Supporting lives lived whilst protecting lives saved during COVID-19: The relational invariant in person-centred care

Abstract

There has been an impressive development of nursing knowledge around the ethics, principles, frameworks, models and practices of person-centred care over the last 15 years, with colleagues from the Nordic countries making significant contributions to global knowledge across the discipline of nursing and beyond. A disciplinary challenge remains to map the variability in person-centred care with an aim to empirically clarify the invariant in person-centred care. Based on current research and practice, as well as the COVID-19 pandemic, this article argues that the relational aspect of person-centred care is such an invariant, building on the socially constructive notion of ‘personhood’ being a standing or status that is bestowed on one human being by another in the context of relationship and social being. During the current COVID-19 pandemic, several of the key determinants of person-centred care are under threat due to health service responses and/or infection control measures, such as keeping older adults safe, imposing relationship restrictions, social distancing and isolation (or the lack thereof). Clinical examples from an Australian health service are used to show how recognizing the relational invariant of person-centred aged care facilitated supporting lives lived whilst also protecting lives saved. The relational invariant to person-centred care is who we are, constructed or deconstructed by and with others; something that may have become more visible through the relational restrictions imposed due to COVID-19. Protecting relationality in life and care and advocating for both safe and person-centred care for those who need it most is now more important than ever.

A scoping review of patient engagement activities during COVID-19: More consultation, less partnership

“…Patient engagement activities through the use of other technology (e.g. social media, online-based interventions) were identified as a way of sharing information (n = 4) [ 36 , 42 , 59 , 60 ], creating connections (n = 4) [ 33 , 44 , 55 , 59 ] and gathering information (n = 6) [ 34 , 38 , 39 , 41 , 54 , 57 ].…”

“…Patient engagement activities using technology (digital health solutions, email, teleconferencing) for creating or maintaining social connections were identified in four articles [ 33 , 44 , 55 , 59 ]. The importance of maintaining person-centred care, which included promoting communication between patients, families and healthcare providers and limiting relationship and social restrictions during the pandemic was discussed in two articles [ 44 , 55 ]. Residents at a rural healthcare facility in Australia remained socially engaged with their family and friends through the use of email and social media [ 55 ].…”

“…The importance of maintaining person-centred care, which included promoting communication between patients, families and healthcare providers and limiting relationship and social restrictions during the pandemic was discussed in two articles [ 44 , 55 ]. Residents at a rural healthcare facility in Australia remained socially engaged with their family and friends through the use of email and social media [ 55 ].…”

“…We also saw some examples of broader community engagement, also through use of technology, to not only share information, but to create a space for the community to connect, ask questions or share concerns [ 42 , 55 , 59 ]. Given the short time window of our scoping review, it is not surprising that individual engagement such as virtual consultations and home monitoring were implemented and published more quickly compared to other levels of engagement along Carman’s continuum (e.g.…”

Developmental Evaluation of the CHOICE+ Champion Training Program

“…This is a noted structure component in the intervention theory. As residential care homes continue to weather the COVID-19 pandemic, there is an even greater need to provide ongoing training to empower leadership and staff in ways that emphasize and protect relationships and social connections within these communities (Cammer et al, 2013;Evardsson et al, 2020;Estabrooks et al, 2020).…”