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

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 mor e patient-centred care. In this descriptive, cross-sectional study, a sampl e of 113 rural patients from Hebei Province attending outpatient Neurology, Orthopaedic and Cancer clinics completed the COOP/WONCA Charts. The 80 rur al patients who indicated significant functional difficulty and 11 doctors then responded to questionnaires to determine perceived usefulness and sati sfaction with use of the COOP/WONCA Charts. Respondents remained blind to t he other's responses. A focus group interview was conducted to expand overa ll views on perceived advantages and disadvantages of the charts. Of the 11 3 patients completing the COOP/WONCA Charts, 71% (n = 80) were considered t o report significant difficulty on at least one chart. Fifty-six per cent o f patients rated themselves as having significant functional problems in ph ysical fitness and 65% for daily activities. In contrast, a response indica ting 'no or little limitation or effect' was given regarding patients' feel ings and/or participation in social activities by 75% of patients in all th ree clinics. There was no statistically significant difference in the propo rtion of patients with functional impairment between the three clinics when analysed using a Chi-square test. Over 90% of doctors and patients perceiv ed the COOP/WONCA Charts as helpful with 'increased communication' as an ou tstanding benefit. This study has shown the COOP/WONCA Charts to be feasibl e and useful tools: to help identify functional limitations in Chinese outp atients; to trigger a more functionally focused patient-centred model of pr actice; and to encourage appropriate referrals to existing rehabilitation e fforts in large Chinese hospitals.