Patient communication competence: development of a German questionnaire and correlates of competent patient behavior

Abstract

Objective: The aim of our study was to design and psychometrically test a patient questionnaire to capture patient communication competence in the context of patient-provider interaction (CoCo questionnaire). We also aimed to determine patient characteristics associated with competent patient behavior.

Methods: To assure content validity, we initially conducted 17 focus groups (n=97) made up of patients and providers. In the main study n=1.264 patients with chronic back pain, chronic-ischemic heart disease or breast cancer who underwent inpatient rehabilitation were surveyed at the end of rehabilitation.

Results: The CoCo questionnaire contains four scales (patient adherence in communication, critical and participative communication, communication about personal circumstances, active disease-related communication) and 28 items addressing competent patient behavior. We provide evidence of unidimensionality, local independence, reliability, a Rasch-Model fit, the absence of differential item functioning, and signs of construct validity. The most important correlates of communication competence are health literacy and communication self-efficacy.

Conclusion: The CoCo questionnaire has good psychometric properties in German. Future research should examine CoCo's responsiveness and analyze criterion validity by means of observation data.

Practice implications: The CoCo questionnaire can be recommended for use in evaluating patient communication training programs.

Keywords: Breast cancer; Chronic back pain; Chronic ischemic heart disease; Patient communication competence; Patient–provider communication; Questionnaire development.