Patient-Centered Behavior Coding Instrument (PCBI)


Developers: Linda Zandbelt, Ellen Smets, Frans Oort, Hanneke de Haes

Year of publication: 2005

Date of last revision: 21 October 2019

Setting in which the tool was originally developed/validated: general internal medicine, rheumatology and gastro-enterology

Restriction to setting(s): None to our knowledge

Target group: Physicians (in training)

Language(s): English

Translations(s): Dutch

Tool topics:

Non-verbal communication
Patient-centered communication
Relationship building

Specific constructs/behaviours:

The PBCI assesses 11 facilitating behaviors (attentive silence, Nonverbal encouragement, verbal encouragement, summary, open question, closed question, educated guess, factual reflection, emotional reflection, process reflection, respectful statements) and 8 inhibiting behaviors (ignoring/changing subject, changing focus, trivialising, premature advice/info, premature referral, expressing criticism, sarcasm, inappropriate interruption)

Types of data required to use the tool: Video recordings, Audio recordings

Intended application: Research

Reference(s) to development/validation paper(s):

Zandbelt, Linda C., Ellen MA Smets, Frans J. Oort, and Hanneke CJM de Haes. "Coding patient-centred behaviour in the medical encounter."жSocial science & medicineж61, no. 3 (2005): 661-671.

Tool/manual available: Yes. (Tool displayed in validation paper; additional information and English translation available from the author upon request)

Tool description by the author:

Some background information about the PBCI:
ж- We coded our videotaped consultations directly from video, using specialized software, The Observer. With this, the recording and the code-system are visible at the same computerscreen and codes are automatically connected to the timeframe of the recording. However, the coding system can also be used without the Observer.
- -жжжжж As you will notice, the total coding manual consists of five 'Runs':
oжж first we note speechtime of the interactants (using The Observer);
oжж second we divide the conversation into different phases (using TheжObserver);
oжж third we fill in the Eurocommunication Scale (paper & pencil);
oжж fourth we code patient active participation behaviour (using The Observer), and
oжж fifth we code physician facilitating and inhibiting behaviour (using The Observer).
Our paper in Social Science and Medicine (Zandbelt et al, 2005) was only related to the fifth run (coding physicians' patient-centred behaviour).
The first and fourth run were used to determine patients' active participation in the consultation (Zandbelt et al, Patient Education and Counseling 2007). The second run, dividing the conversation into different phases, was related to one of our research questions. The third run, filling in the Eurocommunication Scale, was used to validate the PBCI. Of course you could skip the runs you don't need for your research questions.

- Please be aware that we only code behaviours of interest (i.e. facilitating and inhibiting behaviours), in contrast with for example the RIAS (Roter et al) or the MIPS (Ford et al), which code every single utterance in the conversation. This has its pro's and contra's.
-жжжжж For the statistical analyses in the Social Science and Medicine paper we used component scores yielded by the CATPCA procedure, instead of raw counts of facilitating and inhibiting behaviours (see p 664).

Access: Public