Aligning care with the personal values of patients with complex care needs

Abstract

Objective To identify opportunities to align care with the personal values of patients from three distinct groups with complex medical, behavioral, and social needs. Data Sources/Study Setting Between June and August 2019, we conducted semi‐structured interviews with individuals with complex care needs in two integrated health care delivery systems. Study Design Qualitative study using semi‐structured interviews. Data Collection Methods We interviewed three groups of patients at Kaiser Permanente Washington and Kaiser Permanente Colorado representing three distinct profiles of complex care needs: Group A (“obesity, opioid prescription, and low‐resourced neighborhood”), Group B (“older, high medical morbidity, emergency department, and hospital use”), and Group C (“older, mental and physical health concerns, and low‐resourced neighborhood”). These profiles were identified based on prior work and prioritized by internal primary care stakeholders. Interview transcripts were analyzed using thematic analysis. Principal Findings Twenty‐four patients participated; eight from each complex needs profile. Mean age across groups was 71 (range 48–86) years. We identified five themes common across the three groups that captured patients' views regarding values‐aligned care. These themes focused on the importance of care teams exploring and acknowledging a patient's values, providing access to nonphysician providers who have different perspectives on care delivery, offering values‐aligned mental health care, ensuring connection to community‐based resources that support values and address needs, and providing care that supports the patient plus their family and caregivers. Conclusions Our results suggest several opportunities to improve how care is delivered to patients with different complex medical, behavioral, and social needs. Future research is needed to better understand how to incorporate these opportunities into health care.

Motivation and preferences for learning of patients with COPD or asthma and their significant others in pulmonary rehabilitation: a qualitative study

“…In this context, spending time with family may serve as a motivational factor for learning since acquiring knowledge and skills may lead to the opportunities for social engagement again. A similar value as spending time with family was found previously, in which relationships with significant others were identified as important for patients with chronic diseases (49,50).…”

Echoes of Support: A Qualitative Meta-Synthesis of Caregiver Narratives in Lung Cancer Care

“…Further, the interventions offered might not align with the specific needs or preferences of certain caregivers. Delivering care that aligns with individual values involves blending conventional standardized care methods with personalized approaches that cater to the diverse and varied needs of caregivers [44]. Recognizing the heterogeneous nature of caregivers' needs is pivotal in this process.…”

Interprofessional Collaboration in Complex Patient Care Transition: A Qualitative Multi-Perspective Analysis

“…An initial literature search regarding complex patient care transitions identified topics that were included in the interview guide. These topics encompass factors influencing complex patient care transitions [34], personal experience regarding such care transitions [35,36], and the potential of IPC in this context [21,37]. The interview guide was validated by a research team member (K.-U.S.) before its first use.…”