Study instument reliability
To determine the reliability of the PCQ-P, the acceptable value of Cronbach’s alpha was set at ≥ 0.7 . As shown in Table 2, the Cronbach’s alpha value of the PCQ-P as a whole scale was 0.840, indicating that the Arabic version of the PCQ-P has good internal consistency and is able to reliably measure the person-centered climate as perceived by the patient in a tertiary care hospital. The Cronbach’s alpha values of the three subscales were Hospitality, 0.766; Safety, 0.690; and Everydayness 0.684. Deleting any one item from the quaetionnaire would not affect the instrument’s reliability, since the Cronbach’s alphas would still be in the range of 0.81–0.84. Corrected item total correlation coefficients varied between 0.19 and 0.63. Item 3 had the smallest correlation coefficient of 0.19, which might indicate that this item did not correlate very well with the overall scale; however, deleting it would not affect the overall reliability.
Person-centered care climate
The overall mean score for the PCQ-P was 73 ± 9.988 out of 85, indicating that the participants in this study perceived their care environments as having good person-centered climate of care. The highest two mean scores for the PCQ-P were achieved by item 3, “A place where I feel safe” (4.95 ± 0.39 SD), and item 9, “A place that is neat and clean” (4.90 ± 0.54 SD); both of which related to Safety. The item with the lowest mean score was item 11, “A place that has something nice to look at (e.g., views, or artwork, etc.), (2.51 ± 1.82 SD), which is related to Everydayness (see Table 2). For Hospitality, the highest two mean scores were achieved by item 1, “A place where the staff are knowledgeable” (4.89 ± 0.59 SD), and item 4, “A place where I feel welcome” (4.89 ± 0.54 SD). However, patients positively agreed with all of the items in the Hospitality domain; percentage scores ranged from 77.7–96%, indicating that patients perceived a good climate of hospitality in their hospital. As mentioned, the statement receiving the highest mean score in the domain of Safety—and the PCQ-P overall—was item 3, while, the lowest mean score in the Safety domain was item 10, “A place where the staff seem to have time for patients: (4.36 ± 1.38 SD). The percentage scores in this domain ranged between 81% and 98%, indicating a very high perception of a climate of safety in the hospital. The highest mean score in the domain of Everydayness was achieved by item 12, “A place that feels homely” (3.96 ±1.67 SD); as mentioned, the lowest scoring item in this domain—and in the PCQ-P overall—was item 11. Percentage scores of agreement in this domain ranged between 32.4% and 70.5%, revealing a low patient perception of a climate of everydayness.
Factors associated with the climate of person-centered care
Associations between the mean overall PCQ-P scores, Safety, Hospitality, and Everydayness, and independent variables, were analyzed by t-tests and ANOVA and presented in Table 3. The overall PCQ-P scale has a maximum score of 85, divided between Hospitality (40), Safety (25), and Everydayness (20). In terms of the overall PCQ-P, the only independent variables found to have a significant association were age (patients younger than 20 years, P = 0.005), gender (males, P<0.001), nationality (Saudis, P = 0.026), area of residency (living outside of Riyadh, P = 0.001), route of admission (referred from another hospital, P = 0.002), length of stay (more than 2 weeks, P = 0.003), and hospital preference for treatment (governmental hospitals, P = 0.010). The following independent variables were found to be significantly associated with the Hospitality dimension: age (41–60 years; P<0.001), gender (male, P<0.001), employment status (employed, P = 0.002), area of residency (living outside Riyadh, P = 0.019), and length of stay (more than 2 weeks, P = 0.052). In terms of the Safety dimension, the following were significantly associated: age (20 years and younger, P = 0.012), gender (male, P = 0.000), employment status (employed, P = 0.001), area of residency (living outside Riyadh, P = 0.000), length of stay (more than 2 weeks, P = 0.005), and hospital preference (governmental hospitals, P = 0.016). For Eeverydayness, significant associations were found with gender (males, P = 0.001), area of residency (living outside Riyadh, P = 0.001), route of admission (referred from another hospital, P = 0.002), length of stay (more than 2 weeks, P = 0.015), and hospital preference (governmental hospitals, P = 0.032).
Multivariate linear and logistic regression analysis was used to identify significant predictors of PCC, both as a whole and at the level of the three subscales. Multivariate analysis showed that gender was significantly associated with Everydayness (P = 0.004), and age was significantly associated with Hospitality (P = 0.009). Living outside of Riyadh was a significant predictor of PCC in the Hospitality dimension (P = 0.040), and in the PCQ-P overall (P = 0.047). Length of hospitalization was a significant predictor for all scales (Hospitality, P = 0.010; Safety, P<0.001; Everydayness, P = 0.007; overall, P = 0.001). Preference of hospital type for treatment was independently associated with respondents’ perceptions of the tertiary care hospital environment as being person-centered in terms of Safety and overall (see Table 4).