Thoughts About Meanings of Compliance, Adherence, and Concordance

2020 ◽  
Vol 33 (4) ◽  
pp. 358-360
Author(s):  
Jacqueline Fawcett
Keyword(s):  
Conceptual Model ◽  
Patient Autonomy ◽  
Healthcare Providers ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Or Groups ◽  
Health Related Behaviors ◽  
Centered Care ◽  
Health Related

The purpose of this essay is to explore the meanings of the widely used terms compliance and adherence and the less widely used term concordance and to raise questions about the appropriateness of these terms when used to describe individuals’ or groups’ health-related behaviors. Discussion focuses on how recognition of how the meanings of these terms has uncovered the failure to honor nursing’s emphasis on person/patient-centered care due to power imbalances between healthcare providers and patents and the subsequent lack of patient autonomy. Consideration of these problems with existing terms could facilitate identification of a potentially more appropriate term based on the language of a nursing conceptual model and/or theory.

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

Patient-centered communication: an extension of the HCAHPS survey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Shahidul Islam ◽  
Nazlida Muhamad
Keyword(s):  
Service Quality ◽  
Gap Analysis ◽  
Healthcare Providers ◽  
Measurement Model ◽  
Patient Centered Care ◽  
Emerging Economy ◽  
Patient Centered ◽  
Affective Communication ◽  
Content Type ◽  
Centered Care

PurposeThe Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been recognized as a “gold standard” set of “practical standardized measures” for assessing hospital service quality. Beginning with the HCAHPS, the purpose of this paper is to extend efforts to assess patient-centered communication (PCC) and the quality of healthcare and presents a scale for measuring patient perceptions and expectations of service quality in an emerging economy context.Design/methodology/approachA self-administered survey of patients in private hospitals (N = 171) was conducted to test the proposed framework. Exploratory and confirmatory factor analyses were used to establish the measurement model. Multiple regression analysis was used to explain the scale's predictive ability. ANOVA was used to analyze service quality gaps and rank patients' priorities.FindingsFive components of PCC are identified. Among these, nurse affective communication has a significant positive effect on patient satisfaction. The gap analysis shows that patients have high expectations for doctors' affective communication, while they perceive a low level of service performance in the realm of nurse affective communication. The study highlights a new means of measuring “reliability” in healthcare. Important findings on patients' priorities are evaluated and discussed.Practical implicationsHealthcare organizations and practitioners can improve patient-centered care by stressing the dimensions of PCC, including clinicians' affective and instrumental communication.Originality/valueThe study expands the understanding of HCAHPS instruments in an emerging economy context and opens avenues for more widespread use of the measures. The research contributes to the literature on patient-centered care and healthcare service quality by proposing a scale for managing specific practices and interactions in healthcare.

scholarly journals A Nurse-Led Conceptual Model to Inform Patient-Centered Type 2 Diabetes Management in Public Clinical Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 576-577
Author(s):  
Stella Bosun-Arije ◽  
Candidus Nwakasi
Keyword(s):  
Type 2 Diabetes ◽  
Conceptual Model ◽  
Diabetes Management ◽  
Patient Centered Care ◽  
Public Hospitals ◽  
Clinical Settings ◽  
Clinical Practices ◽  
Patient Centered ◽  
Centered Care

Abstract Globally, there is an increased need to provide patient-centered care for people diagnosed with Type 2 diabetes mellitus (T2DM). In Nigeria, a poorly financed health system worsens the difficulties associated with managing T2DM in clinical settings, resulting in a detrimental effect on patient-centered care. We aimed to develop a conceptual model to promote patient-centered T2DM care in clinical settings. We explored nurses' contextual perceptions of clinical practices and operations that are relevant to T2DM management across public hospitals in Lagos, Nigeria. Identifying a nurse-led intervention is critical to care optimization for people diagnosed with T2DM. Using a qualitative research, we used semi-structured questions and the Constant Comparison Method to interview 17 practice (registered) nurses with over 1-year experience working in public hospitals across Lagos, Nigeria. The Framework Method was used for data analysis. The nurses provided insight into four areas of patient-centered T2DM management in clinical settings. They are: empowering collaboration, empowering flexibility, empowering approach, and empowering practice. The nurses discussed an empowering pathway through which health settings could provide patient-centered care to individuals diagnosed with T2DM. The pathway includes the integration of macro, meso, and micro levels for patient management. Their views informed the development of a conceptual model for the optimization of patient care. The model developed from this research sits within the Patient-Centered Care model of healthcare delivery. The model has the potential to inform patient-centered care in countries with poorly financed healthcare systems, and developed countries with comparatively better healthcare.

