scholarly journals Challenges of Research on Person-Centered Care in General Practice: A Scoping Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Jako S. Burgers ◽  
Trudy van der Weijden ◽  
Erik W. M. A. Bischoff
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Outcome Measures ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Core Values ◽  
Practice Research ◽  
Positive Effects ◽  
Person Centered Care ◽  
Centered Care

Background: Delivering person-centered care is one of the core values in general practice. Due to the complexity and multifaceted character of person-centered care, the effects of person-centered care cannot be easily underpinned with robust scientific evidence. In this scoping review we provide an overview of research on effects of person-centered care, exploring the concepts and definitions used, the type of interventions studied, the selected outcome measures, and its strengths and limitations.Methods: Systematic reviews on person-centered care compared to usual care were included from Pubmed, Embase, and PsycINFO. The search was conducted in February 2021. Data selection and charting was done by two reviewers.Results: The literature search yielded 481 articles. A total of 21 full-text articles were assessed for eligibility for inclusion. Four systematic reviews, published between 2012 and 2018, were finally included in this review. All reviews used different definitions and models and classified the interventions differently. The explicit distinction between interventions for providers and patients was made in two systematic reviews. The classification of outcomes also showed large differences, except patient satisfaction that was shared. All reviews described the results narratively. One review also pooled the results on some outcome measures. Most studies included in the reviews showed positive effects, in particular on process outcomes. Mixed results were found on patient satisfaction and clinical or health outcomes. All review authors acknowledged limitations due to lack of uniform definitions, and heterogeneity of interventions and outcomes measures.Discussion: Person-centered care is a concept that seems obvious and understandable in real life but is complex to operationalize in research. This scoping review reinforces the need to use mixed qualitative and quantitative methods in general practice research. For spreading and scaling up person-centered care, an implementation or complexity science approach could be used. Research could be personalized by defining therapeutic goals, interventions, and outcome variables based on individual preferences, goals, and values and not only on clinical and biological characteristics. Observational data and patient satisfaction surveys could be used to support quality improvement. Integrating research, education, and practice could strengthen the profession, building on the fundament of shared core values.

PRELIMINARY ASSESSMENT OF GPS' KNOWLEDGE AND ATTITUDE ABOUT PERSON CENTRED CARE

2018 ◽  
Vol 28 (2) ◽  
pp. 567-570
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
General Practice ◽  
Patient Empowerment ◽  
Patient Relationship ◽  
Preliminary Assessment ◽  
Doctor Patient Relationship ◽  
Patient Centered ◽  
Term Care ◽  
Family Doctors ◽  
Person Centered Care ◽  
Centered Care

Introduction: The European definition of WONCA of general practice introduces the determinant elements of person-centered care regarding four important, interrelated characteristics: continuity of care, patient "empowerment", patient-centred approach, and doctor-patient relationship. The application of person-centred care in general practice refers to the GP's ability to master the patient-centered approach when working with patients and their problems in the respective context; use the general practice consultation to develop an effective doctor–patient relationship, with respect to patient’s autonomy; communicate, set priorities and establish a partnership when solving health problems; provide long-lasting care tailored to the needs of the patient and coordinate overall patient care. This means that GPs are expected to develop their knowledge and skills to use this key competence. Aim: The aim of this study is to make a preliminary assessment of the knowledge and attitudes of general practitioners regarding person-centered care. Material and methods: The opinion of 54 GPs was investigated through an original questionnaire, including closed questions, with more than one answer. The study involved each GP who has agreed to take part in organised training in person-centered care. The results were processed through the SPSS 17.0 version using descriptive statistics. Results: The distribution of respondents according to their sex is predominantly female - 34 (62.9%). It was found that GPs investigated by us highly appreciate the patient's ability to take responsibility, noting that it is important for them to communicate and establish a partnership with the patient - 37 (68.5%). One third of the respondents 34 (62.9%) stated the need to use the GP consultation to establish an effective doctor-patient relationship. The adoption of the patient-centered approach at work is important to 24 (44.4%) GPs. Provision of long-term care has been considered by 19 (35,2%). From the possible benefits of implementing person-centered care, GPs have indicated achieving more effective health outcomes in the first place - 46 (85.2%). Conclusion: Family doctors are aware of the elements of person-centered care, but in order to validate and fully implement this competence model, targeted GP training is required.

