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BACKGROUND AND OBJECTIVES: Due to health and/or financial limitations, older migrants may become especially dependent on their neighborhoods, highlighting the importance of investigating their experiences. We explored older Moroccan adults' views on the relative importance of neighborhood resources for aging in place. RESEARCH DESIGN AND METHODS: Thirty Moroccans aged ≥ 65 years residing in Amsterdam, Rotterdam, The Hague, and Utrecht were interviewed and asked to perform a ranking task developed with the combined quantitative and qualitative Q methodology. They ranked the relative importance of 38 statements representing the World Health Organization's eight global age-friendly cities domains, with explanation of their reasoning. By-person factor analysis was performed to identify factors representing distinct viewpoints, which were interpreted with reference to the interviewees' comments. RESULTS: Four viewpoints were identified: "home sweet home"; "connected, well-informed, and engaged"; "suitable and affordable living"; and "a lively neighborhood." The perceived importance of neighborhood resources for aging in place differed among viewpoints. DISCUSSION AND IMPLICATIONS: Older Moroccan adults prioritize different neighborhood resources for aging in place. Our findings suggest that their diverse needs can be satisfied by enabling family to live in close proximity, providing diverse, inclusive neighborhoods with affordable, suitable housing, understandable information, social/cultural activities, and care services for vulnerable groups. Future studies may build on our findings to explore older (migrant) adults' views on needs for aging in place in the Netherlands and other western countries.

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BACKGROUND: Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. METHODS: Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically. RESULTS: The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. CONCLUSIONS: Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised.

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BACKGROUND: Healthcare professionals working in long-term care facilities reported heavy job demands and a lack of job resources during the 2019 coronavirus disease (COVID-19) pandemic. However, how job demands and resources in these facilities changed during the pandemic, and how possible changes affected professionals' work-related well-being, remains unclear. Thus, we explored changes in job demands and resources in the face of surging COVID-19 infection rates, and investigated associations of these changes with changes in burnout and work engagement, among healthcare professionals working in long-term care facilities in the Netherlands. METHODS: This longitudinal study was conducted with healthcare professionals working in five long-term care facilities in the Netherlands. Data were collected in early and late 2021, when infection rates in long-term care facilities were low and high (mean, 29.1 and 275.4 infections/day), respectively. In total, 173 healthcare professionals completed the validated Job Demands and Resources Questionnaire, Copenhagen Burnout Inventory, and Utrecht Work Engagement Scale at both timepoints. We performed paired-samples t tests to examine changes in job demands and resources, and fixed-effects linear regression analyses to examine associations of within-person changes in job demands and resources with those in burnout and work engagement. RESULTS: Healthcare professionals perceived increased workloads, associated with increased burnout and decreased work engagement during the study period. Within-person increases in perceived collegial support were associated positively with work engagement and negatively with burnout symptoms. CONCLUSIONS: Healthcare professionals in long-term care facilities perceived increased workloads in the wake of surging infection rates during the COVID-19 pandemic, resulting in increased burnout and decreased work engagement. These changes in burnout and work engagement were also perceived in response to declining collegial support. Efforts to protect the work-related well-being of healthcare professionals working in long-term care facilities in the pandemic context that focus on workload reduction and the promotion of collegial support may be most beneficial.

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OBJECTIVES: Against the background of the growing recognition of the need for a holistic perspective on health behaviour, we aim to identify longitudinal patterns of multiple health behaviours, and to assess associations of such patterns with depressive symptoms among older people in China. METHODS: Using three waves of China Health and Retirement Longitudinal Study data (n = 8439), we performed latent class growth analyses (LCGAs) to identify longitudinal patterns of multiple health behaviours. Random-effects models were estimated to assess associations between health behaviour patterns and depressive symptoms. RESULTS: The best fitting LCGA model had seven classes: (1) connected active non-smokers (average posterior probability: 21.8%), (2) isolated active non-smokers (24.7%), (3) isolated inactive non-smokers (17.0%), (4) isolated active smokers (14.5%), (5) connected active smokers (12.2%), (6) increasingly connected and active non-smokers (5.4%), and (7) moderately connected inactive smokers (4.4%). Depressive symptoms were highest in the four classes with lower probabilities of social participation across waves. No evidence was found of change over time in depressive symptomatology gaps between people with different health behaviour trajectories. CONCLUSION: Health behaviour patterns characterized by consistently low social participation were associated with raised depressive symptomatology, suggesting that focusing on social participation may benefit later-life mental health promotion strategies.

