Aim. This paper analyses how the role and function of family physicians in primary health care relates to person centeredness. Method. Based on the model of the Ecology of Medical Care the interaction of individuals with health care has been deduced and from this were identified main implications for the provision of care. Results. Individuals experience a large variety of health problems over time, of which only a minority is presented to health care professionals, with care in the direct vicinity (community) the most likely place of contact. From this, common health problems and their prognosis, self-care and autonomy, reasons for contact, multi-morbidity and community related social determinants of health define the conditions to provide health care for all health problems in all individuals. Discussion and Conclusions. The variety of health problems presented over time for individual-specific expectations, make the person with the health problem the self-evident focus of care. The person-centered approach serves to relate the patient’s agenda to professional considerations of the nature and prognosis of the health problem identified and the risks and benefits of treatment. From this, the importance can be established of continuity of care, shared decision making, individual prognostication and ascertaining individual risks from community-specific determinants of health. Priorities of research are to come to a better understanding of the mechanisms of continuity of care and the building of professional relations of trust. Other priorities of research are to strengthen the knowledge base of diagnosis, prognostication and interventions of frequent health problems in the community.
{"title":"Person Centered Primary Heath Care: The Role and Positionof the Family Physician-Generalist and Implications for Research","authors":"C. Weel","doi":"10.5750/IJPCM.V6I1.564","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.564","url":null,"abstract":"Aim. This paper analyses how the role and function of family physicians in primary health care relates to person centeredness. Method. Based on the model of the Ecology of Medical Care the interaction of individuals with health care has been deduced and from this were identified main implications for the provision of care. Results. Individuals experience a large variety of health problems over time, of which only a minority is presented to health care professionals, with care in the direct vicinity (community) the most likely place of contact. From this, common health problems and their prognosis, self-care and autonomy, reasons for contact, multi-morbidity and community related social determinants of health define the conditions to provide health care for all health problems in all individuals. Discussion and Conclusions. The variety of health problems presented over time for individual-specific expectations, make the person with the health problem the self-evident focus of care. The person-centered approach serves to relate the patient’s agenda to professional considerations of the nature and prognosis of the health problem identified and the risks and benefits of treatment. From this, the importance can be established of continuity of care, shared decision making, individual prognostication and ascertaining individual risks from community-specific determinants of health. Priorities of research are to come to a better understanding of the mechanisms of continuity of care and the building of professional relations of trust. Other priorities of research are to strengthen the knowledge base of diagnosis, prognostication and interventions of frequent health problems in the community.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"334 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":"133843643","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}
Treating patients as persons, by considering, a.o., their individual level of understanding, self-management skills, concerns and care preferences, is only logical, at least from an ethical point of view. Yet, in medical practice, such an approach does not come easy, as many other obligations and formalities have to be taken care of which distract attention from the person behind the patient. As a consequence, many patients continue to experience barriers while communicating with their healthcare provider [1]. For this reason, numerous interventions have been developed and implemented to either increase healthcare professionals’ attitudes and communication skills to really engage with a patient, or to strengthen a patient's communication skills in order to be heard and understood. For patients with malignant lymphoma, for example, a tailored online intervention has been developed to increase their participation [2], and medical students learn to listen by using open questions in soliciting patient problems [3]. The three papers that together form a special section on communication in healthcare in this issue of the IJPCM each describe a different study aimed to enhance a patient's personhood.
