Person-Centered Care Delivery Interventions Overcome Cancer Screening Disparities

2020 ◽  
Vol 60 (8) ◽  
pp. 1424-1435
Author(s):  
Liza L Behrens ◽  
Marie Boltz ◽  
Ann Kolanowski ◽  
Mark Sciegaj ◽  
Caroline Madrigal ◽  
...  

Abstract Background and Objectives Nursing home (NH) staff perceptions of risks to residents’ health and safety are a major barrier to honoring resident preferences, the cornerstone of person-centered care (PCC) delivery. This study explored direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents’ preferences for everyday living and care activities. Research Design and Methods Qualitative, descriptive design using sequential focus group (FG) methodology. Results Participants (N = 27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs recently experiencing 6–12 health citations. Content analysis of 12 sequential FGs indicated nursing staff perceptions of risks may impede delivery of person-centered care. This is supported by the overarching theme: pervasive risk avoidance; and subthemes of: staff values, supports for risk-taking, and challenges to honoring preferences. Discussion and Implications Development of a multidimensional framework with specific risk engagement measures that account for the unique risk perspectives of nursing staff will contribute significantly to the clinical management of older adult preferences and research on the effectiveness of preference-based PCC delivery in the NH setting.


2020 ◽  
Vol 40 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Peter G Blake ◽  
Edwina A Brown

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.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 837-837
Author(s):  
Liza Behrens ◽  
Kimberly Van Haitsma ◽  
Ann Kolanowski ◽  
Marie Boltz ◽  
Mark Sciegaj ◽  
...  

Abstract Nursing home (NH) staff perceptions of risks to residents’ health and safety is a major barrier to honoring resident preferences, the cornerstone of person-centered care delivery. This study examined direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents’ preferences for everyday living and care activities. Participants (N=27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs experiencing 6-12 health citations. Content analysis of 12 focus groups indicated nursing staff perceptions of risks may impede delivery of PCC. This is supported by the overarching theme: pervasive risk avoidance; and sub-themes of: staff values, supports for risk-taking, and challenges to honoring preferences. Findings will be discussed considering a newly modified risk engagement framework meant to understand and inform the clinical management of older adult preferences perceived to carry risks. Opportunities for future research will be discussed (e.g. measurement development). Part of a symposium sponsored by the Research in Quality of Care Interest Group.


2014 ◽  
Vol 40 (10) ◽  
pp. 34-46 ◽  
Author(s):  
Kimberly Van Haitsma ◽  
Katherine M. Abbott ◽  
Allison R. Heid ◽  
Brian Carpenter ◽  
Kimberly Curyto ◽  
...  

Author(s):  
Nioushah Noushi ◽  
Christophe Bedos ◽  
Nareg Apelian ◽  
Jean-Noel Vergnes ◽  
Charo Rodriguez

There has been a relatively slow incorporation of person-centered care into dental care. Despite the efforts to sustain this approach in dental health care delivery, the perspectives of patients have yet to be considered, especially those using free dental clinics. Our objectives were: (1) to describe the perspectives of adults unable to access private dental clinics when using free dental clinics, (2) to document their suggestions for improvements to dental care. This qualitative descriptive study included 13 adults using a free dental clinic. To select participants, we adopted a maximum variation sampling strategy regarding age, sex, marital status, education level and employment status. We used in-depth, semi-structured interviews to collect data and thematic content analysis to analyze the verbatim transcripts. Participants were generally satisfied with the dental care they received in private and free dental clinics. However, they did not appreciate the long wait times at free clinics, and were bothered by the cost at private clinics. They emphasized a desire for quality time with the dentist allowing for more informed and shared decisions about their care, regardless of the clinic they visited. Participants want to feel cared for through a trustworthy relationship with the clinician, and suggested incorporating a walk-in concept into free clinics to address access to care. Adults using free dental clinics have various experiences with private and public dentistry, but they all need clinicians who adopt a comprehensive approach when providing information. This could improve patients’experiences through a more person-centered approach to dental care.


2021 ◽  
Author(s):  
Diya Chowdhury ◽  
Leonardo Baiocco-Romano ◽  
Veronica Sacco ◽  
Karen El Hajj ◽  
Paul Stolee

BACKGROUND Integrating culturally competent approaches in the provision of healthcare services is recognized as a promising strategy for improving health outcomes for racially and ethnically diverse populations. Person-centered care, which ensures patient values guide care delivery, necessitates cultural competence of healthcare providers in order to reduce racial/ethnic health disparities. Previous work has focused on interventions to improve cultural competence among healthcare workers generally; however, little investigation has been undertaken regarding current practices focused on racialized foreign-born older adults. OBJECTIVE We seek to synthesize evidence from existing literature in the field to gain a comprehensive understanding of culturally competent interventions for health professionals who work with racialized foreign-born older adults. The aim of this paper is to describe the protocol for this review. METHODS Our protocol will follow the PRISMA guidelines (PRISMA-P) for systematic review protocols. We will conduct a systematic search for relevant studies from three electronic databases that focus on health and social sciences (PubMed, CINAHL, and Scopus). After selecting relevant papers using the inclusion and exclusion criteria, data will be extracted, analyzed, and synthesized to yield recommendations for practice and for future research. RESULTS The systematic review is currently at the search phase where authors are refining the search strings for the selected databases. We expect that the systematic review will be completed within 18 months from the publication of the protocol paper. CONCLUSIONS This study will inform future development and implementation of interventions to support culturally competent, person-centered care of racialized immigrant older adults.


Author(s):  
Yvette M. McCoy

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.


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