Twenty years on – has patient-centered care been equally well integrated among medical specialties?

Lim, Sarah Ashley; Khorrami, Amir; Wassersug, Richard J.

doi:10.1080/00325481.2021.2009237

Cited by 8 publications

(2 citation statements)

References 33 publications

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“…Patient-centered care can improve health outcomes by addressing each patient's individual needs, increasing patients' ownership of their health decisions, and improving patient-physician relationships [1][2][3][4]. In obstetrics, patient-centered care is recognized as important, yet providing this care during pregnancy remains challenging [5][6][7][8] as providers need to gather information from patients about their health and well-being throughout their pregnancies. To facilitate the gathering of person-centered information, there is increasing interest in the role of patients in reporting health-related data to their providers to inform patient-centered care.…”

Section: Introductionmentioning

confidence: 99%

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

MacEwan,

Olvera,

Jonnalagadda

et al. 2024

JMIR Form Res

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Background There is increasing interest in using patient-generated health data (PGHD) to improve patient-centered care during pregnancy. However, little research has examined the perspectives of patients and providers as they report, collect, and use PGHD to inform obstetric care. Objective This study aims to explore the perspectives of patients and providers about the use of PGHD during pregnancy, including the benefits and challenges of reporting, collecting, and using these data, as well as considerations for expanding the use of PGHD to improve obstetric care. Methods We conducted one-on-one interviews with 30 pregnant or postpartum patients and 14 health care providers from 2 obstetrics clinics associated with an academic medical center. Semistructured interview guides included questions for patients about their experience and preferences for sharing PGHD and questions for providers about current processes for collecting PGHD, opportunities to improve or expand the collection of PGHD, and challenges faced when collecting and using this information. Interviews were conducted by phone or videoconference and were audio recorded, transcribed verbatim, and deidentified. Interview transcripts were analyzed deductively and inductively to characterize and explore themes in the data. Results Patients and providers described how PGHD, including physiologic measurements and experience of symptoms, were currently collected during and between in-person clinic visits for obstetric care. Both patients and providers reported positive perceptions about the collection and use of PGHD during pregnancy. Reported benefits of collecting PGHD included the potential to use data to directly inform patient care (eg, identify issues and adjust medication) and to encourage ongoing patient involvement in their care (eg, increase patient attention to their health). Patients and providers had suggestions for expanding the collection and use of PGHD during pregnancy, and providers also shared considerations about strategies that could be used to expand PGHD collection and use. These strategies included considering the roles of both patients and providers in reporting and interpreting PGHD. Providers also noted the need to consider the unintended consequences of using PGHD that should be anticipated and addressed. Conclusions Acknowledging the challenges, suggestions, and considerations voiced by patients and providers can inform the development and implementation of strategies to effectively collect and use PGHD to support patient-centered care during pregnancy.

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Section: Introductionmentioning

confidence: 99%

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

MacEwan,

Olvera,

Jonnalagadda

et al. 2024

JMIR Form Res

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“…Over the past two decades healthcare systems have shifted to a more holistic, patient-centred care system (Lim et al, 2022). Patient-centred care was defined in 2001 by the Institute of Medicine as 'providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions' (Institute of Medicine, 2001).…”

Section: Introductionmentioning

confidence: 99%

Toward a paradigm shift in healthcare

van der Veen

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This thesis examines the foundations and effects of the BigMove intervention, an innovative approach to person-centred, integrated, and community-based care for people with physical and mental health conditions. The intervention aims to improve participants’ functioning, capabilities, and quality of life while fostering behaviour change. As the number of adults living with multimorbidity continues to grow, healthcare systems face increasing challenges in providing adequate care. Current interventions, often targeting specific diseases and their associated health-related risk behaviours, frequently fail to meet the needs of people with multimorbidity. A person-centred, integrated, community-based intervention that goes beyond isolated, disease-oriented approaches may improve outcomes beyond narrow disease-specific aspects. Over the past decades, two frameworks have significantly contributed to the transition towards more integrated and person-centred care: the International Classification of Functioning, Disability, and Health (ICF) and the Capability Approach (CA). The joint use of these frameworks has three advantages; (1) it provides the opportunity to increase patients’ influence and choice regarding their functioning and to give them a more equal position in the delivery of care, (2) it enables an evaluation of functionings and capabilities from the perspective of patients; and (3) it provides a basis for recording self-perceived functioning and evaluation of goals suitable for use in research and quality improvement. A practical example is presented through a unique e-health application used in the intervention that allows a person to self-assess, record, and evaluate their self-perceived functioning, as well as formulate related goals and action plans. The theoretical frameworks reflected in the intervention are the Capability Approach (CA) and Self-Determination Theory. Essential elements of the intervention are motivational interviewing, functional goal setting using the ICF, cognitive behavioural therapy, enjoyment, group support and physical activity. The design combines individual sessions and group sessions. Furthermore, the intervention incorporates collaboration between healthcare professionals. Examining data on participants' self-perceived functioning, goals, and action plans before and after experiencing at least 120 days demonstrated that the application can be used to record self-perceived functioning, goals, and action plans and capture changes over time. The evaluation of outcomes on self-perceived health, quality of life, coping behaviour, and social and mental functioning after 120 days in the intervention, indicated significant improvements. The observed changes can be considered clinically relevant improvements. Based on the theoretical perspectives and the findings of this thesis, a novel model to capture the process of behaviour change in the intervention is presented: the Model of Complex Dynamic Behaviour Change. Finally, recommendations for policy, practice, education, and future research are made. More emphasis should be placed on integrating relational autonomy and freedom of choice into care pathways. The use of the ICF to assess self-perceived functioning, goals, and action plans could provide a novel method of evaluating person-centred care as well as provide information for policymakers to shape future policies. This thesis offers valuable insights for future development and evaluation of interventions for individuals with multimorbidity.

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Beyond standard treatment: A qualitative descriptive study of cancer patients' perceptions of hypnotherapy in cancer care

Szmaglinska,

Andrew,

Massey

et al. 2024

Complementary Therapies in Clinical Practice

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Twenty years on – has patient-centered care been equally well integrated among medical specialties?

Cited by 8 publications

References 33 publications

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

Toward a paradigm shift in healthcare

Beyond standard treatment: A qualitative descriptive study of cancer patients' perceptions of hypnotherapy in cancer care

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