Promoting relationship-centred care skills and attitudes: study protocol for the development and ef-fectiveness assessment of a training program for health professionals

Ana Virgolino, Osvaldo Santos, Duarte Burnay-Bastos, Ana Cristina Miranda, António Vaz-Carneiro


Background: Patient-centred and relationship-centred care (RCC) are considered crucial for therapeutic success. However, due to time pressure and fatigue, among other constraints, health professionals tend to act based on implicit directive (i.e., more authoritative) attitudes, common to the traditional biomedical approach to care. Despite current agreement on the importance of the relationship established between patients and health professionals, limited understanding exists regarding how to promote health professionals’ implicit attitudes, in line with the concept of RCC.

Goals: To develop and evaluate the effectiveness of a sustainable short-term training program to promote awareness and endorsement of attitudes and values aligned with RCC in health professionals.

Methods: The development of the training program to promote RCC attitudes will be supported by literature reviews and a Delphi panel to define its structure, format, and contents. The effectiveness assessment of the RCC training program will entail a 2-arms randomized controlled trial, over three moments: at baseline, immediately after the training, and two months afterward. For the effectiveness assessment, implicit and explicit attitudes regarding RCC will be evaluated, considering the sociodemographic and professional characteristics of the participants. An implicit association test (IAT) targeting RCC attitudes will be specifically developed and validated for the Portuguese population to be applied in the effectiveness assessment process. Intention-to-treat and per-protocol statistical analyses will be performed for primary and secondary outcomes, respectively.

Discussion: Integrating RCC-related content in health professionals’ education programs may promote attitudes more aligned with RCC and fitting with the participatory healthcare paradigm.



Centered care; Shared decision-making; Implicit attitudes; Health personnel; Mixed-methods approach

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