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Worldwide, the maintenance of well-being in ageing populations with associated frailty has become increasingly important. To maintain well-being during ageing, investment in frail older people's self-management abilities and the fostering of productive interactions with healthcare professionals may lead to higher levels of well-being. The aim of this study was to investigate the relationships between community-dwelling frail older people's self-management abilities, productive patient-professional interactions and well-being, while controlling for socio-demographic characteristics. This cross-sectional study included 588 community-dwelling frail older people (aged ≥ 75 years) from 15 general practitioner (GP) practices in the Netherlands. Well-being (Social Production Function Instrument for the Level of well-being short), productivity of interactions with GPs (relational coproduction instrument), and self-management abilities (Self-Management Ability Scale short) were measured during in-home face-to-face interviews by trained interviewers. Data were analysed using descriptive statistics, correlation analyses, and linear mixed-effects models. Significant relationships were detected between self-management abilities and the overall, social, and physical well-being of older people, and between productive interactions with GPs and overall and social well-being, but not physical well-being. In a time of ageing populations with associated frailty, investment in frail older people's self-management abilities and the productivity of patient-professional interactions may be beneficial for this population's well-being.

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BACKGROUND: The present study describes how primary care can be improved for patients with multimorbidity, based on the evaluation of a patient-centered care (PCC) improvement program designed to foster the eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, coordination of care, continuity and transition, emotional support, and family and friends). This study characterizes the interventions implemented in practice as part of the PCC improvement program and describes the experiences of healthcare professionals and patients with the resulting PCC delivery. METHODS: This study employed a mixed-methods design. Semi-structured interviews were conducted with nine general practitioners and nurse practitioners from seven primary care practices in Noord-Brabant, the Netherlands, that participated in the program (which included interventions and workshops). The qualitative interview data were examined using thematic analysis. A longitudinal survey was conducted with 138 patients with multimorbidity from these practices to assess perceived improvements in PCC and its underlying dimensions. Paired sample t tests were performed to compare survey responses obtained at a 1-year interval corresponding to program implementation. RESULTS: The PCC improvement program is described, and themes necessary for PCC improvement according to healthcare professionals were generated [e.g. Aligning information to patients' needs and backgrounds, adapting a coaching role]. PCC experiences of patients with multimorbidity improved significantly during the year in which the PCC interventions were implemented (t = 2.66, p = 0.005). CONCLUSION: This study revealed how primary PCC can be improved for patients with multimorbidity. It emphasizes the importance of investing in PCC improvement programs to tailor care delivery to heterogenous patients with multimorbidity with diverse care needs. This study generates new perspectives on care delivery and highlights opportunities for its improvement according to the eight dimensions of PCC for patients with multimorbidity in a primary care setting.

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BACKGROUND: the present authors examined changes made in disability service organizations supporting residents with intellectual disabilities and challenging behaviours, because these changes may influence residents' support and subsequently their challenging behaviours. METHOD: In this multiple case study, the present authors collected and qualitatively analysed data (organizational documents, meetings records and focus group reports) on organizational changes made in two specialized Dutch disability service organizations, using ecological theory as a sensitizing framework and the constant comparative method. RESULTS: Themes describing organizational changes in this context were as follows: a messy start to the transition; staff, professionals and managers remain at a distance; staff members' ability to change; clear boundaries between formal and informal caregivers; and staff's feelings of being unheard. CONCLUSIONS: Organizational changes can enhance, but also limit, the quality of residential support services provided to people with intellectual disabilities and challenging behaviours. The change process and impact of organizational changes on residents must be examined closely.