{"title":"Person Centered Communication in Healthcare: A Matter of Reaching Out","authors":"S. Dulmen","doi":"10.5750/IJPCM.V6I1.565","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.565","url":null,"abstract":"Treating patients as persons, by considering, a.o., their individual level of understanding, self-management skills, concerns and care preferences, is only logical, at least from an ethical point of view. Yet, in medical practice, such an approach does not come easy, as many other obligations and formalities have to be taken care of which distract attention from the person behind the patient. As a consequence, many patients continue to experience barriers while communicating with their healthcare provider [1]. For this reason, numerous interventions have been developed and implemented to either increase healthcare professionals’ attitudes and communication skills to really engage with a patient, or to strengthen a patient's communication skills in order to be heard and understood. For patients with malignant lymphoma, for example, a tailored online intervention has been developed to increase their participation [2], and medical students learn to listen by using open questions in soliciting patient problems [3]. The three papers that together form a special section on communication in healthcare in this issue of the IJPCM each describe a different study aimed to enhance a patient's personhood.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"15 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":"124085155","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}
Anne Weiland, A. Blankenstein, J. V. Saase, H. Molen, David Kosak, R. Vernhout, L. Arends
Objectives : Medically unexplained physical symptoms (MUPS) burden patients in their well-being and functioning and have a prevalence of approximately 25-50% in primary and specialist care. Medical specialists often find patients with unexplained symptoms difficult to deal with, whereas patients are not always understood. We report effects on patient outcomes of an evidence-based MUPS-focused communication training for medical specialists. Methods: In a multi-center randomized controlled trial medical specialists and residents allocated to the intervention received a 14-hour MUPS-focused communication training. They practiced a patient-centered approach, including multi-factorial symptom exploration and explanation of MUPS with perpetuating factors. To study intervention effects, each doctor had to include three MUPS patients before and three after the intervention and to ask them to complete questionnaires at baseline and at 3 and 6 months follow-up. The questionnaires included illness worries (Whitely Index), symptom severity (Visual Analogue Scale), distress, depression, anxiety and somatization (4DSQ) and daily functioning (SF-36). Results: A sufficient number of 123 medical specialists and residents participated in the study. They included 478 MUPS patients. Out of them, 297 patients filled out questionnaires at baseline, 165 patients at 3-months follow-up and 71 patients at 6-months follow-up . Recruitment of patients was lower than expected and patients’ non-response to baseline and follow-up questionnaires was higher than estimated. No significant effects were found on patient outcomes. Conclusions: I t remains unclear whether medical specialist training results in better patient outcomes in MUPS as the trial was underpowered. New research with special attention to patient recruitment and retention is needed to answer this question.
{"title":"Training Medical Specialists in Communication about Medically Unexplained Physical Symptoms: Patient Outcomes from a Randomized Controlled Trial","authors":"Anne Weiland, A. Blankenstein, J. V. Saase, H. Molen, David Kosak, R. Vernhout, L. Arends","doi":"10.5750/IJPCM.V6I1.490","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.490","url":null,"abstract":"Objectives : Medically unexplained physical symptoms (MUPS) burden patients in their well-being and functioning and have a prevalence of approximately 25-50% in primary and specialist care. Medical specialists often find patients with unexplained symptoms difficult to deal with, whereas patients are not always understood. We report effects on patient outcomes of an evidence-based MUPS-focused communication training for medical specialists. Methods: In a multi-center randomized controlled trial medical specialists and residents allocated to the intervention received a 14-hour MUPS-focused communication training. They practiced a patient-centered approach, including multi-factorial symptom exploration and explanation of MUPS with perpetuating factors. To study intervention effects, each doctor had to include three MUPS patients before and three after the intervention and to ask them to complete questionnaires at baseline and at 3 and 6 months follow-up. The questionnaires included illness worries (Whitely Index), symptom severity (Visual Analogue Scale), distress, depression, anxiety and somatization (4DSQ) and daily functioning (SF-36). Results: A sufficient number of 123 medical specialists and residents participated in the study. They included 478 MUPS patients. Out of them, 297 patients filled out questionnaires at baseline, 165 patients at 3-months follow-up and 71 patients at 6-months follow-up . Recruitment of patients was lower than expected and patients’ non-response to baseline and follow-up questionnaires was higher than estimated. No significant effects were found on patient outcomes. Conclusions: I t remains unclear whether medical specialist training results in better patient outcomes in MUPS as the trial was underpowered. New research with special attention to patient recruitment and retention is needed to answer this question.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"15 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":"130351630","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 : It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease. Objectives : To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions. Methodology : A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice. Results : The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.
{"title":"Providing Patient Centered Care for Adolescents with Chronic Conditions","authors":"Nabeel Al-Yateem","doi":"10.5750/IJPCM.V6I1.560","DOIUrl":"https://doi.org/10.5750/IJPCM.V6I1.560","url":null,"abstract":"Background : It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease. Objectives : To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions. Methodology : A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice. Results : The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"6 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":"121680739","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}
In the conceptualization of Person Centered Medicine (PCM) one can recognize core concepts as well as diversity at multiple levels. The core concepts convey vision and depth. Diversity displays plurality, richness and scope. And both are intertwined and articulated through the unfolding process and journey that the construction of PCM represents. This paper briefly elaborates on these complementary perspectives of PCM. And ends introducing a set of papers that illustrate its core and diversity.