Strategies Australian Hospitals Utilize to Incorporate Patient Feedback in the Delivery and Measurement of Person-Centered Care: A Scoping Review

2021 ◽  
pp. 105477382110330
Author(s):  
Joy Davis ◽  
Sue Sinni ◽  
Stephen Maloney ◽  
Lorraine Walker
Keyword(s):  
Scoping Review ◽  
Clinical Expertise ◽  
Educational Strategies ◽  
Hospital Governance ◽  
Societal Values ◽  
Patient Feedback ◽  
Person Centered Care ◽  
Acute Hospitals ◽  
Centered Care ◽  
Strategy Design

Patients are central to healthcare clinicians and organizations but often subsidiary to clinical expertise, knowledge, workplace processes, and culture. Shifting societal values, technology, and regulations have remoulded the patient-clinician relationship, augmenting the patient’s voice within the healthcare construct. Scaffolding this restructure is the global imperative to deliver person-centered care (PCC). The aim of the scoping review was to explore and map the intersection between patient feedback and strategies to improve the provision of PCC within acute hospitals in Australia. Database searches yielded 493 articles, with 16 studies meeting inclusion criteria. Integration of patient feedback varied from strategy design, through to multi-staged input throughout the initiative and beyond. Initiatives actioning patient feedback fell broadly into four categories: clinical practice, educational strategies, governance, and measurement. How clinicians can invite feedback and support patients to engage equally remains unclear, requiring further exploration of strategies to propel clinician-patient partnerships, scaffolded by hospital governance structures.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

Person-Centered Care — Ready for Prime Time

2011 ◽  
Vol 10 (4) ◽  
pp. 248-251 ◽  
Author(s):  
Inger Ekman ◽  
Karl Swedberg ◽  
Charles Taft ◽  
Anders Lindseth ◽  
Astrid Norberg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Practice ◽  
Prime Time ◽  
Care Providers ◽  
Increase Patient Satisfaction ◽  
Person Centered Care ◽  
Centered Care ◽  
Treatment Plans ◽  
Improve Health

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.

scholarly journals Developments in Qualitative Mindfulness Practice Research: a Pilot Scoping Review

Mindfulness ◽  
2021 ◽  
Author(s):  
Pascal Frank ◽  
Marieke Marken
Keyword(s):  
Qualitative Research ◽  
Data Collection ◽  
Stress Reduction ◽  
Scoping Review ◽  
Subjective Experience ◽  
Target Population ◽  
Mindfulness Practice ◽  
Practice Research ◽  
Empirical Inquiry ◽  
Positive Effects

Abstract Objectives While scholars are increasingly emphasizing the potential of qualitative mindfulness practice research (QMPR) for advancing the understanding of mindfulness practice, there has been no significant empirical inquiry looking at actual trends and practices of QMPR. Consequently, it has been impossible to direct research practices toward under-researched areas and make methodical suggestions on how to approach them. The aim of the present study was to analyze current trends and practices in QMPR in order to address these areas of need. Methods Based on a scoping review, 229 qualitative studies published between 2000 and 2019 were analyzed in regard to their disciplinary backgrounds, research questions and intentions, type of mindfulness practice, target population, as well as practices of data collection and analysis. Results A strong focus of QMPR lies in the inquiry of mindfulness-based interventions, particularly mindfulness-based stress reduction, mindfulness-based cognitive therapy, and adaptations. Over 10% of the publications do not fully specify the mindfulness practice. The efficacy and subjective experience of mindfulness practices constitute the dominant research interests of QMPR. Data collection is highly concentrated on practice participants and first-person data. Interpretative paradigms are the predominant analytical approach within QMPR. QMPR studies have a strong proclivity toward emphasizing the positive effects of mindfulness practice. Nine percent of all articles considered for our study did not fully disclose their analytical procedure. Adversarial research groups and pluralistic qualitative research remain scarce. Conclusions Future QMPR should (i) include second- and third-person data, (ii) include dropouts and former mindfulness practitioners, (iii) fully disclose details on the mindfulness practice and data analysis, (iv) intensify the application of critical and deconstructivist paradigms, as well as pluralistic qualitative research, and (v) build adversarial research teams.

scholarly journals Does accreditation of general practice promote patient-reported quality of care? A natural cluster randomised experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034465
Author(s):  
Helle Riisgaard ◽  
Frans Boch Waldorff ◽  
Merethe Kirstine Andersen ◽  
Line Bjørnskov Pedersen
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
General Practitioner ◽  
Outcome Measures ◽  
Negative Relationship ◽  
Secondary Outcome ◽  
Cluster Randomised ◽  
Patient Reported

