The evolution of healthcare towards patient‐centred care and the need for systemic approaches

2021 ◽  
Vol 38 (2) ◽  
pp. 191-196
Author(s):  
Leonie Hallo ◽  
Alex Gorod ◽  
Susan Merchant
Keyword(s):  
Patient Centred Care

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

Medicines management for nursing practice

2013 ◽  
Author(s):  
Graham Brack ◽  
Penny Franklin ◽  
Jill Caldwell
Keyword(s):  
Patient Safety ◽  
Case Studies ◽  
Nursing Practice ◽  
Medicines Management ◽  
Knowledge And Skills ◽  
Practical Advice ◽  
Patient Centred Care ◽  
The Common ◽  
Skills Learning ◽  
Straightforward Approach

Medicines Management for Nursing Practice: Pharmacology, Patient Safety, and Procedures is a friendly guide designed to equip pre-registration and newly qualified nurses with the medicines management knowledge and skills to provide safe patient-centred care. Balancing theory with practical advice, this accessible text covers basic pharmacology, drug calculations, key legislation and standards, and patient safety. Drawing from the most up-to-date sources of evidence and advice, including NMC and BNF guidelines, Medicines Management for Nursing Practice prepares nurses to promote their patients' safety, concordance, understanding of medicines, and wellbeing. This book takes a lively and straightforward approach to a vital set of nursing skills. Learning features such as reflection points, exercises, and further reading help readers to develop and consolidate their knowledge. Chapters on pharmacology and drug calculations take a step-by-step approach and are supported by diagrams and examples to aid understanding. Case studies relate guidelines and theories to the common practical scenarios that nurses encounter on a day-to-day basis.

scholarly journals Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva S. van den Ende ◽  
◽  
Bo Schouten ◽  
Marjolein N. T. Kremers ◽  
Tim Cooksley ◽  
...  
Keyword(s):  
Acute Care ◽  
Patient Perspective ◽  
Large Scale ◽  
Healthcare Professionals ◽  
Well Being ◽  
Good Health ◽  
Care Needs ◽  
Patient Centred Care ◽  
Trial Register ◽  
What Matters

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

scholarly journals Validation of the Patient-Centred Care Competency Scale Instrument for Finnish Nurses

2021 ◽  
Vol 11 (6) ◽  
pp. 583
Author(s):  
Riitta Suhonen ◽  
Katja Lahtinen ◽  
Minna Stolt ◽  
Miko Pasanen ◽  
Terhi Lemetti
Keyword(s):  
Factor Analysis ◽  
Root Mean Square ◽  
Goodness Of Fit ◽  
Item Analysis ◽  
Healthcare Delivery ◽  
Mean Square ◽  
Cronbach’S Alpha ◽  
Patient Centred Care ◽  
Cronbach's Alpha ◽  
Confirmatory Factor

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses’ self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach’s alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach’s alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker–Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses’ self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses’ patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument.

scholarly journals Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chenwen Zhong ◽  
Mengping Zhou ◽  
Zhuojun Luo ◽  
Cuiying Liang ◽  
Lina Li ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Health Knowledge ◽  
Care Practice ◽  
Patient Centred Care ◽  
Time Length ◽  
Significant Difference ◽  
Information Treatment ◽  
Observation Code ◽  
The Relationship

