{"title":"Fourth International Congress of Person Centered Medicine; Programme outline","authors":"J. Mezzich","doi":"10.5750/IJPCM.V6I2.582","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I2.582","url":null,"abstract":"","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125625438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: “Person centered medicine” has recently emerged as a new alternative to “patient centered medicine” with the aim of representing a different focus for clinical practice. However, it is still necessary to clarify its conceptual bases and its identifying features. Objectives : To review the conceptual bases of Person Centered Medicine and highlight its main features. Methods: A non systematic review of the literature on the person and patient centered medicine field and particularly the works that George Engel published in 1977 and 1980 in which this author proposed the biopsychosocial (BPS) model as an alternative to the biomedical one. Results: The a nalysis led to identify one element, a “life dimension” that differs from the biopsychosociocultural determinants that are typical of the BPS and that until now has not been well understood. The “life dimension” takes shape in the interpretation that the person makes of a series of concrete experiences and their consequences, “problems of living”, that are liable to be considered “medical problems”. This is what leads the person to adopt the condition of being a patient (patienthood). Consequently, any medical problem is above all a problem of living or, in other words, a manifestation of a “life or existential dimension” that is inherent to the person (personhood). This perspective requires the physician to consider this dimension along with the model's other components in any clinical interaction, and it is the basis for the use of a hermeneutic or interpretative methodology that has communication and dialogue as its main tools. Conclusions: The term “person centered medicine” reflects the clinical focus that takes into account the “life dimension” of the person. Further research is needed to elucidate the meaning of this dimension as a basis to clarify both the concept of this clinical approach and its main practical elements.
{"title":"What is Person Centered Medicine: Conceptual Review with Focus on George Engel’s Perspectives","authors":"R. Ruiz-Moral","doi":"10.5750/IJPCM.V6I2.575","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I2.575","url":null,"abstract":"Background: “Person centered medicine” has recently emerged as a new alternative to “patient centered medicine” with the aim of representing a different focus for clinical practice. However, it is still necessary to clarify its conceptual bases and its identifying features. Objectives : To review the conceptual bases of Person Centered Medicine and highlight its main features. Methods: A non systematic review of the literature on the person and patient centered medicine field and particularly the works that George Engel published in 1977 and 1980 in which this author proposed the biopsychosocial (BPS) model as an alternative to the biomedical one. Results: The a nalysis led to identify one element, a “life dimension” that differs from the biopsychosociocultural determinants that are typical of the BPS and that until now has not been well understood. The “life dimension” takes shape in the interpretation that the person makes of a series of concrete experiences and their consequences, “problems of living”, that are liable to be considered “medical problems”. This is what leads the person to adopt the condition of being a patient (patienthood). Consequently, any medical problem is above all a problem of living or, in other words, a manifestation of a “life or existential dimension” that is inherent to the person (personhood). This perspective requires the physician to consider this dimension along with the model's other components in any clinical interaction, and it is the basis for the use of a hermeneutic or interpretative methodology that has communication and dialogue as its main tools. Conclusions: The term “person centered medicine” reflects the clinical focus that takes into account the “life dimension” of the person. Further research is needed to elucidate the meaning of this dimension as a basis to clarify both the concept of this clinical approach and its main practical elements.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121120226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For the 9th time, the International College for Person-Centered Medicine (ICPCM) held its annual conference on Person-Centered Medicine in Geneva, Switzerland. Like previous years, the conference was formally co-sponsored by the World Health Organization, the World Medical Association, the World Organization of Family Doctors, the International Council of Nurses, the International Alliance of Patients' Organizations and thirty other global health professional and academic institutions. The organizing committee was composed of the ICPCM Board members, Ruth Wilson as program director and Islene Araujo de Carvalho, Jim Campbell and Nuria Toro Polanco from WHO. Material support was provided by the World Medical Association, the World Health Organization, the Geneva University Hospital, and the Paul Tournier Association.
