2 The effect of training and education at the outpatient clinic 31 created in collaboration with the UMCU Patient Panel with special attention for the use of understandable language. Due to the nature of the intervention, patients and physicians could not be blinded to their own intervention. However, both were unaware of each other’s intervention. 2.4 Data collection and outcomes Baseline characteristics Patient characteristics were extracted from the electronic patient records by the research team (age, gender, Charlson Comorbidity Index (CCI) (14)) and collected via the patient-questionnaires (marital status, educational level, work status, health perception, quality of life and social support). Health perception and quality of life were both measured on a 11-points Likert scale (0 to 10).Social support was measured with the Oslo-3-questionairre(15), translated into Dutch using the validated forward-backward method (16,17). Physicians’ characteristics were collected in the physician-questionnaires (age, gender, resident/specialist and years of training or work experience). Outcome measures The primary outcome was patient satisfaction, as a mean of 2 questions of patient satisfaction on a 11-points Likert scale (0 to 10). This scale is a frequently used outcome measure for patient satisfaction in a multitude of settings and interventions (18–21). The two questions on patient satisfaction were: - How satisfied were you with the conversation with your physician at the outpatient clinic? - How satisfied were you with the information given before, during and after your outpatient clinic visit? Secondary outcomes were: - The patient-doctor relationship, evaluated using the Patient Doctor Relationship Questionnaire (PDRQ-9). 9 items are scored on a 5-point Likert scale ranging from 1 (very low quality) to 5 (very high quality). The total score consists of the sum of each of the items and ranges from 9 to 45 (22,23).
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