Effects of a Provincial-Wide Implementation of Screening for Distress on Healthcare Professionals' Confidence and Understanding of Person-Centered Care in Oncology

2016 ◽  
Vol 14 (10) ◽  
pp. 1259-1266 ◽  
Author(s):  
Rie Tamagawa ◽  
Shannon Groff ◽  
Jennifer Anderson ◽  
Sarah Champ ◽  
Andrea Deiure ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiken Hjuler Persson ◽  
Christian Backer Mogensen ◽  
Jens Søndergaard ◽  
Helene Skjøt-Arkil ◽  
Pernille Tanggaard Andersen

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma Granström ◽  
Carolina Wannheden ◽  
Mats Brommels ◽  
Helena Hvitfeldt ◽  
Monica E. Nyström

Abstract Background Person-centered care (PCC) emphasize the importance of supporting individuals’ involvement in care provided and self-care. PCC has become more important in chronic care as the number of people living with chronic conditions is increasing due to the demographic changes. Digital tools have potential to support interaction between patients and healthcare providers, but empirical examples of how to achieve PCC in chronic care and the role of digital tools in this process is limited. The aim of this study was to investigate strategies to achieve PCC used by the healthcare professionals at an outpatient Rheumatology clinic (RC), the strategies’ relation to digital tools, and the perceived impact of the strategies on healthcare professionals and patients. Methods A single case study design was used. The qualitative data consisted of 14 semi-structured interviews and staff meeting minutes, covering the time period 2017–2019. The data were analyzed using conventional content analysis, complemented with document analyses. Results Ten strategies on two levels to operationalize PCC, and three categories of perceived impact were identified. On the individual patient level strategies involved several digital tools focusing on flexible access to care, mutual information sharing and the distribution of initiatives, tasks, and responsibilities from provider to patients. On the unit level, strategies concerned involving patient representatives and individual patients in development of digital services and work practices. The roles of both professionals and patients were affected and the importance of behavioral and cultural change became clear. Conclusions By providing an empirical example from chronic care the study contributes to the knowledge on strategies for achieving PCC, how digital tools and work practices interact, and how they can affect healthcare staff, patients and the unit. A conclusion is that the use of the digital tools, spanning over different dimensions of engagement, facilitated the healthcare professionals’ interaction with patients and the patients’ involvement in their own care. Digital tools complemented, rather than replaced, care practices.


2017 ◽  
Vol 29 (11) ◽  
pp. 1785-1800 ◽  
Author(s):  
Sarah Alsawy ◽  
Warren Mansell ◽  
Phil McEvoy ◽  
Sara Tai

ABSTRACTBackground:Many strategies have been recommended to support caregivers in communicating with people who live with dementia. However, less is known about what makes communication a good and meaningful experience from the perspective of people with dementia. Understanding this may enhance the person with dementia's sense of connectedness, strengthen their relationships, and facilitate person-centered care. The current review aimed to evaluate research that examined experiences of communication in people living with dementia. Studies that examined reports provided by people with dementia, healthcare professionals, and family caregivers were included.Methods:A mixed-methods systematic review was conducted using PsychINFO, MEDLINE, and EMBASE databases.Results:After applying the eligibility criteria, 15 studies were included. Although eight of these recruited people with dementia, only one focused on their perspectives of communication experiences and the remaining studies focused on the perspectives of family caregivers and healthcare professionals. These studies either explored experiences without suggestions of communication methods, “open exploration,” or through examining experiences of strategies, “exploration of strategies.” A significant theme was around communication difficulties that affected interpersonal relationships and activities of daily living. Conversely, personhood strategies and a strong underlying relationship were believed to facilitate communication. The one study that examined the perspectives of people with dementia emphasized the importance of retaining valued relationships and feeling respected during communication.Conclusions:The need to involve people with dementia in research, particularly around their experiences of communication, is evident. Such research would be imperative for facilitating person-centered care, strengthening social relationships, and informing training programs.


2020 ◽  
Vol 32 (S1) ◽  
pp. 131-131
Author(s):  
Claudia van der Velden ◽  
Marleen Prins ◽  
Henriëtte van der Roest

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.


2021 ◽  
Vol 33 (S1) ◽  
pp. 64-65
Author(s):  
Claudia Van Der Velden ◽  
Henriëtte G. Van Der Roest

Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards person-centered care (PCC). 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 healthcare professionals (HCP).We developed an successful practice-oriented intervention to implement PCC in long-term care facilities (LTCFs), based on the theory of Kitwood. The intervention consists of different components and learning methods: 1)Management of the facility is trained. They have an important role in motivating HCPs and safeguarding PCC-policy in the future.2)Dementia Care Mapping (DCM)-observations are carried out to gain understanding of the LTCF. DCM is an evidence-based observational method and aims to give a good understanding of the quality of life of PwD.3)The training of staff starts with a Kick-off-meeting. During a ‘Mirror theater’ with professional actors, an act representing a familiar care situation is performed. Staff participates in the act to become aware of PCC. The kick-off also serves as a warming-up on PCC knowledge.4)After this, staff complete an interactive e-learning on the basic theory of PCC. The e-learning contains practical videos and exercises.5)Finally, staff follow two consecutive, practical-oriented team-trainings. They will learn what PCC means for their daily practice and how to reflect on it. The most effective part is the reflection on examples of their own clients, and get more aware of their own behavior. In between trainings, HCP will carry out a practice exercise and provide feedback in session two.In an early stage of the intervention we discuss the possibilities and adjust the approach to the needs and situation (culture, level of knowledge etc.) of the LTCF. Involvement of all the staff in the intervention is essential, so everyone speaks the same ‘language’ and staff can rely on each other. Based on experience, these factors contributes to a sustainable way to implement PCC in LTCFs.


2019 ◽  
pp. 118-136
Author(s):  
Ulrik Kihlbom ◽  
Christian Munthe

The aim of this chapter is to outline how different relational aspects of families may ground obligations on the part of healthcare professionals toward patients and their families in the decision-making process. The exploration starts from the core idea within person-centered care of having patients’ general life situation, experiences, wants, and values to be a substantial topic of concern in a process of shared decision making. If relational decision-making paradigms are to be minimally functional, healthcare professionals’ stances need to involve complex schemes of including people closely related to patients, who will have to be recognized as legitimate stakeholders and partners in, as well as resources for, clinical care.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S891-S891
Author(s):  
Claudia van der Velden

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.


2020 ◽  
Vol 20 (1) ◽  
pp. 62-70
Author(s):  
Teresa Martínez ◽  
Victor Martínez-Loredo ◽  
Marcelino Cuesta ◽  
José Muñiz

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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