ObjectiveTo investigate whether accreditation of general practice in Denmark promotes patient-reported quality of care and patient satisfaction.DesignA national cluster randomised case control study based on an online version of the Danish Patients Evaluate Practice questionnaire. Mixed effects ordered logit regression models taking account of clustering of patients in different municipalities were used in the analyses.SettingGeneral practice in Denmark.ParticipantsA representative sample of the Danish population.Primary and secondary outcome measuresThe primary outcome measure was patient-reported quality of care, and patient satisfaction with general practice and patient satisfaction with the general practitioner served as secondary outcome measures.ResultsIn total, 3609 respondents answered the survey. We found no statistically significant relationships between patient-reported quality of care and practice accreditation (2016: OR=0.89, 95% CI 0.73 to 1.07 and 2017: OR=0.85, 95% CI 0.71 to 1.02) and between patient satisfaction with the general practitioner and accreditation (2016: OR=0.93, 95% CI 0.76 to 1.13 and 2017: OR=0.86, 95% CI 0.70 to 1.04). However, there was a statistically significant negative relationship between patient satisfaction with the general practice and recent practice accreditation compared with satisfaction with practices not yet accredited (OR=0.81, 95% CI 0.67 to 0.97) but no significant relationship between patient satisfaction with the general practice and previous accreditation (OR=0.91, 95% CI 0.76 to 1.09).ConclusionAccreditation does not promote patient-reported quality of care or patient satisfaction. On the contrary, patient satisfaction with the general practice decreases when general practice is recently accredited.

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.

scholarly journals From protocolized to person-centered chronic care in general practice: study protocol of an action-based research project (COPILOT)

2019 ◽  
Vol 20 ◽  
Author(s):  
Mieke J.L. Bogerd ◽  
Pauline Slottje ◽  
Francois G. Schellevis ◽  
Anneliet Giebels ◽  
Mieke Rijken ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Chronic Diseases ◽  
Person Centered Care ◽  
Care Approach ◽  
Centered Care ◽  
Person Centered Approach ◽  
The Impact ◽  
Multiple Chronic Diseases

AbstractAim:To develop a proactive person-centered care approach for persons with (multiple) chronic diseases in general practice, and to explore the impact on ‘Quadruple aims’: experiences of patients and professionals, patient outcomes and costs of resources use.Background:The management of people with multiple chronic diseases challenges health care systems designed around single disease. Patients with multimorbidity often receive highly fragmented care that may lead to inefficient, ineffective and potentially harmful treatments and neglect of essential health needs. A more comprehensive, person-centered approach is advocated for persons with multiple morbidities. However, examples on how to provide more person-centered care and evidence of its impact are scarce. A group of Dutch general practitioners (GPs) took the initiative to develop such a care approach.Methods/Design:Mixed methods with a development and pilot-testing phase. The proactive person-centered approach will be developed using an action-based research design consisting of multiple plan-act-observe-reflect-adjust cycles. In each cycle, experiences of patients and primary care professionals from 13 practices will be collected via interviews, observations and focus groups. Starting point for the first cycle is a ‘person-centered consultation’ of up to 1 h in which the GP discusses the health status and health care needs of the patient. Furthermore, shared decisions between GP and patient are made on treatment goals and follow-up. In the pilot-test phase, a nested case cohort study allows to explore the impact of the new approach on ‘Quadruple aim’ outcomes comparing persons with and without exposure to the new care approach.Discussion:This study will provide a proactive person-centered approach for persons with multimorbidity in primary care and estimate its potential impact on quadruple outcomes.

scholarly journals E-LEARNING FOR IMPROVING PERSON-CENTERED ATTITUDE IN PROFESSIONALS WORKING WITH PEOPLE WITH DEMENTIA: PILOT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S891-S891
Author(s):  
Claudia van der Velden
Keyword(s):  
Pilot Study ◽  
Challenging Behavior ◽  
Healthcare Professionals ◽  
Well Being ◽  
User Friendliness ◽  
Positive Effects ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care ◽  
E Learning

Abstract Healthcare professionals working with people with dementia (PwD) have increasingly been moving towards a person-centered care (PCC) attitude. Several studies have showed positive results of PCC on quality of life of PwD. Also, it shows positive effects on self-esteem and work-satisfaction of professionals. An effective way to educate professionals in PCC is by using online-learning-tools. We developed an e-learning - in co-creation with end-users - focusing on well-being and challenging behavior of PwD. The interactive e-learning supports healthcare professionals in developing a PCC-attitude, using practical videos and exercises. In the current pilot-study, the e-learning is evaluated. To date, 32 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. The final participants are currently completing their post-measurement questionnaires and final results are expected in October 2019. Preliminary data-analysis shows promising results. Although no significant effects were found, two-thirds of the participants indicated they had more knowledge about dementia, could better deal with challenging behavior and understood better how their own behavior and actions influence the behavior of PwD. The user-friendliness was also positively evaluated. Preliminary results suggest that the e-learning helps professionals in their approach to PwD and indicate that participants have positive experiences with the e-learning.

Sign in / Sign up

Export Citation Format

Share Document