State of IS Integration in the Context of Patient-Centered Care

2011 ◽  
Vol 6 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Ali Reza Montazemi ◽  
Jeff J. Pittaway ◽  
Karim Keshavjee
Keyword(s):  
Information Exchange ◽  
Information Needs ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Patient Centered Care ◽  
Personal Contact ◽  
Patient Centered ◽  
Centered Care ◽  
Knowledge Asymmetry ◽  
Is Integration

For more than a decade, healthcare reform has emphasized coordinated “patient-centered care”. To that end, policymakers have invested in integration of healthcare providers’ information flows. Research has studied healthcare providers’ information needs but overlooked communicative exchanges among participants in coordinating treatment plan decisions. Consequently, although medical literature asserts that patients should depend on information exchange with healthcare providers to enable participation in treatment plan decisions, the assertion has not been tested. In this paper, the authors conduct an empirical study to elucidate the structure of actors’ communications in support of their information dependencies. The findings illustrate that although patients are well connected through personal contact with healthcare providers, patients are disenfranchised from integrated healthcare information systems (IS) and the potential of IS to support patients’ participation in coordinated “patient-centered care” decisions. Furthermore, knowledge asymmetry between patients and healthcare providers should be considered in the selection and design of healthcare IS.

State of IS Integration in the Context of Patient-Centered Care

2013 ◽  
pp. 127-144
Author(s):  
Ali Reza Montazemi ◽  
Jeff J. Pittaway ◽  
Karim Keshavjee
Keyword(s):  
Information Exchange ◽  
Information Needs ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Patient Centered Care ◽  
Personal Contact ◽  
Patient Centered ◽  
Centered Care ◽  
Knowledge Asymmetry ◽  
Is Integration

For more than a decade, healthcare reform has emphasized coordinated “patient-centered care”. To that end, policymakers have invested in integration of healthcare providers’ information flows. Research has studied healthcare providers’ information needs but overlooked communicative exchanges among participants in coordinating treatment plan decisions. Consequently, although medical literature asserts that patients should depend on information exchange with healthcare providers to enable participation in treatment plan decisions, the assertion has not been tested. In this paper, the authors conduct an empirical study to elucidate the structure of actors’ communications in support of their information dependencies. The findings illustrate that although patients are well connected through personal contact with healthcare providers, patients are disenfranchised from integrated healthcare information systems (IS) and the potential of IS to support patients’ participation in coordinated “patient-centered care” decisions. Furthermore, knowledge asymmetry between patients and healthcare providers should be considered in the selection and design of healthcare IS.

Patient-Centered Care: Lifestyle Modifications Among Adult Participants With Dyslipidemia

2019 ◽  
Vol 12 (1) ◽  
pp. 31-40
Author(s):  
Gulenia E. Rikabi ◽  
Lachel J. Story ◽  
Kamal Rikabi
Keyword(s):  
Heart Disease ◽  
Healthcare Providers ◽  
Plasma Lipid ◽  
Patient Centered Care ◽  
Health Clinic ◽  
Healthy Living ◽  
Lifestyle Modifications ◽  
Patient Centered ◽  
Clinical Interventions ◽  
Centered Care

BackgroundDyslipidemia, a risk factor for coronary heart disease (CHD), is a burden due to morbidity, mortality, and CHD-related costs. Patient-centered clinical interventions improve adherence to lifestyle modifications among adults with dyslipidemia.ObjectiveThe study's objectives were to (a) promote participants' safety through increased knowledge on the risks and prevention of CHD, (b) help participants identify their own barriers to lifestyle modifications, and (c) develop strategies with participants on individualized plans to adhere to healthy living.MethodsSeventeen participants with dyslipidemia enrolled in a quality improvement over 6 weeks. Participants were from one employee health clinic in Mississippi. Measures are Heart Disease Fact Questionnaire (HDFQ), Framingham Tool, pre- and poststudy lipid panels, and physiologic measurements. Interventions include motivational technique-led interviews as a tool for behavioral change.ResultsPre- and post-HDFQ responses indicated an 18% increase in knowledge attainment because of the patient-centered care interventions. Postinterventions, mean plasma lipid panels were 29% lower, weight loss ranged from 0 to 10.1 pounds, and body mass indexes were 0.4 to 1.2 less. Blood pressures (BPs) preintervention ranged from 120/70 to 159/89. Postinterventions BP ranged from 107/82 to 146/70.ConclusionsPatient-centered clinical interventions improve management of dyslipidemia through increased knowledge on risks and prevention of CHD and also through finding own barriers to healthy living.ImplicationsHealthcare providers can make a difference in people's lives through exploring the unhealthy behaviors and discovering ways for better health outcomes.

Development of a Measure to Assess Healthcare Providers’ Implementation of Patient-Centered Care

2014 ◽  
Vol 11 (4) ◽  
pp. 248-257 ◽  
Author(s):  
Souraya Sidani ◽  
Laura Collins ◽  
Patti Harbman ◽  
Kathleen MacMillan ◽  
Scott Reeves ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care
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