? J Comorb. 2016;6(1):4–11.

    Article  Google Scholar 

  4. Lugtenberg M, Burgers JS, Clancy C, Westert GP, Schneider EC. Current guidelines have limited applicability to patients with comorbid conditions: a systematic analysis of evidence-based guidelines. PLoS One. 2011;6(10):e25987.

  5. Tinetti ME, Bogardus ST Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. New Eng J Med. 2004;351(27):2870–4.

    Article  CAS  Google Scholar 

  6. van der Heide I, Snoeijs S, Quattrini S, Struckmann V, Hujala A, Schellevis F, et al. Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project. Health Policy. 2018;122(1):36–43.

    Article  Google Scholar 

  7. Lehnert T, Heider D, Leicht H, Heinrich S, Corrieri S, Luppa M, Riedel-Heller S, König HH. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Med Care Res Rev. 2011;68(4):387–420.

    Article  Google Scholar 

  8. Fortin M, Lapointe L, Hudon C, Vanasse A, Ntetu AL, Maltais D. Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes. 2004;2:51.

    Article  Google Scholar 

  9. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academies Press; 2001.

  10. Gerteis M, Edgman-Levitan S, Walker JD, Stoke DM, Cleary PD, Delbanco TL. What patients really want. Health Manag Q. 1993;15(3):2–6.

    CAS  Google Scholar 

  11. Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70(4):351–79.

    Article  Google Scholar 

  12. den Boer J, Nieboer AP, Cramm JM. A cross-sectional study investigating patient-centred care, co-creation of care, well-being and job satisfaction among nurses. J Nurs Manag. 2017;25(7):577–84.

    Article  Google Scholar 

  13. van der Meer L, Nieboer AP, Finkenflugel H, Cramm JM. The importance of person-centred care and co-creation of care for the well-being and job satisfaction of professionals working with people with intellectual disabilities. Scand J Caring Sci. 2018;32(1):76–81.

    Article  Google Scholar 

  14. Gittell JH. Relationships between service providers and their impact on customers. J Serv Res. 2002;4(4):299–311.

    Article  Google Scholar 

  15. Cottrell E, Yardley S. Lived experiences of multimorbidity: an interpretative meta-synthesis of patients’, general practitioners’ and trainees’ perceptions. Chronic Illn. 2015;11(4):279–303.

    Article  Google Scholar 

  16. Cramm JM, Nieboer AP. Is “disease management” the answer to our problems? No! Population health management and (disease) prevention require “management of overall well-being”. BMC Health Serv Res. 2016;16:500.

    Article  Google Scholar 

  17. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.

    Article  Google Scholar 

  18. Cramm JM, Nieboer AP. Validation of an instrument for the assessment of patient-centred care among patients with multi-morbidity in the primary care setting: the 36-item patient-centred primary care instrument. BMC family practice. 2018;19:143.

  19. Cramm JM, Leensvaart L, Berghout M, van Exel J. Exploring views on what is important for patient-centred care in end-stage renal disease using Q methodology. BMC Nephrol. 2015;16(1):74.

    Article  Google Scholar 

  20. Berghout M, van Exel J, Leensvaart L, Cramm JM. Healthcare professionals’ views on patient-centered care in hospitals. BMC Health Serv Res. 2015;15:385.

    Article  Google Scholar 

  21. Cramm JM, Nieboer AP. Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals. BMC Health Serv Res. 2017;17(1):472.

    Article  Google Scholar 

  22. Nieboer A, Lindenberg S, Boomsma A, Bruggen ACV. Dimensions of well-being and their measurement: the SPF-IL scale. Soc Indic Res. 2005;73(3):313–53.

    Article  Google Scholar 

  23. Gittell JH. Relational coordination: guidelines for theory, measurement and analysis; 2010.

    Google Scholar 

  24. Boter H, De Haan RJ, Rinkel GJ. Clinimetric evaluation of a satisfaction-with-stroke-care questionnaire. J Neurol. 2003;250(5):534–41.

    Article  Google Scholar 

  25. Baumann C, Rat AC, Mainard D, Cuny C, Guillemin F. Importance of patient satisfaction with care in predicting osteoarthritis-specific health-related quality of life one year after total joint arthroplasty. Qual Life Res. 2011;20(10):1581–8.

