Feasibility and acceptability of the COOP/WONCA Charts for identification of functional limitations in rural patients of the People's Republic of China

Abstract

The aim of this study was to test whether the COOP/WONCA Charts could help doctors in three specialty outpatient clinics of Hebei Provincial Hospital, China to identify functional limitations in rural patients and promote more patient-centred care. In this descriptive, cross-sectional study, a sample of 113 rural patients from Hebei Province attending outpatient Neurology, Orthopaedic and Cancer clinics completed the COOP/WONCA Charts. The 80 rural patients who indicated significant functional difficulty and 11 doctors then responded to questionnaires to determine perceived usefulness and satisfaction with use of the COOP/WONCA Charts. Respondents remained blind to the other's responses. A focus group interview was conducted to expand overall views on perceived advantages and disadvantages of the charts. Of the 113 patients completing the COOP/WONCA Charts, 71% (n = 80) were considered to report significant difficulty on at least one chart. Fifty-six per cent of patients rated themselves as having significant functional problems in physical fitness and 65% for daily activities. In contrast, a response indicating 'no or little limitation or effect' was given regarding patients' feelings and/or participation in social activities by 75% of patients in all three clinics. There was no statistically significant difference in the proportion of patients with functional impairment between the three clinics when analysed using a Chi-square test. Over 90% of doctors and patients perceived the COOP/WONCA Charts as helpful with 'increased communication' as an outstanding benefit. This study has shown the COOP/WONCA Charts to be feasible and useful tools: to help identify functional limitations in Chinese outpatients; to trigger a more functionally focused patient-centred model of practice; and to encourage appropriate referrals to existing rehabilitation efforts in large Chinese hospitals. © 2001 Lippincott Williams & Wilkins.