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BACKGROUND: In a time of ageing populations, examination of the ability of multimorbid patients to achieve well-being has become increasingly important. Social production function theory is used to characterise people's ability to achieve well-being. Whereas much research has examined the fulfilment of substantive needs, far less research has investigated the quality of production functions (being in control, avoiding a loss frame, and efficiency) to achieve well-being. Therefore, this study involved the development and validation of the Social Production Function-Quality of production functions (SPF-Q) instrument to assess the quality of production functions via the fulfilment of production needs to achieve well-being. METHODS: The 12-item SPF-Q was used to assess the quality of production functions via the fulfilment of production needs to achieve well-being among patients with multimorbidity from seven health care practices in the region of Tilburg, the Netherlands. A total of 216 patients filled in the questionnaire (55% response rate). To test the validity of the SPF-Q, we used structural equation modelling to specify a measurement model by loading each item on its respective latent factor, and we examined associations between production needs and other measures. RESULTS: Psychometric results clearly showed that the SPF-Q is a valid and reliable instrument for the assessment of the quality of production functions among multimorbid patients. Confirmatory factor analyses revealed good indices of fit for the instrument. As indicated by the high reliability coefficient, the scale also showed good internal consistency. We found support for construct validity through significant positive correlations between substantive and production well-being needs, as well as with overall well-being and life satisfaction. Moreover, production needs added to multimorbid patients' overall level of well-being in addition to the substantive needs. CONCLUSION: This study clearly showed that the SPF-Q is a valid and reliable instrument for the assessment of production needs among multimorbid patients. Given that multimorbidity is becoming the leading threat to population health, such an instrument can help to improve the ability to achieve well-being in this vulnerable population.

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The vital role of active social participation in older people's lives is widely acknowledged. The maintenance of adequate levels of social participation is an essential element of successful aging. Low income may inhibit older people from engaging in social activities. Given its recent rapid economic growth, China provides a unique setting for the study of changes in income and social participation among older people over time. In this study, the longitudinal relationship between income and social participation among Chinese older people was investigated using a nationally representative dataset from three waves of the China Health and Retirement Longitudinal Study (CHARLS). At baseline, a total of 3863 participants with a mean age of 60.4 years (range: 50-89) were included in our study; 49.9% of the participants were female, and 64.4% lived in rural areas. Generalized estimating equations were used to analyze the longitudinal relationship between income and social participation, with and without adjustment for background variables (age, gender, marital status, educational level, empty-nest status, area of residence, and multimorbidity). The results of unadjusted and adjusted analyses clearly showed a longitudinal association between income and social participation. People from the highest income group were almost two times more likely to participate in social activities than were those from the lowest income group. People with a higher educational level are also more likely to participate in social activities compared to people with a lower educational level. Being married and living with children decreased the odds of social participation. Social participation is also less likely among older aged and those living in rural areas. Our findings indicate that higher income levels are associated positively with social participation over time among older people in China.

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BACKGROUND: Health behaviours (physical activity, maintenance of a healthy diet and not smoking) are known to be beneficial to the health and well-being of chronically ill people. With China's ageing population and increased prevalence of people with chronic diseases, the improvement of unhealthy behaviours in this population has become crucial. Although recent studies have highlighted the importance of social participation for health and quality of life (QoL) among older people, no study to date has included social participation along with more traditional health behaviours. Therefore, this study aimed to identify associations of multiple health behaviours (social participation, physical activity, maintenance of a healthy diet and not smoking) with health and QoL outcomes (including cognitive and physical function) among chronically ill older adults in China. METHODS: For this nationally representative cross-sectional study, wave 1 data from the World Health Organization's Study on global AGEing and adult health (China) were examined. In total, 6629 community-dwelling older adults (mean age, 64.9 years) with at least one chronic disease were included. Multivariate linear regression analyses were used to evaluate associations of health behaviours with health and QoL outcomes while controlling for background characteristics. RESULTS: Greater social participation was associated with better QoL [ß = 0.127, standard error (SE) = 0.002, p < 0.001], cognitive function (ß = 0.154, SE = 0.033, p < 0.001) and physical function (ß = - 0.102, SE = 0.008, p < 0.001). Physical activity was associated with better QoL (ß = 0.091, SE = 0.015, p < 0.001) and physical function (ß = - 0.155, SE = 0.062, p < 0.001). Sufficient fruit and vegetable consumption was associated with better QoL (ß = 0.087, SE = 0.015, p < 0.001). CONCLUSIONS: Our findings suggest that social participation is an important health behaviour for quality of life and cognitive function among chronically ill older people in China. Health promotion programmes should expand their focus to include social participation as a health behaviour, in addition to physical activity, maintenance of a healthy diet and not smoking.

