Journal articles on the topic 'Patient centeredne'
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Alshahrani, Shadia Hamoud, Talal H. Alshahrani, Premalatha Paulsamy, and Eva Lobelle Ederango. "Patient Centered Care and Centeredness Perspective." Universal Journal of Public Health 10, no. 4 (August 2022): 339–45. http://dx.doi.org/10.13189/ujph.2022.100407.
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Kamimura, Akiko, Shannon Weaver, Bianca Armenta, Bethany Gull, and Jeanie Ashby. "Patient centeredness: The perspectives of uninsured primary care patients in the United States." International Journal of Care Coordination 22, no. 1 (March 2019): 19–26. http://dx.doi.org/10.1177/2053434519836424.
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Introduction Patient-centered care has become increasingly important within the United States (US) healthcare system. Given that patient-centered care predicts patient satisfaction, health outcomes, and cost-effectiveness, it is of the utmost importance to study patient-centered care from the perspectives of marginalized populations including minorities, immigrants, and other underserved populations. The purpose of this study is to examine factors that affect underserved primary care patients’ perceptions of patient centeredness. Methods The data were cross-sectional and collected in Fall 2016. Free clinic patients (N = 723) completed a self-administered survey, which measures patient centeredness, patient involvement in care, and clinical empathy. Validated measures were part of the survey, and the internal consistency of scales was tested. The general linear model was performed to predict factors associated with patients’ perceptions of patient centeredness. Results Higher levels of perceived patient involvement in care and higher levels of perceived empathy in consultation are related to higher levels of patient centeredness. While better physical health is associated with higher levels of perceived empathy in consultation, high levels of emotional health and depression are not. Conclusions Patients’ perceptions of involvement and empathy are important factors for patient-centered care, although this study did not show causal directions among variables. Based on the findings of this study, it is recommended that future studies should focus on the following three points: (1) to develop and evaluate trainings for providers, (2) develop education classes for patients who utilize free clinics, (3) analyze how these programs affect patient-centered care and health outcomes.
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Jeon, Jaehee, and Seunghye Choi. "Factors Influencing Patient-Centeredness among Korean Nursing Students: Empathy and Communication Self-Efficacy." Healthcare 9, no. 6 (June 12, 2021): 727. http://dx.doi.org/10.3390/healthcare9060727.
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In recent years, there is a growing tendency in the extent to which patients wish to be actively involved in processes related to their healthcare and relevant decision-making. This was a cross sectional study. We examined undergraduate nursing students’ patient-centeredness and investigated its associated factors including empathy and communication self-efficacy using a structured questionnaire. A total of 201 undergraduate nursing students who provided written consent to participate in the study completed measures on patient-centeredness (sharing and caring), empathy (fantasy, perspective taking, personal distress, and empathic concern), and communication self-efficacy. The factors affecting patient-centeredness were analyzed using multiple regression. Communication self-efficacy affected patient-centered sharing, while age, empathy (fantasy, personal distress, empathic concern), and communication self-efficacy affected patient-centered caring. Empathy and communication self-efficacy positively affected patient-centeredness. Therefore, strategies that promote empathy and communication self-efficacy are needed to increase patient-centered care competency.
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Mapes, Marianna V., Peter A. DePergola, and William T. McGee. "Patient-Centered Care and Autonomy: Shared Decision-Making in Practice and a Suggestion for Practical Application in the Critically Ill." Journal of Intensive Care Medicine 35, no. 11 (August 26, 2019): 1352–55. http://dx.doi.org/10.1177/0885066619870458.
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Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients’ preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a patient-centered approach and ensure compassionate, high-quality care that respects our patients’ values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.
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Hansen, Martha Monrad, and Karen Korning Zethsen. "Is Electronic Access to Medical Records an Empowering and Patient-centered Initiative? – a Qualitative Contextual and Linguistic Analysis of Danish Electronic Records." HERMES - Journal of Language and Communication in Business, no. 58 (December 22, 2018): 157–73. http://dx.doi.org/10.7146/hjlcb.v0i58.111683.
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Political correctness demands a patient empowering and patient-centered approach to health care and today patients are increasingly involved in, and responsible for, their own health. Patients are potentially subjected to large amounts of health information and, in a Danish context, patients have recently gained easy electronic access to their hospital records. Access, which used to be by application, is now only a few clicks away. This initiative is praised as patient empowering and patient-centered even though the e-records are not written for patients, but are the working tool of health professionals. Thus, an expert language text, as it stands, has to function as patient information. In this article, we examine the language of the e-records with a view to determining potential lay-friendliness and thus patient-centeredness. We also discuss whether access, by definition, is a progressive initiative and whether patient empowerment is always the same as patient-centeredness.
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Sharma, Meenakshi. "Need to Adopt a Patient Centered Approach for Obtaining Favourable Results of NonPharmacological Interventions among Knee Osteoarthritis Patients in Out Patient Department Settings." International Journal of Healthcare Education & Medical Informatics 05, no. 02 (August 24, 2018): 21–26. http://dx.doi.org/10.24321/2455.9199.201809.
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Khodyakov, Dmitry, Sean Grant, Brian Denger, Kathi Kinnett, Ann Martin, Marika Booth, Courtney Armstrong, et al. "Using an Online, Modified Delphi Approach to Engage Patients and Caregivers in Determining the Patient-Centeredness of Duchenne Muscular Dystrophy Care Considerations." Medical Decision Making 39, no. 8 (November 2019): 1019–31. http://dx.doi.org/10.1177/0272989x19883631.
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Purpose. To determine the patient-centeredness of endocrine and bone health Duchenne muscular dystrophy (DMD) care considerations using the RAND/PPMD Patient-Centeredness Method (RPM), which is a novel, online, modified-Delphi approach to engaging patients and caregivers in clinical guideline development. Methods. We solicited input on the patient-centeredness of care considerations from 28 individuals with DMD and 94 caregivers, randomly assigned to 1 of 2 mixed panels. During a 3-round online modified-Delphi process, participants rated the importance and acceptability of 19 DMD care considerations (round 1), reviewed and discussed the initial results (round 2), and revised their original ratings (round 3). Patient-centeredness was operationalized as importance and acceptability of recommendations. We considered a care consideration to be patient-centered if both panels deemed it important and acceptable. Results. Ninety-five panelists (78%) participated in this study. Of these, 88 (93%) participated in round 1, 74 (78%) in round 2, and 56 (59%) in round 3. Panelists deemed 12 care considerations to be patient-centered: 3 weight management, 3 bone health, 4 vertical growth, and 2 puberty recommendations. Seven care considerations did not meet patient-centeredness criteria. Common reasons were lack of evidence specific to DMD and concerns about insurance coverage, access to treatment, and patient safety. Conclusions. Using the RPM, Duchenne families considered most care considerations to be patient-centered. Besides being clinically appropriate, these considerations are likely to be consistent with the preferences, needs, and values of Duchenne families. While all relevant care considerations should be discussed during patient-provider encounters, those that did not meet patient-centeredness criteria in particular should be carefully considered as part of joint decision making between Duchenne families and their providers. Study Registration: HSRProj 20163126.
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Perfetto, Eleanor, Elisabeth Oehrlein, Marc Boutin, Sarah Reid, and Eric Gascho. "OP38 Improving The Patient Centricity Of Value Assessments: A Rubric." International Journal of Technology Assessment in Health Care 33, S1 (2017): 17–18. http://dx.doi.org/10.1017/s0266462317001337.
