What constitutes patient-centred care for women: a theoretical rapid review

Abstract

BackgroundWomen experience disparities in health care delivery and outcomes. Patient-centred care for women (PCCW) is needed. This study examined how PCC has been conceptualized and operationalized in women’s health research.MethodsWe conducted a theoretical rapid review of PCCW in MEDLINE, EMBASE, CINAHL and SCOPUS from 2008 to 2018 for studies involving women aged 18 years or greater with any condition, and analyzed data using an established 6-domain framework of patient-centred communication.ResultsWe included 39 studies, which covered the following clinical areas: maternal care, cancer, diabetes, HIV, endometriosis, dementia, distal radius fracture, overactive bladder, and lupus erythematosus. The 34 (87.2%) studies that defined or described PCC varied in the PCC elements they addressed, and none addressed all 6 PCC domains. Common domains were exchanging information (25, 73.5%) and fostering the patient-clinician relationship (22, 64.7%). Fewer studies addressed making decisions (16, 47.1%), enabling patient self-management (15, 44.1%), responding to emotions (12, 35.3%), or managing uncertainty (1, 2.9%). Compared with mixed-gender studies, those comprised largely of women more frequently prioritized exchanging information above other domains. Few studies tested strategies to support PCCW or evaluated the impact of PCCW; those that did demonstrated beneficial impact on patient knowledge, satisfaction, well-being, self-care and clinical outcomes.ConclusionsStudies varied in how they conceptualized PCCW, and in many it was defined narrowly. Few studies examined how to implement or measure PCCW; thus, we lack insight on how to operationlize PCCW. Thus, further research is needed to confirm this, and whether PCCW differs across conditions, knowledge needed to inform policies, guidelines and measures aimed at improving health care and associated outcomes for women.

Information and Relationship Functions of Communication between Pregnant Women and Their Health Care Providers

“…As women approach parenthood, they might experience dissonance between the medicalized approach to communication from their healthcare providers and the more personalized and relational expectations they have while expecting (Horstman et al, 2017;Matthias, 2010). Information functions of communication are often prioritized, even in studies of PCC (Ramlakhan et al, 2019). Our results speak to the importance of relationship functions of communication and to ways providers might improve care by relating to patients.…”

“…Notably little research has examined women's perspectives to document what constitutes PCC for women, and work that has done so prioritizes illness contexts with less attention to pregnancy (Ramlakhan et al, 2019;Yeh & Nagel, 2010). Occupying the role of "patient" is inherently negatively valenced because it connotes a problem or imbalance (Lambert et al, 1997).…”

Towards a Reference Architecture for Female-Sensitive Drug Management

“…Personcentered care benefits both the patient, e.g., through enhanced knowledge, improved relationship with providers, service experience and satisfaction, treatment compliance and health outcomes, as well as the health system, e.g., through cost-effective service delivery [30]. Nevertheless, many patients, especially females, do not experience person-centered care due to a lack of insight into operationalizing person-centered care for females [31]. One explanation is the lack of attention paid to person-centered care in medical guidelines [30].…”

“…An already established approach is the use of recommender systems through the application of mHealth, based on explainable AI. However, in the analysis, no contributions could be identified dealing with the development of IS for shared decision-making to tackle the prevailing sex differences despite the frequently discussed relevance of this gap [31]. Therefore, our study aims to develop a reference architecture to support further developments in this field.…”

Gender disparities in clinical practice: are there any solutions? Scoping review of interventions to overcome or reduce gender bias in clinical practice

“…These contributions from research on the relevance of gender inequalities in health care have not gone along with research on effective interventions that could provide health workers with practical tools that facilitate the application of gender oriented clinical interventions. In addition, the lack of patient centred care for women has been reported recently [ 21 – 23 ]. In fact, Celik et al’s 2010 review of the available literature, [ 24 ] the authors failed to find references that contributed to the development of procedures to increase health professionals’ skills related to gender.…”