The impact of person-centred care on patients' care experiences in relation to educational level after acute coronary syndrome: secondary outcome analysis of a randomised controlled trial

Abstract

Background: Research supporting the benefits of person-centred care is growing, still knowledge about patients' experiences of person-centred care is limited.

Aim: To evaluate the effects of person-centred care on patients' experiences of care, and also in relation to educational level, after an acute coronary syndrome.

Method: A total of 199 patients aged less than 75 years, hospitalised for acute coronary syndrome, were randomly assigned to either standard cardiac care ( n=105) or person-centred care plus standard cardiac care ( n=94). Experience of care was assessed at three healthcare settings (hospital, outpatient and primary care) using the 15-item Picker patient experience questionnaire plus two questions concerning information and documentation.

Results: No significant difference was found at the three healthcare settings between the two study groups in the Picker patient experience questionnaire total score. Item level analysis showed that the person-centred care group significantly improved at all three healthcare settings on information received and in documentation of care compared with the standard cardiac care group ( P<0.05). In outpatient care, the person-centred care group reported significantly better family-physician communication ( P=0.004) and information for the family ( P=0.007) compared with the standard cardiac care group. In patients without postsecondary education, the corresponding figures were even more in favour of the person-centred care group ( P=0.0005 and P=0.0049, respectively), and they also reported higher involvement in care decisions ( P=0.023).

Conclusion: A person-centred care approach after an event of acute coronary syndrome improves patients' care experiences for information, shared documentation and involvement of family and friends. This effect was especially prominent in patients with a low educational level, who were also more involved in care decisions.

Trial registration: Swedish registry, Researchweb.org , ID NR 65 791.

Keywords: Acute coronary syndrome; care experience; patient-centered care; person-centred care; randomised controlled trial; secondary prevention.