scholarly journals Resident and Family Engagement in Care Conferences: Important Processes and Supporting Strategies

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 270-270
Author(s):  
Elizabeth Cox ◽  
Thuy Dan Tran ◽  
Hannah Tepsa ◽  
Tonya Roberts
Keyword(s):  
Decision Making ◽  
Family Engagement ◽  
Well Being ◽  
Self Determination ◽  
Tool Development ◽  
Engagement In Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Virtual Meetings ◽  
Existing Structure

Abstract Self-determination is a core value of person-centered care. Research has shown residents and families want to be involved in decisions about care. Care conferences are one existing structure where residents and families can engage in decision-making about care goals. However, there are few tools to support effective engagement. To inform future tool development, this study sought to understand what resident and family stakeholders value about engaging in care conferences. In virtual meetings, 16 stakeholders identified 3 key areas of engagement: being informed about health/well-being, influencing care goals, and advocating for needs. They indicated current approaches do not achieve these engagement goals, which is particularly problematic during COVID when families cannot engage in person. Stakeholders offered ideas for supporting engagement such as provision of data before the conference. The study has implications for individualizing care conferences and encouraging resident and family engagement in decision-making both during and beyond COVID.

Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Francesca Baroni ◽  
Marco Tramontano ◽  
Nicola Barsotti ◽  
Marco Chiera ◽  
Diego Lanaro ◽  
...  
Keyword(s):  
Decision Making ◽  
Structure Function ◽  
Clinical Reasoning ◽  
Well Being ◽  
Narrative Review ◽  
Care Process ◽  
Person Centered Care ◽  
Starting Point ◽  
Centered Care ◽  
Function Models

Abstract Objectives The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon. Methods A structured narrative review was conducted. A database search was conducted using Pubmed, ScienceDirect, and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included. Results Twenty-five findings were reported and grouped into two main themes: 1) Debate on models and theoretical frameworks for osteopathic care; 2) Clinical reasoning and decision-making process in the osteopathic field. Conclusions An integrated osteopathic care approach based on the structure/function models represents a starting point to establish a shared osteopathic diagnostic and clinical reasoning and an evidence-informed practice promoting health in an interdisciplinary person-centered care process. The present review highlights the limited amount of literature on using osteopathic conceptual models in decision-making and treatment strategies. A research plan is required to develop a common framework for an evidence-based osteopathic practice that promotes well-being in an interdisciplinary person-centered care process.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

Listen and you will see the person through the dementia

2022 ◽  
Vol 7 (2) ◽  
pp. 88-97
Author(s):  
Rita Estrada
Keyword(s):  
Communication Skills ◽  
Psychological Assessment ◽  
Self Determination Theory ◽  
Psychological Needs ◽  
Basic Psychological Needs ◽  
Self Determination ◽  
Supportive Psychotherapy ◽  
Psychological Need ◽  
Person Centered Care ◽  
Centered Care

Dementia is an ever-increasing health and social problem, with a growing number of people being affected worldwide. As dementia progresses, dependency on others increases, requiring the presence of caregivers. Caregivers tend to focus on the diagnosis itself – dementia – which makes it difficult to see the person in their uniqueness. The person is there, and can be seen by listening, which requires time and communication skills. The voices of older adults living with several types of dementia, collected while working as a psychologist in a nursing home, are presented in the first person to bring forward the person they are. These excerpts of interactions illustrate the basic psychological need of relatedness, which is built through interaction, stories, and touch, and the needs of competence and autonomy. The framework of this paper encompasses validation therapy, person-centered care, and self-determination theory. Two conclusions emerge: Seeing the person through the dementia enables an adequate psychological assessment and a helpful supportive psychotherapy, and it also makes us acknowledge and help satisfy the three basic psychological needs of relatedness, competence, and autonomy.

scholarly journals Healthcare professionals’ practice and interactions in older peoples’ cross-sectoral clinical care trajectories when acutely hospitalized - a qualitative observation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiken Hjuler Persson ◽  
Christian Backer Mogensen ◽  
Jens Søndergaard ◽  
Helene Skjøt-Arkil ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Decision Making ◽  
Older People ◽  
New Public Management ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Research Integrity ◽  
Care Practice ◽  
Observation Study ◽  
Person Centered Care ◽  
Centered Care

Abstract Background Healthcare services have become more complex, globally and nationally. Denmark is renowned for an advanced and robust healthcare system, aiming at a less fragmented structure. However, challenges within the coordination of care remain. Comprehensive restructures based on marketization and efficiency, e.g. New Public Management (NPM) strategies has gained momentum in Denmark including. Simultaneously, changes to healthcare professionals’ identities have affected the relationship between patients and healthcare professionals, and patient involvement in decision-making was acknowledged as a quality- and safety measure. An understanding of a less linear patient pathway can give rise to conflict in the care practice. Social scientists, including Jürgen Habermas, have highlighted the importance of communication, particularly when shared decision-making models were introduced. Healthcare professionals must simultaneously deliver highly effective services and practice person-centered care. Co-morbidities of older people further complicate healthcare professionals’ practice. Aim This study aimed to explore and analyse how healthcare professionals’ interactions and practice influence older peoples’ clinical care trajectory when admitted to an emergency department (ED) and the challenges that emerged. Methods This qualitative study arises from a hermeneutical stand within the interpretative paradigm. Focusing on the healthcare professionals’ interactions and practice we followed the clinical care trajectories of seven older people (aged > 65, receiving daily homecare) acutely hospitalized to the ED. Participant observations were combined with interviews with healthcare professionals involved in the clinical care trajectory. We followed-up with the older person by phone call until four weeks after discharge. The study followed the code of conduct for research integrity and is reported in accordance with the Standards for Reporting Qualitative Research (SRQR) guidelines. Results The analysis revealed four themes: 1)“The end justifies the means – ‘I know what is best for you’”, 2)“Basic needs of care overruled by system effectiveness”, 3)“Treatment as a bargain”, and 4)“Healthcare professionals as solo detectives”. Conclusion Dissonance between system logics and the goal of person-centered care disturb the healthcare practice and service culture negatively affecting the clinical care trajectory. A practice culture embracing better communication and more person-centered care should be enhanced to improve the quality of care in cross-sectoral trajectories.