    Article  Google Scholar 

  26. Bredart A, Robertson C, Razavi D, Batel-Copel L, Larsson G, Lichosik D, et al. Patients’ satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden. Psycho-Oncology. 2003;12(1):68–77.

    Article  CAS  Google Scholar 

  27. Poder U, Vone L. Perceptions of support among Swedish parents of children on cancer treatment: a prospective, longitudinal study. Eur J Cancer Care. 2009;18(4):350–7.

    Article  CAS  Google Scholar 

  28. Von Essen L, Larsson G, Oberg K, Sjoden PO. ‘Satisfaction with care’: associations with health-related quality of life and psychosocial function among Swedish patients with endocrine gastrointestinal tumours. Eur J Cancer Care. 2002;11(2):91–9.

    Article  Google Scholar 

  29. Cramm JM, Nieboer AP. Chronically ill patients’ self-management abilities to maintain overall well-being: what is needed to take the next step in the primary care setting? BMC Fam Pract. 2015;16:123.

    Article  Google Scholar 

  30. Cramm JM, Nieboer AP. The effects of social and physical functioning and self-management abilities on well-being among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes. Appl Res Qual Life. 2014;9(1):113–21.

    Article  Google Scholar 

  31. Cramm JM, Nieboer AP. The changing nature of chronic care and coproduction of care between primary care professionals and patients with COPD and their informal caregivers. Int J Chronic Obstruct Pulmon Disease. 2016;11:175–82.

    Article  CAS  Google Scholar 

  32. Hopman P, Schellevis FG, Rijken M. Health-related needs of people with multiple chronic diseases: differences and underlying factors. Qual Life Res. 2016;25(3):651–60.

    Article  Google Scholar 

  33. Rosland A-M, Piette JD, Choi H, Heisler M. Family and friend participation in primary care visits of patients with diabetes or heart failure: patient and physician determinants and experiences. Med Care. 2011;49(1):37–45.

    Article  Google Scholar 

  34. Kenning C, Fisher L, Bee P, Bower P, Coventry P. Primary care practitioner and patient understanding of the concepts of multimorbidity and self-management: a qualitative study. SAGE Open Med. 2013;1:2050312113510001.

    Article  Google Scholar 

  35. Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.

    Article  CAS  Google Scholar 

  36. Picavet HSJ. National health surveys by mail or home interview. Effects on response. J Epidemiol Community Health. 2001;55:408–13.

    Article  CAS  Google Scholar 

  37. Buttle F, Thomas G. Questionnaire colour and mail survey response rate. J Mark Res Soc. 1997;39:625–6.

    Google Scholar 

  38. Peters M, Kelly L, Potter CM, Jenkinson G, Gibbons E, Forder J, Fitzpatrick R. Quality of life and burden of morbidity in primary care users with multimorbidity. Patient Relat Outcome Meas. 2018;9:103–13.

    Article  Google Scholar 


Page 2

Characteristic Mean ± standard deviation (range) or percentage
Age (years) 74.44 ± 10.64 (47–94)
Gender (male) 40.8%
Education (low) 39.3%
Marital status (single) 43.3%
Patient-centered care 3.84 ± 0.47 (1.7–5)
 Preferences 3.96 ± 0.63 (1–5)
 Physical comfort 3.92 ± 0.57 (1.8–5)
 Coordination 3.92 ± 0.61 (2–5)
 Emotional support 3.45 ± 0.75 (1–5)
 Access to care 3.99 ± 0.56 (1.67–5)
 Continuity and transition 3.97 ± 0.58 (2–5)
 Information and education 3.89 ± 0.56 (2–5)
 Family and friends 3.57 ± 1.01 (1–5)
Co-creation of care 3.61 ± 0.85 (1–5)
 General practitioner 3.78 ± 0.88 (1–5)
 Nurse practitioner 3.63 ± 1.03 (1–5)
 Specialist 3.12 ± 1.32 (1–5)
Satisfaction with care 3.13 ± 0.45 (1.5–4)
Social well-being 2.71 ± 0.53 (1.44–4)
Physical well-being 2.55 ± 0.62 (1–4)

  1. Note: Based on imputed data