国际以人为中心医学学院(ICPCM)第9次在瑞士日内瓦举行了以人为中心医学年会。与往年一样，这次会议由世界卫生组织、世界医学协会、世界家庭医生组织、国际护士理事会、国际患者组织联盟和其他30个全球卫生专业和学术机构正式共同主办。组织委员会由ICPCM董事会成员、Ruth Wilson作为规划主任以及世卫组织的Islene Araujo de Carvalho、Jim Campbell和Nuria Toro Polanco组成。世界医学协会、世界卫生组织、日内瓦大学医院和保罗·图尼耶协会提供了物质支助。
{"title":"Summary Report of the Ninth Geneva Conference on Person Centered Medicine","authors":"S. Dulmen, J. Mezzich","doi":"10.5750/IJPCM.V6I2.581","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I2.581","url":null,"abstract":"For the 9th time, the International College for Person-Centered Medicine (ICPCM) held its annual conference on Person-Centered Medicine in Geneva, Switzerland. Like previous years, the conference was formally co-sponsored by the World Health Organization, the World Medical Association, the World Organization of Family Doctors, the International Council of Nurses, the International Alliance of Patients' Organizations and thirty other global health professional and academic institutions. The organizing committee was composed of the ICPCM Board members, Ruth Wilson as program director and Islene Araujo de Carvalho, Jim Campbell and Nuria Toro Polanco from WHO. Material support was provided by the World Medical Association, the World Health Organization, the Geneva University Hospital, and the Paul Tournier Association.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115914312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Wilson, J. Appleyard, J. Mezzich, M. Abou-Saleh, C. Gutkin, C. Weel, T. Epperly
Objective: To examine the opportunities and challenges in achieving person centered integrated care through the life course. Methods: Critical literature review and evidence based analysis of person-centered integrated care through the life course, combined with expert consultation. The World Health Organization’s “Global Framework on Integrated People-Centred Health Services” is used as a basis. Results: Using the approach of the life cycle allows connection of persons’ current health status to their sociocultural, biological, and psychological context. Person centered medicine has as its central precept the relationship between the health professional and person seeking care. This principle is the link to primary health care, which is built on a lasting relationship with individuals and populations in their social context. The patient’s medical home provides one promising model of how health services can be organized to support the full achievement of person centered integrated care. Re-orientation of the health professional education towards generalism, and the development of metrics for measurement of person centered integrated care are required. In 2016 the global crisis in refugees is a particularly prominent challenge for the delivery of person centered integrated care . Conclusion: Universal health coverage can provide equitable access to person centered integrated care throughout the life course. Specialized expertise and skills are important for caring for persons with specific conditions at particular times in the life course. When care is well-integrated, transitions of care are smooth and the critical paradigm of person-centeredness is retained.
