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Using Photovoice to Explore Patient Perceptions of Patient-Centered Care in the Veterans Affairs Health Care System

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Abstract

Background

Accounting for patient views and context is essential in evaluating and improving patient-centered care initiatives, yet few studies have examined the patient perspective. In the Veterans Affairs (VA) Health Care System, several VA facilities have transitioned from traditionally disease- or problem-based care to patient-centered care. We used photovoice to explore perceptions and experiences related to patient-centered care among Veterans receiving care in VA facilities that have implemented patient-centered care initiatives.

Design

Participants were provided prompts to facilitate their photography, and were asked to capture salient features in their environment that may describe their experiences and perceptions related to patient-centered care. Follow-up interviews were conducted with each participant to learn more about their photographs and intended meanings. Participant demographic data were also collected.

Results

Twenty-two Veteran patients (n = 22) across two VA sites participated in the photovoice protocol. Participants defined patient-centered care broadly as caring for a person as a whole while accommodating for individual needs and concerns. Participant-generated photography and interview data revealed various contextual factors influencing patient-centered care perceptions, including patient–provider communication and relationships, physical and social environments of care, and accessibility of care.

Conclusions

This study contributes to the growing knowledge base around patient views and preferences regarding their care, care quality, and environments of care. Factors that shaped patient-centered care perceptions and the patient experience included communication with providers and staff, décor and signage, accessibility and transportation, programs and services offered, and informational resources. Our findings may be integrated into system redesign innovations and care design strategies that embody what is most meaningful to patients.

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Acknowledgements

This material is based upon work supported by the Department of Veterans Affairs, Office of Patient-Centered Care and Cultural Transformation, and the Office of Research and Development Health Services Research and Development, Quality Enhancement Research Initiative (PCE-13-002).

Sherri LaVela and Salva Balbale contributed to the study concept, design, and data collection. Megan Morris and Salva Balbale contributed to data analysis and interpretation. All authors, Sherri LaVela, Megan Morris, and Salva Balbale, contributed to the manuscript preparation and review. Salva Balbale will act as the overall guarantor of this manuscript.

None of the authors (Salva N. Balbale, Megan A. Morris and Sherri L. LaVela) have financial disclosures or any conflicts of interests.

The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Department of Veterans Affairs, Center for Evaluation of Practices and Experiences of Patient-Centered Care, Hines, IL, USA

    Salva Najib Balbale, Megan A. Morris & Sherri L. LaVela

  2. Health Services Research and Development, Edward Hines, Jr. VA Hospital, 5000 S. 5th Avenue (151H), Hines, IL, 60141, USA

    Salva Najib Balbale & Sherri L. LaVela

  3. Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Megan A. Morris & Sherri L. LaVela

Authors
  1. Salva Najib Balbale
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Correspondence to Salva Najib Balbale.

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Balbale, S.N., Morris, M.A. & LaVela, S.L. Using Photovoice to Explore Patient Perceptions of Patient-Centered Care in the Veterans Affairs Health Care System. Patient 7, 187–195 (2014). https://doi.org/10.1007/s40271-014-0044-5

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