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INTRODUCTION:Value frameworks, analogous to Health Technology Assessment (HTA) internationally, have emerged in the United States to aid stakeholders in assessing the value of new treatments. Since patient perspectives on value may differ significantly from other stakeholders, formalized procedures to involve patients in their work have been created. Despite these efforts, concerns persist that patient involvement is insufficient or “rhetoric.” To assist in this effort, the National Health Council (NHC) created a rubric to aid decision makers in improving the patient centricity of their value assessments.METHODS:A convenience sample of twenty-eight organizations was invited to participate in a roundtable discussion. Participants discussed experiences with value frameworks; debated and thematically grouped hallmark patient-centeredness characteristics; and developed illustrative examples of the characteristics. These materials were organized into the rubric, and subsequently vetted via multi-stakeholder peer review.RESULTS:Participants agreed upon six key domains of patient centeredness: partnership (patients are involved in every step of development/dissemination processes), transparency (assumptions/inputs are disclosed in an understandable, timely way), inclusiveness (perspectives drawn from broad range of stakeholders), diversity (differences in subpopulations, trajectory of disease, and stage of a life should be accounted for), outcomes (includes those that patients have identified as important), and data (variety of credible data sources are used allowing for timely incorporation of new information and account for the diversity of patient populations and patient-centered outcomes). The Rubric describes each domain and includes illustrative examples of how patient engagement/centeredness can be operationalized through direct and indirect pathways.CONCLUSIONS:The NHC Rubric is a first step toward creating patient-centered value assessments that patients and their families can rely on. It is intended to assist all stakeholders, especially the patient community, in assessing the level of patient centeredness and engagement in a given framework or model. It can be a guide to support developers in conceptualizing plans for meaningfully engaging patients.
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Siouta, Eleni, and Ulf Olsson. "Patient Centeredness from a Perspective of History of the Present: A Genealogical Analysis." Global Qualitative Nursing Research 7 (January 2020): 233339362095024. http://dx.doi.org/10.1177/2333393620950241.
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The overall aim of this study, performed in Sweden, was to problematize the contemporary national and transnational discourse on patient centeredness, which during recent decades has become a given, having become established as a dogma in conversations, writing, and thinking about patients and health care. We did that by showing that ideas such as patient centeredness can be seen differently from the way they are depicted in contemporary discourses about health care. In the presented analysis, we drew on Foucault’s concepts of governmentality, ‘history of the present’ and genealogy. This means that we reflected on contemporary conceptions of how phenomena, such as the care seeker, have been constructed within other discourses about health care. Empirically, we used different health policy documents—government reports from three different historical periods. The analysis showed that contemporary narratives about centeredness are neither more, nor less, care seeker-centered than the narratives of yesteryear. Rather, the phenomenon of the care seeker is given different frames and meanings within the framework of different economic and historical discourses about health care. Our analysis raised questions about the contemporary construction of patient centeredness. In a world with such huge economic differences between nations, as well as between citizens within most nations, the contemporary discourse may be limited as it does not problematize structural issues in the same way as previous discourses had done. Perhaps what is needed today are national and international patient-centered or person-centered discourses which also discuss policies and practices that are population- and social group-centered. In the final discussion of the analysis, we identified a new patient-centered discourse, which views the patient as a resource among other resources. The most important limitation of this type of study is that it is only about discourses and policy issues and not about daily practical activities.
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Mann, Keith J., Amber Hoffman, DeeJo Miller, Sheryl Chadwick, and Denise Bratcher. "The Effect of a Patient- and Family-Centered Care Curriculum on Pediatrics Residents' Patient-Centeredness." Journal of Graduate Medical Education 5, no. 1 (March 1, 2013): 36–40. http://dx.doi.org/10.4300/jgme-d-11-00254.1.
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Abstract Background Patient- and family-centered care (PFCC) approaches to care are important in enhancing the patient-centeredness of the health care experience, yet little is known about the effectiveness of formal approaches for teaching patient-centeredness in residency. Intervention We developed and implemented a PFCC curriculum and assessed its impact on residents' self-perceptions of patient-centered behavior and practices. Methods We used a quasi-experimental, nonrandomized approach with a pretest-posttest design. An experimental group of 24 interns filled out the Patient Practitioner Orientation Scale (PPOS) before residency, and a control group of 18 graduating residents who had not been exposed to a PFCC curriculum also completed the PPOS. After 2 years of residency and exposure to a PFCC curriculum, interns in the experimental group repeated the PPOS. We compared mean total and subscale PPOS scores. Results There was no difference in baseline total or subscale PPOS scores between the experimental and control group. The mean total PPOS score for the experimental group after exposure to the curriculum was 4.55 (P = .45), reflecting no change in patient-centeredness. The 17 female interns in the intervention group were more patient centered (4.8 ± 0.36) than the 6 male interns (4.2 ± 0.38) (P = .005), scoring significantly higher (4.6 ± 0.39 versus 4.0 ± 0.38) in the sharing domain (P = .001). Conclusion Interns' exposure to a PFCC curriculum did not result in a change in their perceived patient-centeredness. Most pediatrics residents at our children's hospital perceive themselves as patient and family centered at the start of residency and remain so throughout.
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Jarrar, Mu’taman, Mohammad Al-Bsheish, Badr K. Aldhmadi, Waleed Albaker, Ahmed Meri, Mohammed Dauwed, and Mohd Sobri Minai. "Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness." Healthcare 9, no. 11 (November 18, 2021): 1578. http://dx.doi.org/10.3390/healthcare9111578.
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This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-h shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned to more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety. Medical and surgical nurses, working in a healthy environment, had a high level of person-centeredness, which, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and prevent patient harm.
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Manchaiah, Vinaya, Ashley L. Dockens, Monica Bellon-Harn, and Erin S. Burns. "Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness." Journal of the American Academy of Audiology 28, no. 07 (July 2017): 636–43. http://dx.doi.org/10.3766/jaaa.16084.
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AbstractTrends in preferences of both healthcare providers and patients to patient-centeredness have been emphasized in research. However, an understanding of the nature of preferences to patient-centeredness within the context of the audiologist–patient relationship is needed.The purpose of this study is to explore the congruence between audiologist and patient preferences for patient-centeredness.A cross-sectional survey design was used to gather data from audiologists and patients with hearing loss.Participants included 75 audiologists and 105 consecutive patients with hearing loss.Participants completed the modified Patient–Practitioner Orientation Scale (PPOS) and provided selected demographic information. Data were analyzed using an independent sample t test to evaluate the differences between audiologist and patient congruence. Regression analysis was performed to evaluate factors contributing to preferences for patient-centeredness.Patients had significantly lower scores in PPOS full scale when compared to the audiologists [t (170) = 0.78; p ≤ 0.001] with a very large effect size (Cohen’s d = 1.43). Patients also had significantly lower scores when compared to the audiologists on both the sharing [t (170) = 1.01; p ≤ 0.001] and caring [t (170) = 0.56; p ≤ 0.001] subscales. Statistically significant lower scores were noted for patients when compared to audiologists on 12 items on the PPOS. No relationship between any demographic factors and preferences for patient-centeredness were found.The current study results indicated noncongruence in preferences for patient-centeredness among audiologists and patients with hearing loss. Results point toward the need for more research considering the nature and impact of patient-centered audiology practice.
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De Castro, Rodrigo Caprio Leite, and Daniela Riva Knauth. "FACTORS ASSOCIATED WITH THE PERSON-CENTERED CLINICAL METHOD IN PRIMARY HEALTH CARE: A STUDY IN PORTO ALEGRE, BRAZIL." International Journal of Person Centered Medicine 10, no. 3 (October 13, 2022): 7–26. http://dx.doi.org/10.5750/ijpcm.v10i3.1063.