{"title":"Challenges and Opportunities for Person Centered Integrated Care Through the Life Course","authors":"C. Wilson, J. Appleyard, J. Mezzich, M. Abou-Saleh, C. Gutkin, C. Weel, T. Epperly","doi":"10.5750/IJPCM.V6I2.576","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I2.576","url":null,"abstract":"Objective: To examine the opportunities and challenges in achieving person centered integrated care through the life course. Methods: Critical literature review and evidence based analysis of person-centered integrated care through the life course, combined with expert consultation. The World Health Organization’s “Global Framework on Integrated People-Centred Health Services” is used as a basis. Results: Using the approach of the life cycle allows connection of persons’ current health status to their sociocultural, biological, and psychological context. Person centered medicine has as its central precept the relationship between the health professional and person seeking care. This principle is the link to primary health care, which is built on a lasting relationship with individuals and populations in their social context. The patient’s medical home provides one promising model of how health services can be organized to support the full achievement of person centered integrated care. Re-orientation of the health professional education towards generalism, and the development of metrics for measurement of person centered integrated care are required. In 2016 the global crisis in refugees is a particularly prominent challenge for the delivery of person centered integrated care . Conclusion: Universal health coverage can provide equitable access to person centered integrated care throughout the life course. Specialized expertise and skills are important for caring for persons with specific conditions at particular times in the life course. When care is well-integrated, transitions of care are smooth and the critical paradigm of person-centeredness is retained.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127610712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Myasthenia gravis (MG), an autoimmune disorder characterised by muscle weakness caused by impairment of the acetylcholine receptors at the neuromuscular junction as a result of autoantibodies acting against the ACh receptors, is twice as common in women, occurring in the second and third decades. Successful pregnancy outcomes are possible with patient compliance to medication and care by a multidisciplinary team. Objective: The article demonstrates the ethical dilemma doctors face when dealing with termination of pregnancy in myasthenia gravis in pregnancy. Discussion: During pregnancy, MG exacerbates in one third of patients during the first trimester, and tends to improve during the second and third trimesters, with most women achieving normal delivery. The authors put up a case where decision for termination of pregnancy (TOP) could have been avoided through application of an ethical decision making framework. The patient could have decided otherwise if a clear alternative line of management had been offered. Fully informed consent is essential preserving was not given and patient autonomy in such complex decisions. The emotive effects on the patient that biomedical imaging like showing a normal and active foetus through ultrasonography also needs to be considered. Analysis: A possible ethical framework using some of the principles of ethical decision-making, under the headings of i) . Clear justification according to the norms and values of the individual, law and society for the intervention ii) . Patient autonomy iii). Incongruence between parents in the abortion decision iv). The foetus as a person v). Directive counselling vi). Principle-based ethics, and, vii) . Case-based ethics and case-based reasoning could be applied when confronted with the issue of termination of pregnancy in MG. While principle-based ethics is a useful starting point, care-based ethics also has a place in decisions on TOP.
{"title":"ETHICS OF TERMINATION OF PREGNANCY (TOP) IN MYASTHENIA GRAVIS: A CASE REPORT","authors":"S. Nalliah, S. M. Ling, C. Thuraisingham","doi":"10.5750/IJPCM.V6I2.516","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I2.516","url":null,"abstract":"Introduction: Myasthenia gravis (MG), an autoimmune disorder characterised by muscle weakness caused by impairment of the acetylcholine receptors at the neuromuscular junction as a result of autoantibodies acting against the ACh receptors, is twice as common in women, occurring in the second and third decades. Successful pregnancy outcomes are possible with patient compliance to medication and care by a multidisciplinary team. Objective: The article demonstrates the ethical dilemma doctors face when dealing with termination of pregnancy in myasthenia gravis in pregnancy. Discussion: During pregnancy, MG exacerbates in one third of patients during the first trimester, and tends to improve during the second and third trimesters, with most women achieving normal delivery. The authors put up a case where decision for termination of pregnancy (TOP) could have been avoided through application of an ethical decision making framework. The patient could have decided otherwise if a clear alternative line of management had been offered. Fully informed consent is essential preserving was not given and patient autonomy in such complex decisions. The emotive effects on the patient that biomedical imaging like showing a normal and active foetus through ultrasonography also needs to be considered. Analysis: A possible ethical framework using some of the principles of ethical decision-making, under the headings of i) . Clear justification according to the norms and values of the individual, law and society for the intervention ii) . Patient autonomy iii). Incongruence between parents in the abortion decision iv). The foetus as a person v). Directive counselling vi). Principle-based ethics, and, vii) . Case-based ethics and case-based reasoning could be applied when confronted with the issue of termination of pregnancy in MG. While principle-based ethics is a useful starting point, care-based ethics also has a place in decisions on TOP.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134327762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective : to get insight into the perspectives of physical therapy patients with different levels of health literacy on ‘ease of use’ and ‘usefulness’ of the most frequently used questionnaire in Dutch physical therapy: the Patient Specific-Complaint questionnaire (PSC). Methods : Cognitive interviews were conducted with twenty-five Dutch and twenty-five Turkish physical therapy patients with variable health literacy levels after they completed the Dutch PSC. A thematic content analysis approach was used to analyze the data. Results: Nineteen respondents did not complete the PSC fully and ten were not able to complete the questionnaire at all. All respondents but one experienced difficulties completing the PSC. Most problems were experienced in understanding and interpreting the instructions and questions. Low educated and low health literate respondents experienced more difficulties than high educated and adequate health literate respondents did. Due to these difficulties in twenty-four cases the PSC generated other information than was intended by its developers. Almost half of the respondents were positive about the usefulness of the PSC in relation to their treatment process. Conclusions : Completing questionnaires is more difficult for patients than care providers might realize. The results of this study confirm the necessity to collaborate with patients in all stages of questionnaire development. The ease of use of questionnaires should be tested and if necessary improved. To stimulate questionnaire developers to take usability and face and content validity into account, it is recommended to incorporate assessment of these criteria in quality evaluation tools like the COSMIN checklist.