Abstract Background Patient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations. Methods This is a direct observational study conducted in eight community health centres in China. Level of familiarity was rated by GPs using a dichotomized variable (Yes/No). The provision of patient-centred care during GP consultations was measured by coding audiotapes using a modified Davis Observation Code (DOC) interactional instrument. Eight individual codes in the modified DOC were selected for measuring the provision of patient-centred care, including ‘family information’, ‘treatment effects’, ‘nutrition guidance’, ‘exercise guidance’, ‘health knowledge’, ‘patient question’, ‘chatting’, and ‘counseling’. Multivariate analyses of covariance were adopted to evaluate the association between GP perceived doctor-patient familiarity and patient-centred care. Results A total of 445 audiotaped consultations were collected, with 243 in the familiar group and 202 in the unfamiliar group. No significant difference was detected in overall patient-centred care between the two groups. For components of patient-centred care, the number of intervals (1.36 vs 0.88, p = 0.026) and time length (7.26 vs. 4.40 s, p = 0.030) that GPs spent in ‘health knowledge’, as well as time length (13.0 vs. 8.34 s, p = 0.019) spent in ‘patient question’ were significantly higher in unfamiliar group. The percentage of ‘chatting’ (11.9% vs. 7.34%, p = 0.012) was significantly higher in the familiar group. Conclusions This study suggested that GP perceived doctor-patient familiarity may not be associated with GPs’ provision of patient-centred care during consultations in the context of China. Not unexpectedly, patients would show more health knowledge and ask more questions when GPs were not familiar with them. Further research is needed to confirm and expand on these findings.

scholarly journals Informing patients: The Bolam legacy

2020 ◽  
Vol 20 (2) ◽  
pp. 103-130
Author(s):  
Emma Cave ◽  
Caterina Milo
Keyword(s):  
Hospital Management ◽  
Medical Advice ◽  
Diagnosis And Treatment ◽  
Health Board ◽  
Management Committee ◽  
Patient Centred Care ◽  
Capacity To Consent ◽  
Incremental Development ◽  
The Uk ◽  
Treatment Alternatives

In the context of medical advice to patients, the UK decision in Montgomery v. Lanarkshire Health Board rejected the application of Bolam v. Friern Hospital Management Committee. This article argues that the rejection is neither complete nor settled. We explore doctrinal, conceptual and practical limitations of Montgomery to demonstrate the vestiges of Bolam’s relevance to medical advice. Medical advice does not end with disclosure of material risk but incorporates information on prognosis, diagnosis and treatment alternatives. Montgomery does not always apply in these cases, nor outside the medical mainstream or where patients lack capacity to consent. We identify ways in which the extension of patient-centred care in the giving of medical advice can be achieved through incremental development of Montgomery and application of the Bolitho gloss to require that processes conform to Montgomery principles of partnership and autonomy.

scholarly journals Understanding how a palliative-specific patient-reported outcome intervention works to facilitate patient-centred care in advanced heart failure: A qualitative study

2017 ◽  
Vol 32 (1) ◽  
pp. 143-155 ◽  
Author(s):  
Pauline M Kane ◽  
Clare I Ellis-Smith ◽  
Barbara A Daveson ◽  
Karen Ryan ◽  
Niall G Mahon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Unmet Needs ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Specific Patient ◽  
Patient Centred Care ◽  
Palliative Care Outcome Scale ◽  
Patient Reported

Background: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients’ needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. Aim: To explore whether and how a palliative care–specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients’ experience of patient-centred care in nurse-led chronic heart failure disease management clinics. Design: A feasibility study using a parallel mixed-methods embedded design was undertaken. The qualitative component which examined patients and nurses experience of the intervention is reported here. Semi-structured interviews were conducted and analysed using framework analysis. Setting/participants: Eligible patients attended nurse-led chronic heart failure disease management clinics in two tertiary referral centres in Ireland with New York Heart Association functional class II–IV. Nurses who led these clinics were eligible for inclusion. Results: In all, 18 patients and all 4 nurses involved in the nurse-led clinics were interviewed. Three key themes were identified: identification of unmet needs, holistic assessment and patient empowerment. The intervention impacted on processes of care by enabling a shared understanding of patients’ symptoms and concerns, facilitating patient–nurse communication by focusing on these unmet needs and empowering patients to become more involved in clinical discussions. Conclusion: This Integrated Palliative care Outcome Scale–based intervention empowered patients to become more engaged in the clinical consultation and to highlight their unmet needs. This study adds to the evidence for the mechanism of action of patient-reported outcome measures to improve patient-centred care and will help inform outcome selection for future patient-reported outcome measure research.

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