A Preference-Based Model of Care: An Integrative Theoretical Model of the Role of Preferences in Person-Centered Care

Abstract

Knowledge of individuals’ everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person–environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.

Living Well With Dementia: Factors Associated With Nursing Home Residents' Affect Balance

“…Frameworks that focus on behavioral symptoms operate from a deficit perspective and may not be appropriate for modeling positive outcomes such as affect balance. Strong conceptual frameworks from a strength perspective are needed to guide future research on affect balance and are being developed (Van Haitsma et al, 2019). More research is needed to design and evaluate staff communication interventions and their effect on affect balance.…”

Evaluating the Implementation of a Pragmatic Person-Centered Communication Tool for the Nursing Home Setting: PAL Cards

“…The concept of recreational preference congruence has been put forward as one way to operationalize and measure person-centered care. Recreational preference-congruence is the match between important resident preferences for how they spend their leisure time and attendance/ engagement with activities offered, which is hypothesized to lead to greater well-being (VanHaitsma et al, 2020). Methods of tracking recreational preference congruence have been developed and tested (Van Haitsma et al, 2016) and prior research has found that having more important preferences is associated with greater preference-congruent care.…”

Patient preferences for different tooth replacement strategies for the edentulous mandible: A willingness-to-pay analysis

“…As such, assessing patient preferences is now acknowledged as an essential element of patient-centered healthcare [8] since it encompass all aspects of healthcare interventions on patients' well-being [7,9].…”