Achieving Person-Centred Health Systems

North, Jonathan

doi:10.1017/9781108855464

Cited by 45 publications

(12 citation statements)

References 362 publications

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“…There is a worldwide effort to increase people's empowerment, rights and patient participation in health care [1,2]. Person-centred care (PCC) is a core phenomenon within this endeavour that is growing in popularity among policymakers, leaders, health care professionals (HCP) and other stakeholders in health care [1,3]. PCC can be viewed as the co-creation of health care in the actual meeting between HCPs and patients.…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care

Fridberg

Wallin

Wallengren

et al. 2020

BMC Health Serv Res

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Background Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients’ perceptions of PCC. Further aims were to evaluate its content and measurement properties using a mixed-methods approach entailing Rasch and qualitative content analyses. Methods The study was conducted in three iterative phases. Phase one included six key informants to gain a broad view of the concept. Phase two entailed a Delphi study involving two rounds with eight experts who generated ratings on relevance, readability, comprehensiveness and suggestions for revision. Data were analysed using the Item Content Validity Index in conjunction with qualitative comments to improve the questionnaire. Phase three was performed using a mixed-methods design. Quantitative data were collected from patients (n = 553) responding to the questionnaire who were recruited from six in- and outpatient care units in a health care region in Sweden. Data was analysed using the Rasch measurement model. Qualitative data were based on the respondents’ free-text comments, cognitive interviews (n = 10) and field notes, and then analysed with deductive content analysis. Results A questionnaire was developed and operationalised based on the information given by key informants in phase one and then validated for its content by experts in phase two. In phase three Rasch analyses revealed problems with targeting, thresholds and two misfitting items. These problems were corroborated by data from the qualitative analyses, which also revealed some issues of wording and interpretation of items. When thresholds were resolved and two items removed, the questionnaire met the assumptions of the Rasch model. Conclusions Experts gave the questionnaire content high ratings and it met measurement requirements assumed by the Rasch model after revisions. Those problems on targeting that remain need to be addressed in future studies. Meanwhile, we regard the questionnaire as of sufficient quality to be useful in benchmarking PCC.

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Section: Introductionmentioning

confidence: 99%

Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care

Fridberg

Wallin

Wallengren

et al. 2020

BMC Health Serv Res

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show abstract

“…Patient involvement in decisions is essential to deliver person-centered care (PCC), in which the patient is an active participant in decisions about their care plan. The goal of PCC is to include the patient´s preferences, needs, and values in clinical decisions [ 10 , 11 ]. Through a meaningful dialogue where an exchange of information on options, benefits and harms, and what is important to the patient, the healthcare professional will involve the patient in decisions about planning care and treatment [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Patient Involvement in Decisions regarding Emergency Department Discharge: A Multimethod Study

Rasmussen

Lomborg

Iversen

et al. 2023

Emergency Medicine International

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Background. Unmet care needs and more than one reasonable discharge solution have been identified among patients in the emergency department. Less than half of the patients attending emergency care have reported being involved in decisions to the degree they have wanted. Having a person-centered approach, such as involving patients in decisions regarding their discharge, has been reported as being associated with beneficial outcomes for the patient. Aim. The aim of the study was to explore the extent of patients’ involvement in discharge planning in acute care and how patient involvement in decisions regarding discharge planning is managed in clinical practice. Methods. A multimethod study, including both quantitative and qualitative data, was carried out. The quantitative part included a descriptive and comparative analysis of additional data from the patient’s medical records and patient’s responses to the CollaboRATE questionnaire. The qualitative part included a content analysis of notes from field studies of interactions between healthcare professionals and patients. Results. A total of 615 patients from an emergency department at a medium-sized hospital completed the questionnaire. Roughly, a third gave top-box scores (36%), indicating optimal involvement in decisions. Two factors, being discharged home and not readmitted, were significantly associated with the experience of being involved. In clinical practice, there was a focus on symptoms, and diagnostic tools and choice of treatment were decisive for the further care trajectory of the patients. Speed and low continuity left limited opportunities for dialogue to uncover patients’ preferences. At the same time, the patients did not expect to be involved. Conclusions. Two out of three patients did not experience being involved in decisions regarding emergency department discharge. The interactions reflected an organizational structure in which the conditions for patient involvement were limited. Uncovering opportunities and initiatives to increase the number of patients who experience being involved in decisions is important tasks for the future.

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“…Over the past few decades, healthcare organisations in Western countries have aimed for a more collaborative approach to healthcare, where patients are increasingly regarded as active partners in their care, rather than passive recipients (1). This pursuit stems from legislations and policy directives urging healthcare organisations to reflect a growing recognition of the importance of person-centred care, which takes into account the individual's condition, needs, and preferences (2).…”

Section: Introductionmentioning

confidence: 99%

“…The concept of patient participation should be recognised as a fundamental value in healthcare. This is imperative, as it is known to result in favourable outcomes such as improved healthcare quality (3), patient safety (4), health related patient outcomes (5) such as enhanced well-being (1,(6)(7)(8), and patient satisfaction (9). However, while healthcare organisations are struggling to position the patient at the centre of care, the global population is also ageing.…”

Section: Introductionmentioning

confidence: 99%

Patient Participation in Kidney Care : Patients’ and professionals’ perspectives

Hurtig

2023

Linköping University Medical Dissertations

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When I was a teenager, a close relative of mine became seriously ill and passed away within a few months of fighting her illness. Looking back, I remember how important it was for us -her next of kin -to ensure that her needs and preferences were taken into consideration by the healthcare professionals. Later, as a registered nurse, and subsequently a midwife, I have maintained the ideal to recognise the patient as a person, acknowledge their individual situations, and help them to make their voices heard. In 2018, I had the opportunity to become a research assistant in the pilot project on patient participation that eventually became part of my thesis. The project addressed individuals undergoing treatment with haemodialysis, and I noted the many similarities between obstetric care and care for persons with long-term conditions. In both contexts, mutual relationships and exchange of knowledge and information between patients and healthcare professionals are essential. What appealed to me was the prospect of engaging in research that could make a difference. The research project addressed a gap that I recognised from everyday practice, where patients and healthcare professionals seldom talk about or engage in discussions about their conceptualisation of patient participation. How do they then understand its significance and the factors that either enable or hinder patient participation? Does participation align with the individual needs and preferences of patients? Is patient participation really facilitated? Despite the long-standing recognition of its significance, there is still much to learn about patient participation. As a researcher and healthcare professional, I hope to promote a coproduced approach to patient participation, wherein the perspectives of patients themselves are actively integrated and valued.

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Achieving Person-Centred Health Systems

Abstract: PaperbackCambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Cited by 45 publications

References 362 publications

Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care

Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care

Patient Involvement in Decisions regarding Emergency Department Discharge: A Multimethod Study

Patient Participation in Kidney Care : Patients’ and professionals’ perspectives

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