Table 1 Data extracted from included studies

Cheraghi 2017 Iran [26]

Qualitative interviews with patients (n = 10; mean age 52.6; 5 women, 5 men) 50.0% women

To explore and describe PCC in critical care units

patient-centered

Authors defined PCC as the provision of respectful care in response to patients’ preferences, needs and values During interviews, participants were asked to describe experiences and perceptions of PCC and how it can be achieved; themes established inductively

• Relationship: Maintaining human dignity, fulfilling patients’ needs

• Information: Establishing therapeutic communication, analyzing the situation, individualizing care; patients receiving adequate information about treatment reduced anxiety

• Decision-making: Involving patients in decision-making increased satisfaction with care

• Self-management: Clinicians addressed and alleviated concerns, and outlined self-care activities, which promoted patient autonomy

• Ease of contact: Timely response to requests gained patient trust and sense of security

• Humanization: identify, prioritize, and fulfill patients’ biological, psychosocial, and spiritual needs), individualization of care

Cuevas 2017 USA [27]

Qualitative focus groups with patients (n = 142; age not reported; 14 groups with women, 13 with men; n in each group not reported) 51.9% women groups

To explore views about PCC across three groups with chronic conditions (i.e. diabetes, hypertension) in primary care: African Americans, Europeans and Latinos

patient-centered

PCC not defined During interviews, participants were asked about what makes a good and bad experience; themes established inductively

• Information: Patients want clinician attentive to patients’ needs and listen to their comments/ concerns

• Decision-making: Patients wanted to be more participatory in their interactions with providers and be more involved in their own care

• Consider race/ethnicity: African Americans felt that it was important for clinician to consider patient’s race in treatment plans

• Speak native language: Many preferred a physician that knew their language in order to communicate effectively with patients, enable patients to understand their recommendations

• *differences in findings between men and women not reported

Adamson 2016 Scotland [28]

Qualitative interviews with patients (n = 15, aged 69 to 95; 8 women, 7 men) 53.3% women

To understand the meaning of PCC for older people attending day hospitals for a variety of health care issues

person-centred

PCC not defined During interviews, participants were asked about talking with nurses, relationships, involvement in decisions, feeling valued, and getting information; themes emerged inductively

• Relationships: Developed trusting relationship with nursing staff, depended on nurses and had confidence that they would advocate for them, were informed about their progress with treatment or care, built rapport with staff

• Information: patients appreciated when they were informed about how they were progressing with treatment. Following treatment, patients valued knowing what was coming next in care.

• Relationships: when staff shared aspects of their own life with the patient and participated in casual ‘banter’ this strengthened the relationship with clinical staff

• Decision-making: Patients felt involved in decision-making, which enhanced their dignity and respect

• Coordination of care: Patients reported that they were seen by clinicians in their home following treatment to see if they had everything they needed. This continuation of care was appreciated

Gill 2016 Canada [29]

Qualitative interviews with patients and family members (n = 32; 15/46.9% aged 50 to 64, 8 were < 50, 9 ≥ 65; 11 patients, 21 family; 17 women, 15 men) 53.1% women

To understand views about PCC among intensive care unit patients and their families

patient-centered

PCC not defined During interviews participants were asked to describe experiences they wished had been different; themes emerged inductively

• Decision-making: Family felt stressed about being patient’s spokesperson. Families’ ability to make decisions about patient care and have confidence in their decisions was impacted by the information and support they received.

• Relationship: Providers were perceived as impatient and family members sometimes felt dismissed; they desired greater empathy

–

Doubova 2016 Mexico [30]

Telephone survey of patients (n = 6005; 82.2% were aged 20 to 59; 3126 women, 2869 men) 52.1% women

To explore public views about the PCC elements that contribute to high quality primary care

patient-centered

PCC takes into account the view of users in the design, provision and evaluation of health care services Survey included 10 PCC attributes based on Commonwealth Fund survey used in other countries: primary care provider (PCP) knows relevant information about the patient’s medical history; PCP gives an opportunity to ask questions about recommended treatment; PCP spends enough time with the patient; PCP explains things in a way that is easy to understand; PCP helps the patient to coordinate or arrange his/her healthcare from other doctors and places; patient perceives difficulties in communication with the primary care clinic during regular practice hours about a health problem; a nurse or another clinical staff (other than a doctor) is involved in primary healthcare; PCP who during a routine medical checkup in the past 2 years talked about an exercise or physical activity; PCP who during a routine medical checkup in the past 2 years spoke of a healthy diet and healthy eating; PCP who during a routine medical checkup in the past 2 years talked about things that worry the patient or cause stress

• Information: PCP provides information and explanations, and opportunities to ask questions

• Ease of contact: Easy to reach the primary care clinic

• Problems are solved: PCP solves most health problems

• Familiarity with patient: PCP knows relevant info about patient’s medical history

• Coordination of care: PCP coordinates healthcare

Raja 2015 USA [31]

Qualitative interviews with patients (n = 20; aged 21 to 74; 18 women, 2 men) 90.0% women

