Table 1.
The Self-Efficacy in Patient Centeredness Questionnaire (SEPCQ-27): Instructions, item wordings, factor loadings, and differential item function (DIF)
| Items: I am confident that I am able to … | Factor 1: Exploring the patient perspective | Factor 2: Sharing information and power | Factor 3: Dealing with communicative challenges | DIF-MH | DIF-IRT |
|---|---|---|---|---|---|
| ETC.-category c | K-index d | ||||
| 1. Make the patient feel that I am genuinely interested in knowing what he/she thinks about his/her situation | 0.69 | 0.18 | 0.21 | A | 0.15 |
| 2. Make the patient feel that I have time to listen | 0.66 | 0.28 | 0.21 | A | 0.13 |
| 3. Recognize the patient’s thoughts and feelings | 0.69 | 0.18 | 0.30 | A | 0.06 |
| 4. Be attentive and responsive | 0.74 | 0.25 | 0.15 | A | 0.13 |
| 5. Be aware of when the patient is scared or concerned | 0.62 | 0.26 | 0.32 | A | 0.14 |
| 6. Treat the patient in a caring manner | 0.77 | 0.26 | 0.08 | A | 0.04 |
| 7. Make the patient experience me as empathetic | 0.81 | 0.19 | 0.13 | A | 0.08 |
| 8. Make the patient feel that he/she can talk with me about confidential, personal issues | 0.64 | 0.28 | 0.27 | A | 0.04 |
| 9. Show a genuine interest in the patient and his/her situation | 0.80 | 0.23 | 0.18 | A | 0.10 |
| 10. Focus on compassion, care and symptomatic treatment, when there is no curative treatment | 0.71 | 0.25 | 0.18 | A | 0.06 |
| 11. Record a complete medical history | 0.19 | 0.56 | 0.15 | A | 0.13 |
| 12. Reach agreement with the patient about the treatment plan to be implemented | 0.27 | 0.60 | 0.24 | A | 0.14 |
| 13. Advise and support the patient in making decisions about his/her treatment b | 0.34 | 0.60 | 0.27 | A | 0.10 |
| 14. Ensure that the patient makes his/her decisions on an informed basis | 0.25 | 0.71 | 0.27 | A | 0.18 |
| 15. Explain the diagnosis and treatment plan to the patient so that he/she understands | 0.17 | 0.73 | 0.10 | A | 0.12 |
| 16. Explain things so that the patient feels well-informed | 0.35 | 0.76 | 0.15 | A | 0.07 |
| 17. Inform the patient about the expected side effects, so the patient understands them | 0.30 | 0.65 | 0.22 | A | 0.13 |
| 18. Explain how the treatment works or is expected to work | 0.12 | 0.82 | 0.13 | A | 0.10 |
| 19. Explain how the treatment is likely to affect the patient's condition, so that the patient understands | 0.25 | 0.79 | 0.16 | A | 0.06 |
| 20. Explain the treatment procedures, so that the patient understands them | 0.18 | 0.83 | 0.13 | A | 0.07 |
| 21. Accept when there is no longer curative treatment for the patient | 0.10 | 0.23 | 0.63 | A | 0.20 |
| 22. Be aware of when my own feelings affect my communication with the patient | 0.22 | 0.14 | 0.70 | A | 0.11 |
| 23. Deal with my own emotional reactions when the situation is difficult for me | 0.16 | 0.11 | 0.68 | A | 0.28 |
| 24. To maintain the relationship with the patient when he/she is angry | 0.22 | 0.14 | 0.65 | A | 0.11 |
| 25. To stay focused on what is best for the patient if there is a professional disagreement about the diagnosis and treatment b, c, d | 0.10 | 0.34 | 0.62 | B | 0.34 |
| 26. Avoid letting myself be influenced by preconceptions about the patient d | 0.25 | 0.10 | 0.68 | A | 0.32 |
| 27. Separate my personal views from my approach in the professional situation | 0.21 | 0.11 | 0.69 | A | 0.03 |
Instructions: In the following, a number of statements describing different aspects of how physicians and medical students can relate to and communicate with patients are presented. Please read each statement carefully and judge how confident you are in your ability to relate to and communicate with patients in the manner described in the statement. Please answer all questions and provide your best assessment of how confident you are that you will be able to behave in the way described in the statement. Please answer as honestly and sincerely as possible. Remember that each question must be answered based on how confident you are that you will be able to make the patient experience the particular behavior - not the extent to which you would like to be able to engage in the behaviora
a)English translation-backtranslation: The original Danish item wordings were translated independently into English by two English-speaking persons, and following a backtranslation, a final English version was negotiated
b)Two items (13 and 25) did not meet the primary criterion (difference between the highest and second highest loading ≥ 0.30), but were retained in the model on the basis of content analysis. The remaining 25 items met both criteria: Loading ≥ 0.50; difference between highest and second highest loading ≥ 0.30
c)Mantel-Haenszel Chi-Square Differential item function (DIF) analysis: Negligible gender-related DIF (A) for all items except item 25 (moderate DIF = B) in favor of men (Zieky, 1993)
d)IRT DIF-analysis: K-index (Kumagai, 2012) for item 25 and 26 exceeded the criterion of 0.30 with possible gender-bias in favor of men (item 25) and women (item 26)