Patient-Centered Care for Women: Delphi Consensus on Evidence-Derived Recommendations

Abstract

Patient-centered care (PCC) could reduce gender inequities in quality of care. Little is known about how to implement patient-centered care for women (PCCW). We aimed to generate consensus recommendations for achieving PCCW.Methods: We used a 2-round Delphi technique. Panelists included 21 women of varied age, ethnicity, education, and urban/ rural residence; and 21 health professionals with PCC or women's health expertise. Panelists rated recommendations, derived from prior research and organized by a 6-domain PCC framework, on a 7-point Likert scale in an online survey. We used summary statistics to report response frequencies and defined consensus as when $85% panelists chose 5 to 7.Results: The response rate was 100%. In round 1, women and professionals retained 46 (97.9%) and 42 (89.4%) of 47 initial recommendations, respectively. The round 2 survey included 6 recommendations for women and 5 recommendations for professionals (did not achieve consensus in round 1 or were newly suggested). In round 2, women retained 2 of 6 recommendations and professionals retained 3 of 5 recommendations. Overall, 49 recommendations were generated. Both groups agreed on 44 (94.0%) recommendations (13 retained by 100% of both women and clinicians): fostering patient-physician relationship (n = 11), exchanging information (n = 10), responding to emotions (n = 4), managing uncertainty (n = 5), making decisions (n = 8), and enabling patient self-management (n = 6). Conclusion:The recommendations represent the range of PCC domains, are based on evidence from primary research, and reflect high concordance between women and professional panelists. They can inform the development of policies, guidelines, programs, and performance measures that foster PCCW.

How is patient‐centred care conceptualized in obstetrical health? comparison of themes from concept analyses in obstetrical health‐ and patient‐centred care

“…Our review identified a few studies of PCC among women, and those studies failed to fully conceptualize or describe PCC. We subsequently explored women's and clinicians' views about what constitutes PCC, 18 and generated recommendations by which to achieve PCC for women 19 …”

Physician behaviours that optimize patient‐centred care: Focus groups with migrant women

“…We mapped findings to a PCC framework as a means of thoroughly exploring elements of the health-care experience important to migrant women. 9,[18][19][20] In so doing, we further validated the Framework of PCC for Women and revealed key elements of PCC desired by migrant women. As a practical output, we generated 28 approaches that physicians can adopt to optimize PCC for migrant women.…”

“…We developed questions based on a comprehensive PCC framework that was rigorously developed by McCormack et al 9 with patients and clinicians, and then tailored based on interviews about PCC with diverse women who were largely Caucasian. [18][19][20] The Framework of PCC for Women is organized in six domains (foster a healing relationship, exchange information, address concerns, manage uncertainty, share decisions and enable self-care) and identifies strategies that clinicians can use to achieve each domain (File S1). We used a semistructured question guide (File S2) to understand whether migrant women experienced PCC according to its multidimensional components, and which domains were met or not met.…”

Evolución de la ginecología peruana al Bicentenario, y el futuro

“…Durante los últimos años, la atención centrada en el paciente ha sido un foco intenso de los líderes de la atención sanitaria, así como un sinónimo de excelencia en la prestación de la atención (66) . Una de las innovaciones tiene en cuenta a la mujer, y la atención centrada en la mujer es considerada ahora parte de la atención sanitaria de las mujeres (67) . Sin embargo, los pacientes siguen teniendo poca influencia en los asuntos que más les afecta.…”