CAT - Aplicação do Communication Assessment Tool a profissionais de saúde : validação do instrumento no contexto português

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2015Ob ject ive: Effective communication is an essential aspect of high-quality patient care and an important ability for physicians and for other health professionals. Therefore, interpersonal and communication skills have been identified as a core competency that must be demonstrated by physicians. To date, assessment of communication skills, in the portuguese context, has not been well established. The Communication Assessment Tool (CAT), developed by Makoul e t a l assesses patient perceptions of physicians' interpersonal and communication skills. We undertook this study to explore patient perceptions about communication with physicians of different specialties, using the CAT, a psychometrically validated instrument for patient assessment of physician communication skills. For this study we used an european portuguese translated version of CAT that we pretend to validate in the portuguese context. M e th o d s : We began to translate the CAT, a psychometrically validated survey, into european portuguese. We then conducted a field, prospective, cross-sectional questionnaire study, considered exempt, in the Associação Protetora dos Diabéticos de Portugal (APDP), during a three month period, starting on April of 2015 and ending on July of 2015, using the CAT, a 15 items instrument, with physicians and patients from a variety of specialties. 14 items focus on the physician and one targets the staff. Items were answered via a five point response scale, in which one means poor and five means excellent. Pilot testing established that the CAT differentiates between physicians who rated high or low on a separate satisfaction scale. All patients are adults, with more than 18 years old, with diverse ethnic back-grounds, and were eligible if the following exclusion criteria did not apply: primary psychiatric issues, critically ill or physiologically unstable. Part of the sociodemographic characteristics was soon answered, even before the medical's appointment, to engage in a compromise; nevertheless, CAT's questions were immediately answered after the end of the same medical's appointment. CAT filling took place in the waiting room of the APDP. Resu lts: 172 patients were enrolled, but only 150 patients completed the CAT properly, so we analyzed 150 patient surveys, ranged in age from 18 to over 84 years old (50.7% of participants aged between 45 and 64 years), 51.3% were female. Highest ratings were "treated me with respect" (64.0% excellent), "greeted me in a way that made me feel comfortable" (62.0% excellent), and "showed care and concern" (54.7% excellent). The lowest scoring items were for encouraging the patients to ask questions (34.7% excellent), involving the patients in decisions as much as they wanted (38.7% excellent), letting the patients talk without interruptions (46.0% excellent), and checking to be sure the patient understood everything (46.0% excellent) with the same score. Overall scale reliability was high (Cronbach's alpha = 0.97). Con clusio n : The CAT is a reliable and valid instrument for measuring patient perceptions of physician performance in the area of interpersonal and communication skills in the portuguese context, as already happens in other countries. The field test demonstrated that the CAT can be successfully completed by both physicians and patients across clinical specialties. The CAT can be used, since it is a useful tool, to gauge patient perceptions of physicians' communication skills during an appointment