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Background. The medical approach is influenced by several factors present at the patient, doctor, health service, society, and culture levels. Purpose. The purpose of this paper is to establish the degree of person-centeredness of care attributed by patients to the clinical approach of physicians from a primary health care (PHC) service and to ascertain its association with variables related to the care recipient. Methods. This cross-sectional study was conducted with a sample of patients (n = 408) with hypertension and/or diabetes treated at 12 health centers belonging to a PHC network in the city of Porto Alegre, Rio Grande do Sul, Brazil. The degree of person-centered clinical method (PCCM) orientation was measured by the “Patient Perception of Patient-Centeredness” (PPPC) questionnaire. Results. The variables “educational attainment” and “duration of follow-up with the same physician” were significantly associated with a higher prevalence of low overall PPPC scores (corresponding to higher patient centeredness) assigned to physicians by the patients (PR = 1.04, 95% CI = 1.02–1.06, p-value < 0.001 and PR = 1.01, 95% CI = 1.00–1.02, p-value = 0.032, respectively). On the other hand, the variables “living alone” and “fair/poor/very poor self-perception of health” were significantly associated with a lower prevalence of person centeredness (PR = 0.83, 95% CI = 0.72–0.96, p-value = 0.011 and PR = 0.88, 95% CI = 0.77–1.00, p-value = 0.041, respectively). Conclusions. These findings demonstrate that clinical approaches to people with a high level of social vulnerability require improvement, and that the length of follow-up provided by one physician can be an indicator of the extent to which providers are able to deliver person-centered care.
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Mazurenko, Olena, Basia Andraka-Christou, Matthew Bair, Areeba Kara, and Christopher A. Harle. "2183 Balancing patient-centeredness and patient safety in the hospitals: The case of pain care and patient satisfaction." Journal of Clinical and Translational Science 2, S1 (June 2018): 79. http://dx.doi.org/10.1017/cts.2018.278.
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OBJECTIVES/SPECIFIC AIMS: This study seeks to understand the relationship between opioid prescribing and patient satisfaction among non-surgical, hospitalized patients. As part of this study, we qualitatively examined challenges in delivering safe and patient-centered care through voices of physicians’, and nurses.’ METHODS/STUDY POPULATION: We collected data through in-person interviews using semi-structured guides tailored to the informant roles. Study participants came from 1 healthcare system located in a mid-Western state. Each interview lasted 30–45 minutes, was audio-recorded with consent, and transcribed for analysis. Two researchers each coded 17 transcripts for discussions around patient-centeredness (including patient satisfaction, patient experiences), and patient safety for hospitalized patients experiencing pain. Analysis followed a general inductive approach, where researchers identified themes related to the research questions using an open coding technique. They discussed and reached consensus on all codes, and extracted several preliminary themes. The analysis was supported by NVivo software. RESULTS/ANTICIPATED RESULTS: The following themes emerged: (1) complex decision-making process to prescribe opioids for hospitalized patients; (2) the role of objective findings in prescribing decisions; (3) bargaining process in prescribing opioids; (4) balancing patient-centeredness and patient safety for selected populations; (5) opioids are the predominant medications for pain care. DISCUSSION/SIGNIFICANCE OF IMPACT: Clinicians’ decision to prescribe opioids for nonsurgical hospitalized patients is based on multiple factors, including patient’s condition, patient’s preference for pain medications, or standard hospital’s pain care regimen. Interventions that improve clinicians’ ability to prescribe opioids may be needed to improve delivery of patient-centered and safe pain care.
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Meirovich, Adaya, Rosalie Ber, Michael Moore, and Avi . Rotschild. "Student-centered tutoring as a model for patient-centeredness and empathy." Advances in Medical Education and Practice Volume 7 (July 2016): 423–28. http://dx.doi.org/10.2147/amep.s107115.
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Phillips, Louise, and Michael Scheffmann-Petersen. "Minding the Gap Between the Policy and Practice of Patient-Centeredness: Cocreating a Model for Tensional Dialogue in the “Active Patient Support” Program." Qualitative Health Research 30, no. 9 (April 4, 2020): 1419–30. http://dx.doi.org/10.1177/1049732320913855.
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Several studies identify obstacles to patient-centered care that can be eradicated by bridging the gap between policy goals and practice. In this article, “patient-centeredness” is theorized as an unstable entity riddled with intrinsic, ineradicable tensions. The purpose of the article is to propose a reflexive approach to the tensions as the most appropriate strategy for narrowing the gap between policy and practice. The reflexive approach is illustrated in an account of an action research project on a Danish, patient-centered initiative, “Active Patient Support.” The account focuses on the development of a dialogic communication model through collaborative, reflexive analyses of the tensions in the enactment of “patient-centeredness” in dialogue between health care practitioners and citizens—in particular, the tension between empowerment and self-discipline. Finally, the conceptual expansion of one of the dimensions of patient-centeredness, “health-practitioner-as-person,” is discussed as a platform for reflexivity, and the limitations of reflexivity are addressed.
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Zhang, Jing, Yunan Chen, Shazia Ashfaq, Kristin Bell, Alan Calvitti, Neil J. Farber, Mark T. Gabuzda, et al. "Strategizing EHR use to achieve patient-centered care in exam rooms: a qualitative study on primary care providers." Journal of the American Medical Informatics Association 23, no. 1 (November 13, 2015): 137–43. http://dx.doi.org/10.1093/jamia/ocv142.
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Abstract Objective Electronic health records (EHRs) have great potential to improve quality of care. However, their use may diminish “patient-centeredness” in exam rooms by distracting the healthcare provider from focusing on direct patient interaction. The authors conducted a qualitative interview study to understand the magnitude of this issue, and the strategies that primary care providers devised to mitigate the unintended adverse effect associated with EHR use. Methods and Materials Semi-structured interviews were conducted with 21 healthcare providers at 4 Veterans Affairs (VAs) outpatient primary care clinics in San Diego County. Data analysis was performed using the grounded theory approach. Results The results show that providers face demands from both patients and the EHR system. To cope with these demands, and to provide patient-centered care, providers attempt to perform EHR work outside of patient encounters and create templates to streamline documentation work. Providers also attempt to use the EHR to engage patients, establish patient buy-in for EHR use, and multitask between communicating with patients and using the EHR. Discussion and Conclusion This study has uncovered the challenges that primary care providers face in integrating the EHR into their work practice, and the strategies they use to overcome these challenges in order to maintain patient-centered care. These findings illuminate the importance of developing “best” practices to improve patient-centered care in today’s highly “wired” health environment. These findings also show that more user-centered EHR design is needed to improve system usability.
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Isetts, Brian, Anthony Olson, and Jon Schommer. "Reframing the Medication Experience in Pharmacy Using Seminal Concepts of Patient-Centered Care—Implications for Practice." Pharmacy 9, no. 1 (January 5, 2021): 9. http://dx.doi.org/10.3390/pharmacy9010009.
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Team-based, Patient-Centered Care is essential to chronic disease prevention and management but there are differing ideas about the concept’s meaning across healthcare populations, settings and professions. This commentary’s objective is to empirically evaluate the theoretical relationships of the [a] Medication Experience, [b] Patient-Centeredness and other relevant component concepts from pharmaceutical care (i.e., [c] Therapeutic Relationship, [d] Patient-specific preferences for achieving goals of therapy and resolving drug therapy problems) so as to provide practice-based insights. This is achieved using a secondary analysis of 213 excerpts generated from in-depth semi-structured interviews with a national sample of pharmacists and patients about Patient-Centeredness in pharmacist practice. The four component concepts (i.e., a–d) related to the objective were examined and interpreted using a novel 3-archetype heuristic (i.e., Partner, Client and Customer) revealing common practice-based themes related to care preferences and expectations in collaborative goal setting, enduring relationships, value co-creation and evolving patient expectations during challenging medical circumstances. Most practice-based insights were generated within the Partner archetype, likely reflecting high congruence with pharmacist and patient responses related to the Medication Experience and Therapeutic Relationship. The practice-based insights may be especially useful for new practitioners and students accelerating their advancement in providing effective and efficient Patient-Centered Care.
