Patient-Centeredness: Contribution to the Adaptation of the Patient-Practitioner Orientation Scale (PPOS)

Ana Monteiro Grilo, Joana Santos Rita, Elisabete Teresa Carolino, Ana Isabel Gomes, Margarida Custódio dos Santos


Objective: The purpose of this study was to contribute to the European Portuguese adaptation of the Patient-Practitioner Orientation Scale (PPOS). Method: A sample of 593 medical students participated in the study. After permission from the original author, the translation procedures required to ensure translation of the PPOS to European Portuguese were performed. Construct validity (exploratory and confirmatory factor analysis) and reliability (internal consistency) were assessed. Results: The final version confirmed the original structures of two factors, explaining 31.54% of total variance; Caring (19.56%) and Sharing (11.98%). Items 2 and 4 showed inconsistencies with the factors defined earlier in the original version of the instrument, itens 9 and 17 obtained a factorial load less than .3, and the item 3 achieved a difference of less than .1 between factorial charges for the two domains. The internal consistency of PPOS-P scales were adequate (Cronbach’s alpha of .65, .50 and .56 for total scale, and subscales Caring and Sharing, respectively). Confirmatory factor analysis provided an acceptable adjustment for the observed variables (χ2(132, N = 593) = 344.28, p < .001; χ2/gl = 2.61; GFI = .93; AGFI = .92; CFI = .87; NNFI = .81; SRMR = .084; RMSEA = .05, 95% CI [0.045, 0.059], p = .293). Subsequent exploratory analyzes suggest the potential for improving the levels of validity and reliability of the total scale and Caring subscale, with the removal of specific items. Conclusion: Although the fragilities identified in the validity and reliability of the PPOS-P in a sample of Portuguese medical students, this work can represent an important and useful contribute to further investigations that might consider this instrument as a measure of student’s changes of patient-centeredness attitudes.


patient-centeredness; caring; sharing; adaptation; PPOS; health professionals