Developing and validating the Unhurried Conversations Assessment Tool (UCAT)

OBJECTIVE

Given the importance of unhurried conversations for providing careful and kind care, we sought to create, test, and validate the Unhurried Conversations Assessment Tool (UCAT) for assessing the unhurriedness of patient-clinician consultations.

METHODS

In the first two phases, the unhurried conversation dimensions were identified and transformed into an assessment tool. In the third phase, two independent raters used UCAT to evaluate the unhurriedness of 100 randomly selected consultations from 184 videos recorded for a large research trial. UCAT's psychometric properties were evaluated using this data.

RESULTS

UCAT demonstrates content validity based on the literature and expert review. EFA and reliability analyses confirm its construct validity and internal consistency. The seven formative dimensions account for 89.93% of the variance in unhurriedness, each displaying excellent internal consistency (α > 0.90). Inter-rater agreement for the overall assessment item was fair (ICC = 0.59), with individual dimension ICCs ranging from 0.26 (poor) to 0.95 (excellent).

CONCLUSION

UCAT components comprehensively assess the unhurriedness of consultations. The tool exhibits content and construct validity and can be used reliably.

PRACTICE IMPLICATIONS

UCAT's design and psychometric properties make it a practical and efficient tool. Clinicians can use it for self-evaluations and training to foster unhurried conversations.

Promoting Patient Portals: An Application of Social Cognitive Theory to Post-Adoption Patient Portal Use

Many healthcare clinics encourage the use of online patient portals so that patients can have easier access to their health information, yet some patients are hesitant to interact with these portals. We used social cognitive theory to develop and test a theoretically grounded model that incorporates several (1) technological factors, (2) individual factors, and (3) social factors that influence individuals' post-adoption, active use of patient portals. Based on cross-sectional survey data from a sample of healthcare clinic patients (N = 431), we found that individuals' severity of illness predicted active use of patient portals and that trust in doctors predicted attitudes toward patient portals. Moreover, attitudes toward patient portals mediated the relationship between technology factors (i.e., perceived usefulness, ease of use, customization, and interactivity), and active use of patient portals. The paper concludes with a discussion of key findings, implications, and directions for future research.