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Körner, Mirjam, Hanna Dangel, Anne Plewnia, Julia Haller, and Markus A. Wirtz. "Psychometric evaluation of the Client-Centered Rehabilitation Questionnaire (CCRQ) in a large sample of German rehabilitation patients." Clinical Rehabilitation 31, no. 7 (September 1, 2016): 926–35. http://dx.doi.org/10.1177/0269215516665158.
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Objective: Structural analysis of the German translation of the “Client-Centered Rehabilitation Questionnaire” (CCRQ). Design: Cross-sectional multicenter study. Setting: Ten inpatient rehabilitation centers in Germany. Subjects: The CCRQ was completed by patients in the ten rehabilitation centers. Main measures: The psychometric analysis of the CCRQ was conducted using exploratory and confirmatory factor analysis. Results: The CCRQ was completed by 496 patients (average age: 59 years; 59.7% women). The CCRQ’s 7-factor structure could not be confirmed. Factor analysis showed that the three latent constructs “decision-making/communication”, “self-management/empowerment”, and “psychosocial well-being” (60.73% variance explained) adequately represent patient-centeredness in medical rehabilitation assessed by the CCRQ. The scales possess good reliability (Cronbach’s α = .83 to .87) and convergent criterion validity (r = 0.48 to 0.68). The three-factorial model exhibited good local and global data fit (RMSEA: 0.063, CFI 0.962, TLI 0.954) and proved to have a better data fit than concurring models (e.g. a model assuming an underlying factor). Conclusions: A validated short form of the Client-Centered Rehabilitation Questionnaire, CCRQ-15, could be identified. Three scales based on 15 items allow assessing the key aspects of patient-centeredness in German medical rehabilitation.
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Jakobsson, Sofie, Daniel S. Olsson, Eva Andersson, Tobias Hallén, David Krabbe, Ann-Charlotte Olofsson, Oskar Ragnarsson, Thomas Skoglund, Gudmundur Johannsson, and Eva Jakobsson Ung. "Extended Support Within a Person-Centered Practice After Surgery for Patients With Pituitary Tumors: Protocol for a Quasiexperimental Study." JMIR Research Protocols 9, no. 7 (July 21, 2020): e17697. http://dx.doi.org/10.2196/17697.
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Background Patients with pituitary tumors often live with lifelong consequences of their disease. Treatment options include surgery, radiotherapy, and medical therapy. Symptoms associated with the tumor or its treatment affect several areas of life. Patients need to adhere to long-term contact with both specialist and general health care providers due to the disease, complex treatments, and associated morbidity. The first year after pituitary surgery constitutes an important time period, with medical evaluations after surgery and decisions on hormonal substitution. The development and evaluation of extended patient support during this time are limited. Objective The aim of this study is to evaluate whether support within a person-centered care practice increases wellbeing for patients with pituitary tumors. Our main hypothesis is that the extended support will result in increased psychological wellbeing compared with the support given within standard of care. Secondary objectives are to evaluate whether the extended support, compared with standard care, will result in (1) better health status, (2) less fatigue, (3) higher satisfaction with care, (4) higher self-efficacy, (5) increased person-centered content in care documentation, and (6) sustained patient safety. Methods Within a quasiexperimental design, patients diagnosed with a pituitary tumor planned for neurosurgery are consecutively included in a pretest-posttest study performed at a specialist endocrine clinic. The control group receives standard of care after surgery, and the interventional group receives structured patient support for 1 year after surgery based on person-centeredness covering self-management support, accessibility, and continuity. A total of 90 patients are targeted for each group. Results Recruitment into the control group was performed between Q3 2015 and Q4 2017. Recruitment into the intervention group started in Q4 2017 and is ongoing until Q4 2020. The study is conducted according to the Declaration of Helsinki, and the protocol has received approval from a regional ethical review board. Conclusions This study entails an extensive intervention constructed in collaboration between clinicians, patients, and researchers that acknowledges accessibility, continuity, and self-management support within person-centeredness. The study has the potential to compare standard care to person-centered practice adapted specifically for patients with pituitary tumors and evaluated with a combination of patient-reported outcomes and patient-reported experience measures. Following the results, the person-centered practice may also become a useful model to further develop and explore person-centered care for patients with other rare, lifelong conditions. Trial Registration Researchweb.org. https://www.researchweb.org/is/sverige/project/161671 International Registered Report Identifier (IRRID) DERR1-10.2196/17697
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Ciasullo, Maria Vincenza, Weng Marc Lim, Mohammad Fakhar Manesh, and Rocco Palumbo. "The patient as a prosumer of healthcare: insights from a bibliometric-interpretive review." Journal of Health Organization and Management 36, no. 9 (April 5, 2022): 133–57. http://dx.doi.org/10.1108/jhom-11-2021-0401.
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PurposeHealthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.Design/methodology/approachA hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.FindingsPatient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.Originality/valueThe article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.
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Kalra, Sanjay, Ganapathy Bantwal, and Mathew John. "The ADA-EASD patient-centered guidelines for management of hyperglycemia: Are they patient-centered enough?" Journal of Social Health and Diabetes 01, no. 01 (June 2013): 041–43. http://dx.doi.org/10.1055/s-0038-1676180.
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Abstract Background: The American diabetes association (ADA) and European association for the study of diabetes (EASD) recently issued an updated position statement on the management of hyperglycemia in type 2 diabetes. The choice of nomenclature of these guidelines is refreshing as it highlights a patient-centered approach to managing diabetes. Discussion: This debate looks at these guidelines through the prism of patient-centeredness, it tries to assess if the authors of the ADA-EASD position statement have been able to “walk the talk” with respect to the patient-centered approach that they advocate. Conclusion: We conclude that the guidelines can be made more patient-centered, by emphasizing psychosocial and psychiatric comorbidity of diabetes, ethno pharmacy, and patient-friendly insulin regimes and oral fixed dose combinations, in a culturally competent, globally acceptable manner.
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Liu, Jing, Shengchao Hou, Richard Evans, Chenxi Xia, Weidong Xia, and Jingdong Ma. "What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness." Journal of Medical Internet Research 21, no. 8 (August 7, 2019): e14634. http://dx.doi.org/10.2196/14634.
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Background Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. Objective The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. Methods First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. Results In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. Conclusions Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.
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Park, Sung-Yeon, Gi Woong Yun, Sarah Friedman, Kylie Hill, and Max J. Coppes. "Patient-Centered Care and Healthcare Consumerism in Online Healthcare Service Advertisements: A Positioning Analysis." Journal of Patient Experience 9 (January 2022): 237437352211336. http://dx.doi.org/10.1177/23743735221133636.