To explore views about PCC among primary care patients with little or no health insurance

patient-centered

Authors cited Institute of Medicine PCC definition: Providing care that is respectful and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions During interviews, participants were asked about what made visits positive or negative; themes emerged inductively

• Relationship: Chatting with patients, asking questions, and telling patients about themselves helps build rapport

• Information: Give overview of the procedure and clear expectations, results, appointment flow, realistic expectation of pain; patients desired more time with provider

• Physical setting: Pleasant environment makes participants feel respected and welcomed

• Humanization: Feeling listened to, cared for, or seen as an entire human being with needs and emotions; providers consider the totality of a patient’s physical health, their ways of coping, and their environment

• Avoiding jargon: Express technical terms in an understandable manner

• Ease of contact: Inability to schedule appointments led to feeling devalued

Leijen-Zeelenberg 2015 Netherlands [32]

Qualitative interviews with patients (n = 22; mean age 52.8 years; 13 women, 9 men) 59.1% women

To explore PCC views and preferences among those visiting an ear, nose & throat outpatient unit

patient-centred

Authors defined PCC using Institute of Medicine (IOM) 6 domains: Respect for patients’ values, preferences and expressed needs; Information, communication and education; Coordination and integration of care; Emotional support - relieving fear and anxiety; Physical comfort; Involvement of family and friends During interviews, participants were asked to share experiences related to each of the 6 IOM domains; views about themes emerged inductively

• Information: Some respondents felt that they had to be assertive at the clinic in order to get respect for their preferences and needs. Being able to ask questions during consultations and receive clear responses was very important. It is also important to get an explanation when an expressed preference is not being complied with.

• Emotional support: More attention needed on emotional and psychological support.

• Coordination of care: some find it difficult to plan more than 3 months in advance and disliked the inflexibility in the planning system. Negative experiences due to alternating doctors (seeing different doctors at subsequent appointments).

• Physical setting: Nice atmosphere at outpatient clinic helps provide physical comfort.

• Involvement of family and friends

Papp 2014 Hungary [33]

Qualitative focus groups (n = 61; 14 groups with 8 to 10 per group; 69.8% aged 41 or greater; 34 women, 27 men) 55.7% women

To explore views about the elements of high quality primary care including patient-centeredness

patient-centered

Authors defined PCC as the degree to which a system actually functions by placing the patient at the center of its delivery of health-care, assessed in terms of patient’s experience During interviews, participants were asked about general aspects of quality and elements of patient-centeredness; themes emerged inductively

• Information: Nurses should have an important role in providing information to patients; physicians should spend time to explain the situation to patients

• Relationship: Patients expect doctor to be empathetic, friendly, attentive, good listeners, sympathetic, and willing to help

• Avoiding jargon: Information for patients should be understandable and clear

• Humanization: Patients expect to be treated as a human being, not only as a disease

Marshall 2012 Australia [34]

Qualitative interviews with patients (n = 10; aged 30 to late 60’s; 8 women, 2 men) 80.0% women

To explore views about PCC among surgical inpatients

patient-centred

Authors note inconsistency in PCC definitions (treating people as individuals, tailoring care to patients’ needs, understanding the patient as a unique human being, etc.) and lack of definition derived from patients During interviews, participants were asked what they valued in care, what they thought patient-centred care meant, and what constitutes patient-centred care; themes emerged inductively

• Relationship: Helpful, respectful, open communication

• Decision-making: Being involved in decisions and to contribute in care consultations

–

Bann 2010 USA [35]

Survey of patients (n = 216; 43% aged 55 or greater; 184 women, 31 men) 85.2% women

To assess views about PCC among complementary and alternative medicine patients

patient-centered

Authors defined PCC as building an empathetic relationship that considers the patient as a partner with the health care provider in the priorities, problems, and goals of Treatment. The survey included 10 PCC attributes: I feel seen and heard as a unique individual by my therapist; My therapist has a full picture of me as a unique individual; My therapist is really interested in finding and addressing my health problems; The root causes of my problems are identified by my therapist; The root causes of my problems are being treated by my therapist; The treatment is individualized for me at each session; My therapist receives feedback from my body that guides treatment; My therapist asks me for feedback from my body that guides treatment; I know what to expect during treatment sessions; My therapist teaches me ways to relieve symptoms myself

–

• Humanization: Feeling seen and heard as a unique individual; receiving individualized treatment

• Problems are solved: The therapist being interested in finding and addressing their health problems

Davis 2008 Australia [36]

Survey of patients (n = 78; mean age 82 years; 72 women, 6 men) 92.3% women

To assess views about PCC among older patients recently discharged from a sub-acute setting

person-centred

Authors defined PCC as valuing people as individuals and as the person being the focal point in a partnership that is both respectful and reciprocal The survey included five dimensions: personalisation, empowerment, information, approachability and availability, and respect

• Information: Many felt that they were not being told what was going on, lack of communication between staff

• Relationship: Respect was typically demonstrated by staff.

• Humanization: Treated as a whole person

• Ease of contact: Majority found they were unable to locate nurses for assistance, and would like to speak with nurses and doctors more often