What Is Patient-Centered Care Really? Voices of Hispanic Prenatal Patients

Abstract

Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients’ voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients’ understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling.

ACKNOWLEDGMENTS

Alicia A. Bergman is now at Richard L. Roudebush VA Medical Center, Health Services Research and Development, Center of Excellence on Implementing Evidence-Based Practice. This article is based on data from the doctoral dissertation of the first author, of which the second author served as advisor and mentor. Time for article preparation for the project reported here was supported in part by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (Associated Health Fellowship). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. government.

Notes

¹Pseudonym. The name of the organization was changed to protect participants’ confidentiality.