{"title":"Completing the Patient Specific-Complaint Questionnaire in Physical Therapy Practice is Problematic for High and Low Literate Patients: A Qualitative Study","authors":"M. Welbie, H. Wittink, M. Westerman, W. Devillé","doi":"10.5750/IJPCM.V6I1.566","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.566","url":null,"abstract":"Objective : to get insight into the perspectives of physical therapy patients with different levels of health literacy on ‘ease of use’ and ‘usefulness’ of the most frequently used questionnaire in Dutch physical therapy: the Patient Specific-Complaint questionnaire (PSC). Methods : Cognitive interviews were conducted with twenty-five Dutch and twenty-five Turkish physical therapy patients with variable health literacy levels after they completed the Dutch PSC. A thematic content analysis approach was used to analyze the data. Results: Nineteen respondents did not complete the PSC fully and ten were not able to complete the questionnaire at all. All respondents but one experienced difficulties completing the PSC. Most problems were experienced in understanding and interpreting the instructions and questions. Low educated and low health literate respondents experienced more difficulties than high educated and adequate health literate respondents did. Due to these difficulties in twenty-four cases the PSC generated other information than was intended by its developers. Almost half of the respondents were positive about the usefulness of the PSC in relation to their treatment process. Conclusions : Completing questionnaires is more difficult for patients than care providers might realize. The results of this study confirm the necessity to collaborate with patients in all stages of questionnaire development. The ease of use of questionnaires should be tested and if necessary improved. To stimulate questionnaire developers to take usability and face and content validity into account, it is recommended to incorporate assessment of these criteria in quality evaluation tools like the COSMIN checklist.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116668130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Latin American Conference on Person Centered Medicine 18-19 December 2015, Lima, Peru, Summary Report","authors":"J. Mezzich","doi":"10.5750/IJPCM.V6I1.568","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.568","url":null,"abstract":"","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130282907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Mezzich, J. Appleyard, T. Ghebrehiwet, M. Botbol, J. Groves, I. Salloum, S. Dulmen
a Editor in Chief, International Journal of Person Centered Medicine; Secretary General, International College of Personcentered Medicine; Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA. b President, International College of Person Centered Medicine; Former President, World Medical Association, London, United Kingdom. c Board Director, International College of Person-centered Medicine; Chair, World Psychiatric Association Section on Psychoanalysis in Psychiatry; Professor of Child and Adolescent Psychiatry, University of Western Brittany, Brest, France. d Board Director, International College of Person-centered Medicine; Former Officer, International Council of Nurses; Independent Consultant, Nursing and Health Policy, Alberta, Canada. e Board Director, International College of Person-centered Medicine; Former Chief Executive Officer, International Alliance of Patients' Organizations, London, United Kingdom. f Board Director, International College of Person-centered Medicine; Chair, Section on Classification, World Psychiatric Association; Professor of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA. g Board Director of the International College of Person-Centered Medicine and Professor of Communication in Healthcare at the Netherlands Institute for Health Services Research, Utrecht, the Netherlands; at the Department of Primary and Community Care at Radboud University Medical Center, Nijmegen, the Netherlands; and at the Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway.
