Interventions for providers to promote a patient-centred approach in clinical consultations

Dwamena, Francesca C.; Holmes‐Rovner, Margaret; Gaulden, Carolyn M; Jorgenson, Sarah; Sadigh, Gelareh; Sikorskii, Alla; Lewin, Simon; Smith, Robert C.; Coffey, John; Olomu, Adesuwa; Beasley, Michael A.

doi:10.1002/14651858.cd003267.pub2

Cited by 701 publications

(582 citation statements)

References 211 publications

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“…Evidence suggests that the consultation time requirements are initially higher when practitioners are learning new patient-centred communication skills but reduce once they are proficient (Kurtz 2002). Gaining proficiency in clinical yarning may require training that includes knowledge and a theoretical rationale, skills practice, and reflection and feedback processes (Dwamena et al 2012), similar to techniques we have used previously in student education (see Box 2). A yarning style of consultation takes less time once a relationship has developed (e.g.…”

Section: Challenges To Clinical Yarningmentioning

confidence: 99%

‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

Lin

Green

Bessarab

2016

Aust. J. Prim. Health

134

135

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Abstract. Although successful communication is at the heart of the clinical consultation, communication betweenAboriginal patients and practitioners such as doctors, nurses and allied health professionals, continues to be problematic and is arguably the biggest barrier to the delivery of successful health care to Aboriginal people. This paper presents an overarching framework for practitioners to help them reorientate their communication with Aboriginal patients using 'clinical yarning'. Clinical yarning is a patient-centred approach that marries Aboriginal cultural communication preferences with biomedical understandings of health and disease. Clinical yarning consists of three interrelated areas: the social yarn, in which the practitioner aims to find common ground and develop the interpersonal relationship; the diagnostic yarn, in which the practitioner facilitates the patient's health story while interpreting it through a biomedical or scientific lens; and the management yarn, that employs stories and metaphors as tools for patients to help them understand a health issue so a collaborative management approach can be adopted. There is cultural and research evidence that supports this approach. Clinical yarning has the potential to improve outcomes for patients and practitioners.

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Section: Challenges To Clinical Yarningmentioning

confidence: 99%

‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

Lin

Green

Bessarab

2016

Aust. J. Prim. Health

134

135

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“…[30,31] For example, when teaching about chronic disease management, engaging patients in their learning activates them with the knowledge, skills and confidence needed to manage their long-term illnesses effectively. [32] Engaging patients in their care has demonstrable benefits in reducing adverse events in hospitalized patients, [33] improving patient satisfaction, [34] and raising self-management adherence. [35] Two specific skills need to be learned for effective patient teaching and evaluated as process measures of the quality of patient teaching:…”

Section: Patient Engagementmentioning

confidence: 99%

Teaching students to teach patients: A theory-guided approach

Candela

Piacentine

Bobay

et al. 2018

JNEP

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Nurses in every setting provide patient teaching on a routine basis, often several times a day. Patient teaching skills are essential competencies to be developed during pre-licensure nursing education. While students learn what to teach for specific conditions, they often lack competence in how to teach in ways that individualize and optimize patient learning. The ultimate goal of patient teaching is to arm patients with the knowledge and skills, and the desire and confidence in their ability to reach their targeted health outcomes. We describe the creation of a theoretical framework to guide development of patient teaching skills. The framework, rooted in the contemporary health care values of patient-centered care, is a synthesis of four evidence-based approaches to patient teaching: patient engagement, motivational interviewing, adult learning theory, and teach-back method. Specific patient teaching skills, derived from each of the approaches, are applied within the context of discharge teaching, an important nursing practice linked to patient outcomes. This exemplar emphasizes the use of critical teaching process skills and targeted informational content. An online student learning module based on the theoretical framework and combined with simulation experiences provides the nurse educator with one strategy for use with nursing students. The theoretical framework has applicability for skill development during pre-licensure education and skill refinement for nurses in clinical practice.

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“…A implantação da PCC exige mudança na cultura das organizações e das profissões de saúde. Há diversos instrumentos de avaliação que podem ser usados para caracterizar o grau de "centralidade" no cliente, tanto no nível institucional, quanto no nível dos profissionais e dos pacientes individualmente 21,[23][24][25] . Por último, a formação de profissionais envolve investimentos financeiros, mas ao longo do tempo, os benefícios podem ultrapassar os custos 19 .…”

Section: Desafios Para a Implantação Da Pccunclassified

Prática centrada no cliente na reabilitação: definição, instrumentos e desafios

Vaz

Jubilini

Queiroz

2017

Rev. Ter. Ocup. Univ. São Paulo (Online)

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Vaz DV, Jubilini LG, Queiroz LC. Prática centrada no cliente na reabilitação: definição, instrumentos e desafios. Rev Ter Ocup Univ São Paulo. 2017 jan.-abr.;28(1):122-7. RESUMO:Introdução: Na reabilitação, a habilidade do paciente em lidar com a sua condição de saúde e tomar decisões, sua motivação e sua adesão, são determinantes para os desfechos terapêuticos. A prática centrada no cliente (PCC) reconhece e promove a centralidade dos interesses de pacientes e por isso seu conhecimento é fundamental para o avanço da reabilitação. Objetivos: i) identificar os fundamentos da PCC, ii) descrever instrumentos para sua implementação, iii) registrar resultados da PCC, e iv) analisar as principais dificuldades e benefícios da PCC. Método: Revisão narrativa a partir de bancos de dados e cruzamento de referências. Resultados: segundo estudos revisados, a PCC é uma abordagem clínica colaborativa e empoderadora do paciente, que reconhece-o no centro do processo decisório, aumentando a adequação do cuidado. Diferentes instrumentos simples podem ser imediatamente adotados na clínica. Ainda poucos estudos documentam resultados da PCC na reabilitação. Para implantação da PCC é necessário vencer desafios no nível individual de terapeutas e pacientes e no nível institucional de serviços de saúde. ABSTRACT: Introduction: in rehabilitation, a patient's ability cope with a health condition, make decisions, find motivation and adhere to treatment are determinants of therapeutic outcomes. Client-centered practice (CCP) recognizes and promotes patients' interests as central to care delivery. CCP is essential for the advancement of rehabilitation. Objectives: i) identify the fundamentals of CCP, ii) describe clinical instruments available for implementing it, iii) register CCP results obtained so far, iv) analyze the main barriers and benefits of CCP. Methods: narrative review of literature from databases and reference lists. Results: based on reviewed studies, CCP is a collaborative approach to clinical practice that aims to empower patients and recognize them at the center of the decision making process, in order to deliver better care. Several simple instruments can be immediately used in clinical practice. Few studies have investigated effects of CCP in rehabilitation. Challenges at the individual level of therapists and patients as well as at the institutional level of health services need to be met in order to implement CCP. DESCRITORES:

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Interventions for providers to promote a patient-centred approach in clinical consultations

Cited by 701 publications

References 211 publications

‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

Teaching students to teach patients: A theory-guided approach

Prática centrada no cliente na reabilitação: definição, instrumentos e desafios

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