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BACKGROUND: We investigated relationships of broader self-management abilities (self-efficacy, positive frame of mind, investment behavior, taking initiatives, multifunctionality of resources, variety of resources) to social and emotional loneliness among community-dwelling older people while controlling for background characteristics. METHODS: This cross-sectional study employed a representative sample of 41,327 community-dwelling people aged ≥55 years in Limburg, the Netherlands, identified using the population register (weighted per district, complex sampling design). In total, 20,327 (50%) people responded to the questionnaire. RESULTS: All self-management abilities were associated negatively with emotional loneliness. Taking initiatives, multifunctionality, self-efficacy, and a positive frame of mind were associated negatively with social loneliness. Self-efficacy had the strongest relationships with social and emotional loneliness. CONCLUSIONS: In combatting loneliness among older people, investment in their ability to self-manage their social lives and activities, such as increasing opportunities for positive social interaction and social support and reducing maladaptive cognition, seems to be crucial.

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BACKGROUND: Patient-centered care (PCC) has been proposed as the way forward in improving primary care for patients with multi-morbidity. However, it is not clear what PCC exactly looks like in practice for patients with multi-morbidity. A better understanding of multi-morbid patients' views on what PCC should look like and which elements are most important may help to improve care delivery for this vulnerable population. The present study thus aimed to identify views of patients with multi-morbidity on the relative importance of PCC aspects in a Dutch primary care setting. METHODS: Interviews were conducted with 16 patients with multi-morbidity using Q-methodology, which combines quantitative and qualitative analyses. The participants ranked 28 statements about the eight dimensions of PCC (patients' preferences, information and education, access to care, emotional support, family and friends, continuity and transition, physical comfort, and coordination of care) by relative importance. By-person factor analysis using centroid factor extraction and varimax rotation were used to reveal factors that represent viewpoints. Qualitative interview data were used to interpret the viewpoints. RESULTS: The analyses revealed three factors representing three distinct viewpoints of patients with multi-morbidity on what is important for patient-centered care in the primary care setting. Patients with viewpoint 1 are prepared proactive patients who seem to be well-off and want to be in charge of their own care. To do so, they seek medical information and prefer to be supported by a strongly coordinated multidisciplinary team of healthcare professionals. Patients with viewpoint 2 are everyday patients who visit GPs and require well-coordinated, respectful, and supportive care. Patients with viewpoint 3 are vulnerable patients who are less resourceful in terms of communication skills and finances, and thus require accessible care and professionals taking the lead while treating them with dignity and respect. CONCLUSION: The findings of this study suggest that not all patients with multi-morbidity require the same type of care delivery, and that not all aspects of PCC delivery are equally important to all patients.

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BACKGROUND: Validated instruments are needed to assess the delivery of patient-centred care (PCC) to people with intellectual disabilities (PWIDs) needing 24-h care in residential settings. Eight dimensions of PCC have been identified: taking patients' preferences into account; access to care; emotional support; physical comfort; information and education; involvement of family and friends; coordination of care; and continuity and secure transition. Objective of this study is to validate an instrument to assess these eight PCC dimensions among informal caregivers of PWIDs in residential settings (institutional settings as well as group homes in the community). The original 24-item instrument was developed and validated among professionals providing care to PWIDs. METHODS: This study was conducted in a disability care centre in the Netherlands. All informal caregivers of PWIDs living in institutional settings or group homes in the community in need of 24-h care were invited to participate (n = 941). The response rate was 31% (n = 289). We tested the instrument using structural equation modelling, and examined its validity and reliability. RESULTS: Confirmatory factor analyses revealed good indices of fit and overall internal consistency, as represented by Cronbach's alpha values. All eight dimensions of PCC were related positively to satisfaction with care (all p ≤ 0.001). As expected, informal caregivers were less critical of PCC and its underlying dimensions, except for information and education, than were professionals working in the same disability care centre. CONCLUSIONS: The psychometric properties of the 24-item PCC instrument for informal caregivers (PCC-IC) were satisfactory, indicating that the PCC-IC is valid and reliable for the assessment of the eight dimensions of PCC among informal caregivers of PWIDs in residential settings.

