Patient-centred communication in primary TB care delivery in Western China.

BACKGROUND: Patient-centred communication (PCC) is critical for delivering high-quality TB care. The 4-Habits Coding Scheme (4-HCS) is a tool designed to assess 23 communication behaviours from a patient-centred perspective. METHODS: We aimed to cross-culturally adapt and validate the 4-HCS into Chinese and evaluate PCC skills among TB health care workers (HCWs) in primary health care (PHC) settings in Western China. RESULTS: The Chinese version of the 4-HCS demonstrated robust reliability, face validity, and construct validity, and construct validity, and a total of 2,807 HCWs were included in the study. Community-level TB HCWs (3.872 ± 0.842) had better PCC skills than village-level HCWs (3.748 ± 0.860). The Habit 4 (Invest in the End) dimension which required more TB treatment knowledge had the lowest scores across four dimensions at both levels. Factors associated with higher 4-HCS scores included positive working attitudes, high working satisfaction, more years of TB working experience, and being from the community level (all P < 0.05). CONCLUSION: The Chinese version of the 4-HCS is a reliable and valid tool for assessing PCC skills among TB HCWs in PHC settings. Future research should expand to diverse regions and incorporate objective assessments to further validate the tool and explore its broader applicability.