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Patient-centered care and healthcare consumerism are the two most dominant ideas about the relationship between patients and providers in the United States. To identify providers’ positions between the two perspectives, we analyzed the content of direct-to-consumer healthcare service advertisements. The advertisements were collected in the state of Nevada ( N = 323) and their landing pages were analyzed for provider attributes, patient experience features, and terms referring to patients and providers. The results showed that the advertisements fully embraced the notion of patient-centeredness by commonly claiming patient-centered care and frequently using the term “patient.” The advertisements also contained multiple indicators of healthcare consumerism, although they avoided using the terms “consumer/customer/client” closely associated with consumerism. Contrary to the prominence of patient experience features, provider attributes were not common. An additional analysis of inter-specialty differences in advertising features confirmed the strong consumerism position of cosmetic surgery providers. Application of the healthcare service advertising analytic scheme developed for this study could help providers and healthcare administrators recognize how their advertising messages may reflect their values.
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Tanenbaum, Sandra. "Person-centered medicine: currents and crosscurrents in the United States." European Journal for Person Centered Healthcare 2, no. 2 (April 8, 2014): 141. http://dx.doi.org/10.5750/ejpch.v2i2.691.
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In their editorial introduction to an earlier issue of the International Journal of Person-Centered Medicine, Miles and Mezzich cite positive developments in the United States and United Kingdom. The creation, in the U.S., of the Patient-Centered Outcomes Research Institute (PCORI) is rightly portrayed by these authors as focusing serious attention on the needs of patients for meaningful information about their medical care. PCORI is in some ways--for example, in its apparent commitment to stakeholder engagement and methodological innovation - a departure from earlier public and private efforts to create an evidence base for medical practice. On the other hand, PCORI’s roots and much of the current discourse about its future reflect a residual hold by evidence-based medicine (EBM) on healthcare research and policy-making. First, PCORI was established primarily to promote the conduct of CER, the appetite for which derived from the demand for effectiveness research generally. Second, the patient-centeredness of PCORI is manifest primarily in the conduct of research rather than the process of care. Third, patient-centeredness is commonly taken to refer to patients as a group - as opposed to, say, physicians or researchers as a group -rather than to individual patients. Fourth, it will be difficult and expensive for PCORI to attend to heterogeneity of treatment effects. Fifth and perhaps most important, the creation of PCORI is contemporaneous with other, countervailing, developments in the U.S. healthcare system.
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Oehrlein, Elisabeth, Eleanor Perfetto, T. Rose Love, Yujin Chung, and Parima Ghafoori. "OP95 Are Patient-Reported Outcome Measures Meeting Today's Standards?" International Journal of Technology Assessment in Health Care 34, S1 (2018): 34–35. http://dx.doi.org/10.1017/s0266462318001277.
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Introduction:Over the past decade, health technology assessment (HTA) agencies have become interested in improving the patient-centeredness of their assessments. A common approach has been to prioritize patient-reported outcomes (PROs), often describing PROs as patient-relevant or patient-oriented. However, it is often unclear whether and to what degree PRO measures (PROMs) truly reflect what is important to patients. This review examined the pedigree of a sample of measures used as primary or secondary endpoints in trials and discussed in Food and Drug Administration (FDA) approved product labels between 2003 and 2014.Methods:We examined all 26 PROs included in chapters 1 (Office of Microbial Products) and 2 (Office of Drug Evaluation I) of the FDA's Pilot Clinical Outcome Assessment (COA) Compendium. Three reviewers independently searched PubMed and Google to identify publications or other relevant materials related to method and stage of measure development where patient engagement took place.Results:Among 26 evaluated PROMs, we were unable to locate any information on development or validation for 12 (patient diary=9; rating scale=3). Among the remaining 14 PROMs, 5 did not include any evidence of patient engagement (questionnaire=1; patient diary=2; rating scale=2); 3 engaged patients during concept elicitation or psychometric validation only (disease-specific questionnaires=3); and 6 engaged patients during both concept elicitation and cognitive interviewing (disease-specific questionnaires=6). PROMs either previously qualified or submitted for qualification by FDA were more likely to include patient engagement.Conclusions:PROs can provide patient-centered data useful for HTA; however, patient-reported information is not inherently patient-centered. This study found that only a minority of sampled PROMs engaged patients during both concept elicitation and cognitive interviewing. To facilitate patient-centered HTA, manufacturers should ensure that PROMs incorporated into clinical trials measure concepts important to patients. Similarly, HTAs should request data on development and validation of all outcome measures incorporated into trials.
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Aljuaid, Mohammed, Bashayer Al-Sahli, David Edvardsson, and Khaled Al-Surimi. "Psychometric Evaluation of the Arabic Version of the Person-Centered Climate Questionnaire: Patient Version (PCQ-P)." Healthcare 11, no. 2 (January 8, 2023): 190. http://dx.doi.org/10.3390/healthcare11020190.
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Background: Adopting a person-centered care approach has transformed different healthcare settings worldwide. However, this concept has gained little attention in many Middle Eastern countries, including Saudi Arabia and other Arab countries. This study aimed to evaluate the psychometric characteristics of the Arabic person-centered climate questionnaire—patient version, measuring to what extent the climate of health care settings is perceived as being person-centered. Method: This is a psychometric analysis study. The original validated version of the English Person-Centered Climate Questionnaire—Patient version (PCQ-P) was translated into Arabic and tested among a sample of hospital patients (n = 300) in Saudi Arabia using translation and back translation procedures. For psychometric evaluation, statistical analyses of validity and reliability were used, including exploratory factor analysis as well as conformity analysis. Results: The Arabic version of the person-centered climate questionnaire—patient version—showed good reliability as the Cronbach’s alpha value of the total of 17 items was 0.84, and the Cronbach’s alpha values of the three sub-scales (safety, everydayness, and hospitality) were 0.83, 0.56, and 0.68, respectively. Internal consistency results were high in terms cof orrelation coefficient for all 17 items. The exploratory factor analysis identified the three factors (safety, everydayness, and hospitality) responsible for 47.174% of the total variance. Conclusion: The Arabic version of the PCQ-P showed satisfactory reliability and validity for measuring patients’ perceptions of person-centeredness in Arab healthcare settings. This Arabic version will be accessible to those interested in generating and using empirical evidence to promote a patient-centered care approach in Arab healthcare settings. The results of this study can be used as a starting point for assessing and developing a person-centered care culture in Saudi hospitals and other Arab countries in the Middle East.
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Kusnanto, Hari. "Patient-Centered Care." Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) 1, no. 2 (May 31, 2018): 51. http://dx.doi.org/10.22146/rpcpe.36009.
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..........In the context of patient services constrained by cost barriers, physicians often find it unfavorable to choose an option that prioritizes patient interest. As has been the practice of physicians since Hippocrates, physicians position themselves as the one who best knows what is the most appropriate for the patient. This is in contrary to the concept of patient-centered care. Supported by the ethical principle of patient autonomy, patient-centered services / PCC (LBP/Layanan Berpusat Pasien) empower patients through the provision of more clear and accurate information, allowing patients to be partners in decision-making concerning their health........The cultural shift and the way services are delivered to the patients must be designed, managed and rewarded financially. Patients are no longer merely customers who receive services, but partners in the process of prevention and cure of the disease. The expected benefits of patient-centered services are greater patient and family satisfaction, increased reputation of the physician or the health care provider institution, increased morale and clinical productivity of supporting staffs, and cost savings and service efficiency.......
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McInnes, D. Keith. "Don’t Forget Patients In Patient-Centered Care." Health Affairs 29, no. 11 (November 2010): 2127. http://dx.doi.org/10.1377/hlthaff.2010.0990.
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LaNoue, Marianna D., and Debra L. Roter. "Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees." Patient Education and Counseling 101, no. 6 (June 2018): 1143–46. http://dx.doi.org/10.1016/j.pec.2018.01.016.