{"title":"Communication and Relationships in Person Centered Medicine","authors":"J. Mezzich, J. Appleyard, T. Ghebrehiwet, M. Botbol, J. Groves, I. Salloum, S. Dulmen","doi":"10.5750/IJPCM.V6I1.570","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.570","url":null,"abstract":"a Editor in Chief, International Journal of Person Centered Medicine; Secretary General, International College of Personcentered Medicine; Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA. b President, International College of Person Centered Medicine; Former President, World Medical Association, London, United Kingdom. c Board Director, International College of Person-centered Medicine; Chair, World Psychiatric Association Section on Psychoanalysis in Psychiatry; Professor of Child and Adolescent Psychiatry, University of Western Brittany, Brest, France. d Board Director, International College of Person-centered Medicine; Former Officer, International Council of Nurses; Independent Consultant, Nursing and Health Policy, Alberta, Canada. e Board Director, International College of Person-centered Medicine; Former Chief Executive Officer, International Alliance of Patients' Organizations, London, United Kingdom. f Board Director, International College of Person-centered Medicine; Chair, Section on Classification, World Psychiatric Association; Professor of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA. g Board Director of the International College of Person-Centered Medicine and Professor of Communication in Healthcare at the Netherlands Institute for Health Services Research, Utrecht, the Netherlands; at the Department of Primary and Community Care at Radboud University Medical Center, Nijmegen, the Netherlands; and at the Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128170269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Appleyard, M. Botbol, T. Epperly, T. Ghebrehiwet, Joanna Grove, J. Mezzich, S. Rawaf, I. Salloum, J. Snaedal, S. Dulmen
Primary care and public health have a shared goal of health improvement for each person and their populations. Public health is the science and art of promoting health, preventing disease and prolonging life (adding life to years and years to life) through the organized efforts of society. Public health needs to be person- and people- centered taking into account the biomedical, social, cultural, psychological, and spiritual elements that are crucial to understanding the whole person and the community at large. This paper provides a review of the International College of Person Centred Medicine’s Declarations, which have formed a platform for the development of the ICPCM’s London Declaration on Primary Care and Public Health. Person-Centered Primary Health Care is by its very nature integrative by involving a broad knowledge of all sectors of health care and a strong understanding of community resources and other social determinants of health. Through trusted and healing relationships, a person-centered approach with people over time can achieve the required integration and coordination of care that leads to better health, effective health care and lower cost. Systems of care need to be built around primary care as the core foundational element to ensure that all people are seen and helped at the right time, by the right providers, for the right reasons, and in the right locations. By integrating primary, secondary, tertiary, preventive, and end-of-life care, we will collectively produce healthier persons, healthier people, and healthier nations. The London Declaration sets out a 10-point plan to achieve this by establishing a shared goal of improvement in the health and well being of the population through person and people centered primary care and public health.