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BACKGROUND: Patients with multi-morbidity have complex care needs that often make healthcare delivery difficult and costly to manage. Current healthcare delivery is not tailored to the needs of patients with multi-morbidity, although multi-morbidity poses a heavy burden on patients and is related to adverse outcomes. Patient-centered care and co-creation of care are expected to improve outcomes, but the relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care among patients with multi-morbidity are not known. METHODS: In 2017, a cross-sectional survey was conducted among 216 (of 394 eligible participants; 55% response rate) patients with multi-morbidity from eight primary care practices in Noord-Brabant, the Netherlands. Correlation and regression analyses were performed to identify relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care. RESULTS: The mean age of the patients was 74.46 ± 10.64 (range, 47-94) years. Less than half (40.8%) of the patients were male, 43.3% were single, and 39.3% were less educated. Patient-centered care and co-creation of care were correlated significantly with patients' physical well-being, social well-being, and satisfaction with care (all p ≤ 0.001). Patient-centered care was associated with social well-being (B = 0.387, p ≤ 0.001), physical well-being (B = 0.368, p ≤ 0.001) and satisfaction with care (B = 0.425, p ≤ 0.001). Co-creation of care was associated with social well-being (B = 0.112, p = 0.006) and satisfaction with care (B = 0.119, p = 0.007). CONCLUSIONS: Patient-centered care and co-creation of care were associated positively with satisfaction with care and the physical and social well-being of patients with multi-morbidity in the primary care setting. Making care more tailored to the needs of patients with multi-morbidity by paying attention to patient-centered care and co-creation of care may contribute to better outcomes.

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OBJECTIVE: This study aimed to identify relationships among the actual level of patient-centred care (PCC), the care gap (ideal level of PCC vs actual care delivery) and satisfaction with care. DESIGN: This study was a cross-sectional survey. SETTING: This study was conducted at two locations of a Dutch hospital (Nieuwegein and Leidsche Rijn Utrecht). PARTICIPANTS: Patients visiting the outpatient clinics for heart failure, chronic obstructive pulmonary disease (COPD) and cancer in March-May 2017 were asked to fill in a questionnaire. Inclusion criteria were diagnosis with COPD, heart failure or cancer and clinic visitation for a regular appointment. A total of 186 patients filled in the questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes evaluated were the actual level of PCC, the care gap and satisfaction with care. RESULTS: About half (45%) of the respondents were female, 38% had low educational levels and 31% were single. Respondents' mean age was 67.83 ± 10.02 (range, 16-94) years. Patients' experiences with actual care delivery and their conceptualisation of the ideal type of care differed significantly, representing care gaps, in all PCC dimensions. After controlling for background characteristics, patients' experiences with actual delivery and the care gap were related significantly to patients' satisfaction with care (ß = 0.17 and ß = - 0.41, respectively). CONCLUSIONS: Patients' experiences with the actual level of PCC and the care gap are important for patients' satisfaction with care.

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BACKGROUND: Validated instruments are needed to assess the delivery of patient-centred care (PCC) to patients with multimorbidity in the primary care setting. Eight dimensions of PCC have been identified: respect for patients' preferences, access to care, emotional support, information and education, involvement of family and friends, continuity and secure transition between health care settings, physical comfort, and coordination of care. The main objective of this study was to validate an instrument for the assessment of PCC among patients with multimorbidity in the primary care setting: the 36-item patient-centred primary care (PCPC) instrument. METHODS: We included patients with multimorbidity from seven health care practices in the region of Tilburg, the Netherlands. All patients enrolled in at least two chronic care programmes (involving diagnosis of and treatment for combinations of diabetes, asthma and/or chronic obstructive pulmonary disease, cardiovascular diseases and conditions, and age-related frailty) were selected from the practices' data registries and included as eligible participants. A total of 216 patients with multimorbidity filled in the study questionnaire (55% response rate). We tested the instrument using structural equation modelling, and examined its validity and reliability. RESULTS: Confirmatory factor analyses revealed good indices of fit and overall internal consistency, as represented by Cronbach's alpha values. All eight dimensions of PCC were related positively to satisfaction with care (all p ≤ 0.001). Patients with multimorbidity who experienced joint decision making and responsibility taking in the primary care setting also had significantly higher scores for all eight PCC dimensions, indicating the instrument's construct validity. CONCLUSIONS: We conclude that the psychometric properties of the 36-item PCPC instrument are good. Based on these results the PCPC instrument seems a promising tool for the assessment of PCC among patients with multimorbidity in the primary care setting.