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Manchaiah, Vinaya, David Tomé, Ashley L. Dockens, Monica Harn, and Purushothaman Ganesan. "Preference to Patient-Centeredness in Undergraduate Audiology Students in Portugal." Journal of the American Academy of Audiology 27, no. 10 (November 2016): 816–23. http://dx.doi.org/10.3766/jaaa.15129.
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Background: In health care, the model of patient-centered care is growing; and improved outcomes have been linked to patient-centeredness. Practicing audiologists have been found to strongly prefer a patient-centered approach as years in practice increase. It is unknown whether patient-centeredness begins during education and training. Purpose: The current study was aimed at understanding the preference to patient-centeredness in undergraduate audiology students in Portugal. Research Design: The study used a cross-sectional survey design. Study Sample: One hundred and thirty-seven undergraduate audiology students completed patient–practitioner orientation scale (PPOS) and provided some demographic details. Data Collection and Analysis: The data were analyzed using one-way analysis of variance and one-sample t tests. Results: A significant difference was found for sharing subscale (p ≤ 0.001), caring subscale (p = 0.033), and the PPOS full scale (p ≤ 0.001) among different undergraduate groups. Further, post hoc tests showed that the difference between year 1 and with years 2, 3, and 4 were significant for sharing subscale and PPOS full scale, but not for caring subscale. No significant differences were observed among the years 2, 3, and 4 for sharing subscale, caring subscale, and for PPOS full scale. When compared audiologists’ preferences from a previous study on audiologists with students’ preferences in the current study, significant difference for both subscales and full scale was found between year 1 students and audiologists (p ≤ 0.001), with higher preference to patient-centeredness was reported by qualified audiologists. Also, significant difference was found between audiologists and overall undergraduate group for caring subscale (p = 0.001). Conclusions: The current study suggests that audiology education influences preference to patient-centeredness. Within a year of undergraduate coursework, students tend to develop high preference to patient-centeredness, which stays stable during four years of undergraduate studies. These results provide useful insights to audiology education and training, particularly in the context of audiological rehabilitation.
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Luce, Bryan R., and Jason C. Simeone. "How different is research done by the Patient-centered Outcomes Research Institute, and what difference does it make?" Journal of Comparative Effectiveness Research 8, no. 14 (October 2019): 1239–51. http://dx.doi.org/10.2217/cer-2019-0054.
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Aim: To determine whether research funded by the Patient-centered Outcomes Research Institute (PCORI) is consistent with the original aims of Congress and unique among other major USA funders. Methods: We compared a sample of funded projects from PCORI, NIH (Phase IV) and agency for healthcare research and quality (AHRQ; American Recovery and Reinvestment Act [ARRA]-based comparative effectiveness research funding) from 2014 to 2018 on number of outcomes/study, patient-centeredness of outcomes (those related to survival, function, symptoms and health-related quality of life) and other features that may characterize patient-centered research (e.g., whether conducted in a real-world setting) using PCORI portfolio data and ClinicalTrials.gov. Results: The mean number of outcomes in PCORI studies (≥9) appeared higher than NIH (≥3)/AHRQ (5.5); a higher percentage of outcomes/study were patient-centered: >85% PCORI versus 50% AHRQ and ≤30% NIH. The majority of PCORI studies (≥74%) were conducted in a real-world setting; this characteristic could not be identified for NIH/AHRQ studies. Conclusion: PCORI-funded studies appear to have unique aspects relative to NIH and AHRQ that are consistent with PCORI’s aims of patient-centeredness.
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Vennedey, Vera, Samia Peltzer, Arim Shukri, Hendrik Müller, Frank Jessen, Christian Albus, and Stephanie Stock. "Comparison of Patient and Proxy Assessment of Patient-Centeredness in the Care of Coronary Heart Disease: A Cross Sectional Survey Using the PACIC-S11.1." Journal of Primary Care & Community Health 11 (January 2020): 215013272097623. http://dx.doi.org/10.1177/2150132720976235.
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Introduction: When making medical care more patient-centered, surveys on patients’ and their relatives’ experiences can be helpful in identifying opportunities for improvement. In cases where the targeted patients are unable to express their own perspective, for example, due to them being too young or suffering from severe impairments, proxies can serve as substitutes. Proxies are frequently used in care planning and consent. Nevertheless, it is unclear whether patients’ assessments of how patient-centered their medical care is are similar to those of their proxies. This study aims to assess the level of consistency between patients’ and their proxies’ assessments using an adapted version of the Patient Assessment of Chronic Illness Care (PACIC) short form questionnaire. Methods: In a cross-sectional study, patients with coronary heart disease were recruited at cardiologists’ offices, rehabilitation clinics and hospitals. Participants were surveyed with regard to the perceived level of patient-centeredness during their care using an adapted version of the German PACIC short form (PACIC-S11.1). Correlations in the assessments made by each patient and their respective proxy were analyzed. On the level of the patients group and the relatives group differences between mean ratings for each item were compared using paired t-tests. Results: In total, 74 pairs of patients and proxies submitted the completed questionnaire. On the level of the individual patient/proxy pairs, no correlation, or significant but low correlation, was found between the ratings. On the group level, patients’ and their proxies’ item ratings were similar in the interpretation of averages, but still demonstrated statistically significant differences. Overall, patients rated their care as more patient-centered than their proxies did. Conclusion: The study shows that, on the individual level, proxies’ ratings do not necessarily reflect the patients’ assessment of PCC. On the group level, the assessments of relatives regarding PCC are similar to those of the patients. Trial registration German clinical trials register (Deutsches Register Klinischer Studien, DRKS) Registration Number: DRKS00012434 (URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012434 )
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Taleghani, Fariba, Elaheh Ashouri, Mehrdad Memarzadeh, and Mortaza Saburi. "Barriers to empathy-based care: oncology nurses’ perceptions." International Journal of Health Care Quality Assurance 31, no. 3 (April 16, 2018): 249–59. http://dx.doi.org/10.1108/ijhcqa-12-2016-0185.
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Purpose The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions. Design/methodology/approach The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach. Findings Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient Practical implications Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture. Originality/value Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.
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Helms Andersen, Tue, Nana Folmann Hempler, and Ingrid Willaing. "Educator challenges using participatory methods in group-based patient education." Health Education 114, no. 2 (January 28, 2014): 152–65. http://dx.doi.org/10.1108/he-07-2013-0032.
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Purpose – The purpose of this paper is to explore educators’ experiences of putting a participatory and patient-centered education model, “The Health Education Juggler,” into practice after having attended a one-day seminar. The model consists of four educator roles in participatory group-based patient education in chronic illness: embracer (takes care of the group), facilitator (generates dialogue and participation), translator (communicates professional knowledge) and initiator (motivates action in patients). Design/methodology/approach – Qualitative analysis of observations of eight group-based patient education sessions and seven in-depth semi-structured interviews with 11 educators. Findings – Educators find it difficult to include disease-specific knowledge when working with a flexible patient-centered approach. They tend to stay in the role they find most comfortable during education sessions (most often that of embracer), rather than adopting new and more challenging roles in the teaching process. Educators theoretically understand the role of facilitator, but they do not know how to perform in this role in practice. The ability to juggle all educator roles depends on the ability to master each. Practical implications – The Health Education Juggler model shows promise in promoting participation and patient-centeredness and as a reflection tool for educators and an analytic tool for quality assessment of patient education. These findings support further development of model use. Originality/value – This model of educator roles in group-based patient education in chronic illness provides a new approach to patient education. It indicates the need for various professional competencies among educators to provide patient-centered education in a flexible way, with a strong focus on patient-identified problems and challenges, social learning processes and generation of internal motivation in patients.