{"title":"Patterns and Prospects for the Implementation of Person-Centered Primary Care and People-Centered Public Health","authors":"J. Appleyard, M. Botbol, T. Epperly, T. Ghebrehiwet, Joanna Grove, J. Mezzich, S. Rawaf, I. Salloum, J. Snaedal, S. Dulmen","doi":"10.5750/IJPCM.V6I1.563","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.563","url":null,"abstract":"Primary care and public health have a shared goal of health improvement for each person and their populations. Public health is the science and art of promoting health, preventing disease and prolonging life (adding life to years and years to life) through the organized efforts of society. Public health needs to be person- and people- centered taking into account the biomedical, social, cultural, psychological, and spiritual elements that are crucial to understanding the whole person and the community at large. This paper provides a review of the International College of Person Centred Medicine’s Declarations, which have formed a platform for the development of the ICPCM’s London Declaration on Primary Care and Public Health. Person-Centered Primary Health Care is by its very nature integrative by involving a broad knowledge of all sectors of health care and a strong understanding of community resources and other social determinants of health. Through trusted and healing relationships, a person-centered approach with people over time can achieve the required integration and coordination of care that leads to better health, effective health care and lower cost. Systems of care need to be built around primary care as the core foundational element to ensure that all people are seen and helped at the right time, by the right providers, for the right reasons, and in the right locations. By integrating primary, secondary, tertiary, preventive, and end-of-life care, we will collectively produce healthier persons, healthier people, and healthier nations. The London Declaration sets out a 10-point plan to achieve this by establishing a shared goal of improvement in the health and well being of the population through person and people centered primary care and public health.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114708757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Beach, S. Saha, E. Branyon, I. Ehanire, Z. Mathews, L. Cooper
Background : Respect for persons is regarded as an important value in medical ethics, and yet, there is little written in the bioethics or professionalism literature about what respect actually entails in day-to-day clinical practice. Objective : To describe respectful behaviors and attitudes from the patient’s perspective. Methods: We conducted in-depth semi-structured interviews with 29 adults who saw their primary care physician on a regular basis. This sample consisted of 15 women and 14 men; 19 were African American and 10 were white. Patients were asked to describe their ideas about respect and to provide examples that illustrated respect and disrespect on the part of the physician. Interviews were transcribed and coded to identify major themes for each interview and to link together related themes across all interviews. Results : Participants identified four definitions of respect: being treated ‘as a person’, being treated as an equal, being treated as the physician would want to be treated, and being cared about. Patients readily identified behaviors that they associated with respect. These included listening to and understanding the patient, being polite (e.g. greeting and addressing the patient by name), explaining things in a way he or she can understand, allowing patient input into the treatment plan, attending to privacy/modesty, spending enough time, and being thorough. Conclusions: Patients are aware of, and sensitive to, subtle verbal, behavioral, and attitudinal cues from the physician that are interpreted as conveying respect or disrespect, and these cues may strongly influence the medical encounter. Cultivating an attitude of respect for patients, and communicating that respect through specific behaviors, can help create a more patient-centered healthcare system that embodies the values of the people it serves.
{"title":"Communicating Respect for Patients as Persons: A Qualitative Study","authors":"M. Beach, S. Saha, E. Branyon, I. Ehanire, Z. Mathews, L. Cooper","doi":"10.5750/IJPCM.V6I1.567","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.567","url":null,"abstract":"Background : Respect for persons is regarded as an important value in medical ethics, and yet, there is little written in the bioethics or professionalism literature about what respect actually entails in day-to-day clinical practice. Objective : To describe respectful behaviors and attitudes from the patient’s perspective. Methods: We conducted in-depth semi-structured interviews with 29 adults who saw their primary care physician on a regular basis. This sample consisted of 15 women and 14 men; 19 were African American and 10 were white. Patients were asked to describe their ideas about respect and to provide examples that illustrated respect and disrespect on the part of the physician. Interviews were transcribed and coded to identify major themes for each interview and to link together related themes across all interviews. Results : Participants identified four definitions of respect: being treated ‘as a person’, being treated as an equal, being treated as the physician would want to be treated, and being cared about. Patients readily identified behaviors that they associated with respect. These included listening to and understanding the patient, being polite (e.g. greeting and addressing the patient by name), explaining things in a way he or she can understand, allowing patient input into the treatment plan, attending to privacy/modesty, spending enough time, and being thorough. Conclusions: Patients are aware of, and sensitive to, subtle verbal, behavioral, and attitudinal cues from the physician that are interpreted as conveying respect or disrespect, and these cues may strongly influence the medical encounter. Cultivating an attitude of respect for patients, and communicating that respect through specific behaviors, can help create a more patient-centered healthcare system that embodies the values of the people it serves.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134541270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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