Which is it, person-centred culture, practice or care? It matters

Abstract

Background: Governments, health organisations and regulatory bodies across the world are making their expectations explicit: healthcare professionals and organisations should be providing person-centred care. Yet, it is still not common practice. Aims and objectives: This discussion article aims to explore some of the historical and current perspectives on the interrelated concepts of personhood and personcentred care, and to explain how the persistence of differing perspectives affects the way person-centred care is understood, implemented and evaluated. The article then aims to explain the need for personcentred cultures and practices, and to find a way to progress towards a person-centred agenda. Methods: To develop an understanding of the evolution of and current approach to these concepts, a literature search was undertaken. This included a broad search of the grey literature and the Medline and CINAHL databases, as well as review of articles published in the International Practice Development Journal, and a number of books and literature recommendations. Discussion: Multiple perspectives were found in relation to personhood and person-centred care. How personhood is viewed by healthcare staff and organisations has a direct impact on how person-centred care is delivered. Person-centred practice is a more inclusive concept as it advocates that staff should also experience person-centredness. However, to achieve sustainable person-centred practice, efforts may need to focus on investment in developing person-centred cultures at system and team levels. A person-centred framework can guide this change. Conclusion: Person-centred care is espoused within health policies, visions and mission statements. However, the focus should be on person-centred cultures and on how these can be developed and embedded. The Person-centred Practice Framework can aid understanding, implementation and evaluation of person-centred practice for all.