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Santiago, Luiz Miguel, Ana Filipa Reis, Philippe Couto Botas, and Carolina Duarte Pereira. "Medicina centrada no paciente e capacitação do consulente Medicina Geral e Familiar." Revista ADSO 3, no. 5 (December 29, 2015): 19–32. http://dx.doi.org/10.35323/revadso.35201530.
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吳姵錡, 吳姵錡, 紀淑靜 紀淑靜, 葉日熹 Shu-Ching Chi, 袁立仁 袁立仁, 劉子熒 劉子熒, 王蕾伊 王蕾伊, 侯傑議 侯傑議, and 林佳貞 林佳貞. "以病人為中心的整合照護—義大醫院經驗分享." 醫療品質雜誌 17, no. 1 (January 2023): 070–73. http://dx.doi.org/10.53106/199457952023011701010.
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<p>義大醫院的宗旨為品質、卓越與創新。我們的策略目標是成為南臺灣社區健康的靠山，為了達到以病人為中心整合照護的價值，我們建置有效的品質監測及臨床稽核機制，以達到良好的品質成果，指標皆穩定達閾值之上。為達卓越與創新，每年會重新檢視監測品質指標項目，並依據照護服務執行狀況進行指標項目調整。本團隊與物理治療師著重個別性衛教指導及專門的諮詢管道，更結合長照2.0多元復能轉介，減輕病人在面對術前焦慮及術後復原的不安，增加居家自我照護能力。面臨臺灣老化社會，義大醫院關節置換術疾病照護團隊努力讓南臺灣的高齡者，擁有良好的生活品質。</p> <p> </p><p>The mission of E-Da Hospital is to strive for excellence, to innovate, and to provide high-quality services. Our strategy is to be a beacon of health in South Taiwan. To ensure patient-centered integrated care, we have implemented a quality management system and clinical audits to provide precise services to the highest level of excellence in all areas. Every year, all items are re-examined and adjusted in accordance with the status of the program. In combination with multifunction rehabilitation and Long-Term Care Service 2.0 , our team of physical therapists focuses on individualized education and professional consultation to reduce patients’ anxiety before and after surgery and increase their self-care abilities. As the population of Taiwan ages, our joint replacement team is taking a major step forward in advancing the quality of life for elderly people.</p> <p> </p>
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Schapira, Marilyn M., Arshia Faghri, Elizabeth A. Jacobs, Kathlyn E. Fletcher, Pamela S. Ganschow, Denise Gil, Alicia J. Smallwood, Cindy M. Walker, and Joan M. Neuner. "Communication and Shared Decision Making in the Breast Cancer Treatment Consultation: A Comparative Analysis of English- and Spanish-Speaking Patients." MDM Policy & Practice 4, no. 2 (July 2019): 238146831988165. http://dx.doi.org/10.1177/2381468319881651.
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Background. Communication in the breast cancer treatment consultation is complex. Language barriers may increase the challenge of achieving patient-centered communication and effective shared decision making. Design. We conducted a prospective cohort study among Spanish- and English-speaking women with stage 0 to 3 breast cancer in two urban medical centers in the Midwestern United States. Patient centeredness of care and decisional conflict were compared between Spanish- and English-speaking participants using the Interpersonal Processes of Care (IPC) and Decision Conflict Scale (DCS), respectively. Clinician behaviors of shared decision making were assessed from consultation audio-recordings using the 12-item Observing Patient Involvement in Decision Making (OPTION) scale. Multivariate regression analyses were conducted to control for differences in baseline characteristics and clinician specialty. Results. Fifteen Spanish-speaking and 35 English-speaking patients were enrolled in the study. IPC scores (median, interquartile range [IQR]) were higher (less patient centered) in Spanish- versus English-speaking participants in the domains of lack of clarity (2.5, 1-3 v. 1.5, 1-2), P = 0.028; perceived discrimination (1.1, 1-1 v. 1.0, 1-1), P = 0.047; and disrespectful office staff (1.25, 1-2 v. 1.0, 1-1), P < 0.0005 (Wilcoxon rank-sum test). OPTION scores (median, IQR) were lower in Spanish- versus English-speaking participants (21.9, 17.7-27.1 v. 31.3, 26.6-39.6), P = 0.001 (Wilcoxon rank-sum test). In multivariate analysis, statistically significant differences persisted in the IPC lack of clarity and disrespectful office staff between Spanish- and English-speaking groups. Conclusions. Our findings highlight challenges in cancer communication for Spanish-speaking patients, particularly with respect to perceived patient centeredness of communication. Further cross-cultural studies are needed to ensure effective communication and shared decision making in the cancer consultation.
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Kern, Lisa, Rina Dhopeshwarker, Alison Edwards, and Rainu Kaushal. "Patient experience at the time of practice transformation into Patient-Centered Medical Homes." European Journal for Person Centered Healthcare 1, no. 2 (November 18, 2013): 290. http://dx.doi.org/10.5750/ejpch.v1i2.662.
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Purpose: The Patient-Centered Medical Home (PCMH) is a model of primary care that is being promoted for its potential ability to improve patient-centeredness, improve quality and decrease costs. The effect of the PCMH on patient experience is not clear, with some reports suggesting that patient experience may worsen during transformation. We sought to measure patient experience at the time practices transform into PCMHs.Methods: We conducted a cross-sectional survey of 419 adult patients who were cared for by 85 primary care physicians across 12 practices in the Hudson Valley region of New York State. We measured patient experience, using the 35 questions in the Clinician & Group – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) – Adult Primary Care Questionnnaire (plus 14 additional questions drawn from other survey instruments) and compared the results to national CG-CAHPS benchmarks.Results: Patients’ experience overall was fairly positive, with 79% giving their doctors a ranking of 9 or 10 on a 10-point scale, with 10 being the highest. Patients’ experience in this sample was significantly more positive than the national benchmark on each of 6 subscales (p ≤ 0.05). Patients were generally most satisfied with individual face-to-face encounters with their physicians and somewhat less satisfied with processes of care (such as receiving results from a test or receiving follow-up after discharge from the hospital).Conclusions: This study suggests that medical home transformation does not adversely impact patient experience and identifies organizational processes of care that could potentially be improved with the patient-centered medical home.
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Mead, Holly, Ellie Andres, and Marsha Regenstein. "Underserved Patients’ Perspectives on Patient-Centered Primary Care." Medical Care Research and Review 71, no. 1 (November 27, 2013): 61–84. http://dx.doi.org/10.1177/1077558713509890.
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Gusmano, Michael K., Karen J. Maschke, and Mildred Z. Solomon. "Patient-Centered Care, Yes; Patients As Consumers, No." Health Affairs 38, no. 3 (March 2019): 368–73. http://dx.doi.org/10.1377/hlthaff.2018.05019.
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Hernandez, Brigida, Marco Damiani, T. Arthur Wang, Carolyn Driscoll, Peter Dellabella, Nicole LePera, and Michael Mentari. "Patient-Centered Medical Homes for Patients with Disabilities." Journal of Social Work in Disability & Rehabilitation 14, no. 1 (January 2, 2015): 61–75. http://dx.doi.org/10.1080/1536710x.2015.989562.
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Snaedal, Jon. "WMA´s perspectives on ethics and person centered medicine." International Journal of Person Centered Medicine 4, no. 3 (February 27, 2015): 159–62. http://dx.doi.org/10.5750/ijpcm.v4i3.478.