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BACKGROUND: Person-centred care and co-creation of care (productive interactions between clients and professionals) are expected to lead to better outcomes for clients. Professionals play a prominent role in the care of people with intellectual disabilities at residential care facilities. Thus, person-centred care and co-creation of care may be argued to lead to better outcomes for professionals as well. This study aimed to identify relationships of person-centred care and co-creation of care with the well-being and job satisfaction of professionals working with people with intellectual disabilities (PWID). METHODS: A cross-sectional survey was conducted in 2015 among professionals working at a disability care organisation in the Netherlands. All 1146 professionals involved in the care of people with intellectual disabilities who required 24-hours care were invited to participate. The response rate was 41% (n = 466). RESULTS: Most respondents (87%) were female, and the mean age was 42.8 ± 11.5 years (22-65). The majority of respondents (70%) worked ≥22 hours per week and had worked for the organisation for ≥5 years (88%). Most of the respondents (76.8%) were direct care workers either in residential homes (59.3%) or in day activities (17.5%). After controlling for background variables, person-centred care and co-creation of care were associated positively with job satisfaction and well-being of professionals. CONCLUSIONS: The provision of person-centred care and co-creation of care may lead to better well-being and job satisfaction among professionals working with PWID. This finding is important, as such professionals often experience significant levels of work stress and burnout.

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BACKGROUND: Despite the introduction of Human papillomavirus (HPV) vaccination in national immunization programs (NIPs), vaccination rates in most countries remain relatively low. An understanding of the reasons underlying decisions about whether to vaccinate is essential in order to promote wider spread of HPV vaccination. This is particularly important in relation to policies seeking to address shortfalls in current HPV campaigns. The aim of this study was to explore prevailing perspectives concerning HPV vaccination among girls, boys, and parents, and so to identify potential determinants of HPV vaccination decisions in these groups. METHOD: Perspectives were explored using Q-methodology. Forty-seven girls, 39 boys, and 107 parents in the Netherlands were asked to rank a comprehensive set of 35 statements, assembled based on the health belief model (HBM), according to their agreement with them. By-person factor analysis was used to identify common patterns in these rankings, which were interpreted as perspectives on HPV vaccination. These perspectives were further interpreted and described using data collected with interviews and open-ended questions. RESULTS: The analysis revealed four perspectives: "prevention is better than cure," "fear of unknown side effects," "lack of information and awareness," and "my body, my choice." The first two perspectives and corresponding determinants of HPV vaccination decisions were coherent and distinct; the third and fourth perspectives were more ambiguous and, to some extent, incoherent, involving doubt and lack of awareness and information (perspective 3), and overconfidence (perspective 4). CONCLUSIONS: Given the aim of publically funded vaccination programs to minimize the spread of HPV infection and HPV-related disease and the concerns about current uptake levels, our results indicate that focus should be placed on increasing awareness and knowledge, in particular among those in a modifiable phase.

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BACKGROUND: Patient/Person Centred Care (PCC) has achieved widespread attention which resulted in the identification of eight dimensions of PCC: Respect for the patients' values, preferences and expressed needs; information and education; access to care; emotional support to relieve fear and anxiety; involvement of family and friends; continuity and secure transition between healthcare settings; physical comfort; coordination of care. An instrument to assess patient centeredness of care delivery according to these eight dimensions among professionals is however lacking. The main objective of this study is therefore to develop and validate an instrument to assess the eight PCC dimensions among professionals providing care to institutionalized People With Intellectual Disabilities (PWIDs). METHODS: This cross-sectional survey study was conducted in a disability care centre in the region Twente in the Netherlands, the Twentse Zorgcentra. All professionals delivering care to institutionalized PWIDs (n = 1146) were invited to participate. An instrument was developed to assess the eight dimensions of PCC, which was tested among 464 professionals (response rate = 40%). We tested the instrument by means of structural equation modelling, and examined its validity and reliability. RESULTS: Indices of the 35-item PCC version are satisfactory but showed that the model left room for improvement and shortening of the instrument (RMSEA >0.06 and CFI < 0.95). Confirmatory factor analyses revealed good indices of fit with the 24-item PCC-instrument among professionals. Internal consistency of the overall instrument was also good. CONCLUSIONS: The psychometric properties of the 24-item PCC-instrument were satisfactory, rendering it a valid and reliable instrument for assessing the eight dimensions of PCC among professionals providing care to institutionalized PWIDs.

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