The evolving concept of “patient-centeredness” in patient–physician communication research

• Published in: Social science & medicine (1982) 2013-11, Vol.96, p.147-153
• Main Authors: Ishikawa, Hirono, Hashimoto, Hideki, Kiuchi, Takahiro
• Format: Article
• Language: English
• Subjects: Behavior; Biological and medical sciences; Communication; Communication Research; Competence; Conceptualization; Conflict theory; Decision making; Doctor-patient relationship; Doctors; Functionalism; Health Care Services; Health Communication - methods; Health participants; Health Research; Health Services Research; History of Sociology; Humans; Measurement; Medical sciences; Miscellaneous; Patient-Centered Care - organization & administration; Patient-centeredness; Patients; Patient–physician communication; Physician patient relationships; Physician-Patient Relations; Physicians; Public health. Hygiene; Public health. Hygiene-occupational medicine; Shared decision making; Social construction; Social constructionism; Sociology; Utilitarianism
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2013.07.026

Over the past few decades, the concept of “patient-centeredness” has been intensively studied in health communication research on patient-physician interaction. Despite its popularity, this concept has often been criticized for lacking a unified definition and operationalized measurement. This article reviews how health communication research on patient-physician interaction has conceptualized and operationalized patient-centered communication based on four major theoretical perspectives in sociology (i.e., functionalism, conflict theory, utilitarianism, and social constructionism), and discusses the agenda for future research in this field. Each theory addresses different aspects of the patient–physician relationship and communication from different theoretical viewpoints. Patient-centeredness is a multifaceted construct with no single theory that can sufficiently define the whole concept. Different theoretical perspectives of patient-centered communication can be selectively adopted according to the context and nature of problems in the patient–physician relationship that a particular study aims to explore. The present study may provide a useful framework: it offers an overview of the differing models of patient-centered communication and the expected roles and goals in each model; it does so toward identifying a communication model that fits the patient and the context and toward theoretically reconstructing existing measures of patient-centered communication. Furthermore, although patient-centered communication has been defined mainly from the viewpoint of physician's behaviors aimed at achieving patient-centered care, patient competence is also required for patient-centered communication. This needs to be examined in current medical practice. •“Patient-centeredness” is reviewed in terms of four sociological theories.•The four perspectives differently conceptualize and operationalize the concept.•This study can aid in reconstructing existing measures and developing new measures.•Patient competencies required in patient-centered care should be explored.