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The World Medical Association (WMA), an association of 9 million doctors worldwide, has been their leading body in medical ethics. The most respected policy of the WMA is the Declaration of Helsinki on research involving human subjects. Another one is the Lisbon Declaration on the rights of patients and the Association is currently processing its views on Person Centered Medicine. It has been decided to produce a white paper, describing the various terms that exist on person centeredness in health care. These terms differ in content and use but as their naming is similar, confusion on their meaning easily arises. The WMA needs to balance the views of associations from all corners of the world and the correct use of language and terms is of great importance. Based on this work, a clear policy document on Person Centered Medicine will be produced. Apart from this, person centeredness has been influencing various policies of the WMA for a long time but the actual terms used differ and the term “patient” is still the most prevalent in the various policy documents when addressing the persons physicians are serving on an individual basis.
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Tanenbaum, Sandra. "Person-centered health policy in the US: the case of the Patient-Centered Outcomes Research Institute (PCORI)." European Journal for Person Centered Healthcare 4, no. 2 (July 26, 2016): 396. http://dx.doi.org/10.5750/ejpch.v4i2.1068.
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The Patient-Centered Outcomes Research Institute, known as PCORI, was created by the U.S. healthcare reform legislation of 2010. The Affordable Care Act (ACA), sometimes referred to as “Obamacare,” provided for a public-private institute concerned primarily with funding and guiding comparative effectiveness research. Through a uniquely American blend of anti-statist ideology, corporate interest and disability activism, the determination of comparative effectiveness would also be tasked with patient-centeredness, a concept which PCORI has defined and operationalized. This represents a step toward person-centered healthcare, but unresolved issues of true personalization remain.
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Kelly-Campbell, Rebecca, and Vinaya Manchaiah. "How to Provide Accessible Hearing Health Information to Promote Patient-Centered Care." Perspectives of the ASHA Special Interest Groups 5, no. 1 (February 21, 2020): 173–80. http://dx.doi.org/10.1044/2019_persp-19-00044.
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Purpose This clinical focus article focuses on accessible hearing health information and is written in twofold. First, it outlines the connection between factors of patient-centered care, shared decision making, and health literacy on health outcomes. Second, it provides some practical strategies for providing and assessing accessible health information to promote patient-centeredness and shared decision making. Conclusion Health information accessibility will positively influence the treatment choices made by patients and the way in which they self-manage their health. Hearing health care professionals need to take proactive measures to ensure that the information provided in different mediums have easily readable language, adequate quality, suitability, understandability, and actionability to ensure accessibility of hearing health information.
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Langford, Aisha T., Devin R. Sawyer, Shari Gioimo, Carol A. Brownson, and Mary L. O'Toole. "Patient-Centered." Diabetes Educator 33, S6 (June 2007): 139S—144S. http://dx.doi.org/10.1177/0145721707304475.
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Witteman, Holly O., Gratianne Vaisson, Thierry Provencher, Selma Chipenda Dansokho, Heather Colquhoun, Michele Dugas, Angela Fagerlin, et al. "An 11-Item Measure of User- and Human-Centered Design for Personal Health Tools (UCD-11): Development and Validation." Journal of Medical Internet Research 23, no. 3 (March 16, 2021): e15032. http://dx.doi.org/10.2196/15032.
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Background Researchers developing personal health tools employ a range of approaches to involve prospective users in design and development. Objective The aim of this paper was to develop a validated measure of the human- or user-centeredness of design and development processes for personal health tools. Methods We conducted a psychometric analysis of data from a previous systematic review of the design and development processes of 348 personal health tools. Using a conceptual framework of user-centered design, our team of patients, caregivers, health professionals, tool developers, and researchers analyzed how specific practices in tool design and development might be combined and used as a measure. We prioritized variables according to their importance within the conceptual framework and validated the resultant measure using principal component analysis with Varimax rotation, classical item analysis, and confirmatory factor analysis. Results We retained 11 items in a 3-factor structure explaining 68% of the variance in the data. The Cronbach alpha was .72. Confirmatory factor analysis supported our hypothesis of a latent construct of user-centeredness. Items were whether or not: (1) patient, family, caregiver, or surrogate users were involved in the steps that help tool developers understand users or (2) develop a prototype, (3) asked their opinions, (4) observed using the tool or (5) involved in steps intended to evaluate the tool, (6) the process had 3 or more iterative cycles, (7) changes between cycles were explicitly reported, (8) health professionals were asked their opinion and (9) consulted before the first prototype was developed or (10) between initial and final prototypes, and (11) a panel of other experts was involved. Conclusions The User-Centered Design 11-item measure (UCD-11) may be used to quantitatively document the user/human-centeredness of design and development processes of patient-centered tools. By building an evidence base about such processes, we can help ensure that tools are adapted to people who will use them, rather than requiring people to adapt to tools.
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Apolikhin, O. I., V. I. Perkhov, I. A. Shaderkin, and A. V. Vladimirsky. "Модель пациент-центрированной системы организации медицинской помощи в урологии с использованием телемедицинских технологий." Experimental and Сlinical Urology 9, no. 1 (2018): 14–18. http://dx.doi.org/10.29188/2222-8543-2018-9-1-14-18.
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van der Eijk, Martijn, Frouke A. P. Nijhuis, Marjan J. Faber, and Bastiaan R. Bloem. "Moving from physician-centered care towards patient-centered care for Parkinson's disease patients." Parkinsonism & Related Disorders 19, no. 11 (November 2013): 923–27. http://dx.doi.org/10.1016/j.parkreldis.2013.04.022.
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Pereira, Claudia Maria Alves da Silva, Filipe Miranda Bernardes, Amanda Giroldo Minari, Carlos Henrique Martins da Silva, and Helena Borges Martins da Silva Paro. "Innovations in Curriculum Designs Do Not Guarantee Students’ Patient-Centered Attitudes Running Title: Curricula and Patient-Centered Attitudes." Revista Brasileira de Educação Médica 43, no. 4 (December 2019): 167–75. http://dx.doi.org/10.1590/1981-52712015v43n4rb20180198ingles.
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ABSTRACT Background Medical schools all around the world are engaged in curricular reforms aimed at fostering patient- and learner-centeredness, implementing curricular transformations in order to counterbalance the erosion of humanistic and professional values and the loss of idealism of recent graduate physicians. In Brazil, medical schools are facing the challenge of redesigning medical curricula towards more learner-centered and patient-centered approaches, stimulated by recent national medical education guidelines. However, desirable outcomes towards medical education have not been fully achieved. Aim To access medical students’ attitudes and determine predictors of medical students’ patient-centered attitudes among students from different curricular designs (traditional, innovative and advanced). Methods Medical students from 1st to 6th year from 21 Brazilian medical schools participating in the project for evaluating change and trends proposed by the Brazilian Association of Medical Education, with different stages of curricular designs (traditional, innovative and advanced), answered the Brazilian version of the Patient–Practitioner Orientation Scale (B-PPOS) and a questionnaire with curricular and sociodemographic variables. Results Brazilian medical students care more than they share information, power and responsibility (p < 0.001; d = 0.599). They are more concerned with the psychosocial context than with patient’s perspective (p < 0.001; d = 0.797) and share more power and responsibility than understanding (p < 0.001, d = 0.455). Female gender (B = 0.180), students from public schools (B = 0.132), year of medical training (B = 0.021), preference for future medical practice in public services (B = 0.053) and extracurricular activities (B = 0.068) were predictors of patient-centered attitudes among medical students (p < 0.05). Meanwhile, the father’s educational level and choice to study surgical specialties (p < 0.05) were predictors of less patient-centered attitudes among students. Different curricular designs were not associated with students’ patient-centered attitudes (p > 0.05). Conclusion tant predictors of patient-centered attitudes among medical students. Further research should investigate the direct influence of faculty professionalism development programs on students’ patient centered-attitudes.