Person-centered peritoneal dialysis prescription and the role of shared decision-making

2020 ◽  
Vol 40 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Peter G Blake ◽  
Edwina A Brown
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Care Delivery ◽  
Shared Decision ◽  
Person Centered Care ◽  
Modern Health Care ◽  
Patient Reported ◽  
Centered Care ◽  
End Stage

Person-centered care has become a dominant paradigm in modern health care. It needs to be applied to people with end-stage kidney disease considering the initiation of dialysis and to peritoneal dialysis (PD) prescription and care delivery. It is relevant to their decisions about goals of care, transplantation, palliative care, and discontinuation of dialysis. It is also relevant to decisions about how PD is delivered, including options such as incremental PD. Shared decision-making is the essence of this process and needs to become a standard principle of care. It requires engagement, education, and empowerment of patients. Patient-reported outcomes and patient-reported experience are also central to person-centered care in PD.

EDITORIAL INTRODUCTION: ICPCM EDUCATIONAL PROGRAM ON PERSON-CENTERED CARE: CARE PLANNING, SHARED DECISION MAKING, AND INTERPROFESSIONAL COLLABORATION

2020 ◽  
Author(s):  
James Appleyard ◽  
Juan E. Mezzich
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Latin American ◽  
Educational Program ◽  
Interprofessional Collaboration ◽  
New Delhi ◽  
Shared Decision ◽  
Person Centered Care ◽  
Centered Care

This journal issue includes the third part of the Educational Program on Person-Centered Care of the International College of Person Centered Medicine (ICPCM) that in its initial version was presented at the 6th International Congress of Person Centered Medicine in New Delhi in November 2018. The overall themes of the four papers [1–4] are the planning of care, shared decision making, and interprofessional collaboration. In addition, there is the Lima Declaration 2018 entitled “Towards a Latin American Construction of Persons-Centered Integral Health Care,” which recognizes how important these concepts are to the development of general strategies for integrated health care with persons placed at the center of and as the goal of health actions. Reports from the Symposium on Person-Centered Medicine held during the 2018 World Medical Association’s Conference in Reykjavik and the First Peruvian Conference on Person-Centered Medicine add further evidence of the importance of these perspectives.

scholarly journals PERSON-CENTERED CARE: DEFINITIONS AND PERCEPTIONS OF VARIOUS STAKEHOLDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Gretchen Tucker
Keyword(s):  
Nursing Homes ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Administrative Staff ◽  
Direct Care Staff ◽  
Potential Conflict ◽  
Person Centered Care ◽  
Centered Care

Abstract Implementation of culture change in nursing homes shifts the care model from a traditional, more medically focused approach to person-directed care. Person-directed care promotes resident autonomy and decision making and the empowerment of direct care staff. In this paper, we examine how different stakeholders in nursing homes (residents, family members, direct care staff, administrative staff) conceptualize and experience a selection of person-centered care concepts (consistent assignment, meal choice, waking/bedtime practices, and bathing). We describe the commonalities and differences in the ways different groups of stakeholders operationalize these core person centered care practices and describe areas of potential conflict of views. Lastly, we consider how the well-being and quality of life for residents is affected by the use of these practices.

scholarly journals 415 - Evaluation of an e-learning aiming to improve person-centered attitude in healthcare professionals working with people with dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 131-131
Author(s):  
Claudia van der Velden ◽  
Marleen Prins ◽  
Henriëtte van der Roest
Keyword(s):  
Pilot Study ◽  
Healthcare Professionals ◽  
Well Being ◽  
User Friendliness ◽  
Sense Of Competence ◽  
Positive Effects ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care ◽  
E Learning

Introduction Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards a more person-centered care (PCC) model. Several studies have showed positive results of PCC on the quality of life of PwD. Also, it shows positive effects on self -esteem and work satisfaction of healthcare professionals. An effective way to educate professionals in PCC and improve their knowledge and person-centered attitude is by using online learning tools.We developed an e-learning in co-creation with end users focusing on well-being and (changing) behavior of PwD. The interactive e-learning supports healthcare professionals in developing a person-centered attitude, by using practical videos and exercises.Methods In the current pilot study, the e-learning is evaluated. To date, 33 healthcare professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness.Results The final participants are currently completing their post-measurement questionnaires and final results are expected in September 2019. Preliminary data-analysis shows promising results. Positive effects on knowledge about dementia, person-centered attitude and sense of competence are expected. Also, user-friendliness, especially the flexibility of the e-learning (being able to follow the e-learning at home or at work and being able to stop and continue at any time) and the practice-oriented videos are positively evaluated.Conclusion Preliminary results of this pilot study suggest that the e-learning might contribute to developing a more person-centered attitude in healthcare professionals and indicate that participants have positive experiences with the e-learning module.

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