{"title":"Person Centered Medicine: Core and Diversity","authors":"J. Mezzich, I. Salloum","doi":"10.5750/IJPCM.V5I4.554","DOIUrl":"https://doi.org/10.5750/IJPCM.V5I4.554","url":null,"abstract":"In the conceptualization of Person Centered Medicine (PCM) one can recognize core concepts as well as diversity at multiple levels. The core concepts convey vision and depth. Diversity displays plurality, richness and scope. And both are intertwined and articulated through the unfolding process and journey that the construction of PCM represents. This paper briefly elaborates on these complementary perspectives of PCM. And ends introducing a set of papers that illustrate its core and diversity.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114648562","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: ADHD affects 2.5% to 5% of the adult population, is often under-diagnosed and poorly managed with few treatment options. Limited pharmacotherapeutic options are available, and many patients and clinicians are reluctant to use them for fear of side effects or concerns about substance abuse liability. Very limited psychotherapeutic options are available for ADHD. Cognitive behavioral group therapy (CBTg) is the only approach with some preliminary promising results, however there is no individual CBT option for this population. Objectives: There is a growing popularity of yoga as a therapeutic technique in psychiatric disorders and it may offer distinct advantages for adult ADHD. The objectives of this paper is to discuss the benefit of yoga as a person-centered individualized intervention for adults with ADHD. Methods: We discuss the therapeutic utility of a more encompassing and systematic application of yoga practices, including their physical and philosophical, meditative and spiritual aspects to address the symptoms of ADHD and to enhance wellness through lifelong growth and skill building yoga for adults with ADHD. We also present a systematic comparison between yoga practices and the standard CBTg therapy to demonstrate that the proposed yoga intervention is able to address ADHD symptoms areas targeted by CBTg. Results: Intervention based on a systematic application of yoga practices may offer targeted interventions to match ADHD patients’ symptoms and needs and compares positively with CBTg. Furthermore, yoga therapy may be superior to CBTg in terms of convenience, person-centeredness and individualized care. Conclusions: Yoga may offer a valuable option to meet patients’ needs by integrating both physical and philosophical aspects to dynamically targeting specific areas of emotional, behavioral and cognitive dysfunctions as well as the hyperactivity symptoms.
{"title":"Person-centered Yoga Therapeutic Approach for Adult Attention Deficit-Hyperactivity Disorder","authors":"I. Salloum, J. Cichon","doi":"10.5750/IJPCM.V5I4.550","DOIUrl":"https://doi.org/10.5750/IJPCM.V5I4.550","url":null,"abstract":"Background: ADHD affects 2.5% to 5% of the adult population, is often under-diagnosed and poorly managed with few treatment options. Limited pharmacotherapeutic options are available, and many patients and clinicians are reluctant to use them for fear of side effects or concerns about substance abuse liability. Very limited psychotherapeutic options are available for ADHD. Cognitive behavioral group therapy (CBTg) is the only approach with some preliminary promising results, however there is no individual CBT option for this population. Objectives: There is a growing popularity of yoga as a therapeutic technique in psychiatric disorders and it may offer distinct advantages for adult ADHD. The objectives of this paper is to discuss the benefit of yoga as a person-centered individualized intervention for adults with ADHD. Methods: We discuss the therapeutic utility of a more encompassing and systematic application of yoga practices, including their physical and philosophical, meditative and spiritual aspects to address the symptoms of ADHD and to enhance wellness through lifelong growth and skill building yoga for adults with ADHD. We also present a systematic comparison between yoga practices and the standard CBTg therapy to demonstrate that the proposed yoga intervention is able to address ADHD symptoms areas targeted by CBTg. Results: Intervention based on a systematic application of yoga practices may offer targeted interventions to match ADHD patients’ symptoms and needs and compares positively with CBTg. Furthermore, yoga therapy may be superior to CBTg in terms of convenience, person-centeredness and individualized care. Conclusions: Yoga may offer a valuable option to meet patients’ needs by integrating both physical and philosophical aspects to dynamically targeting specific areas of emotional, behavioral and cognitive dysfunctions as well as the hyperactivity symptoms.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116706911","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}
The language of an EBM paper screams objectivity . The personal interests of the authors are skilfully expunged. These are men and women of science! Taken out altogether are the drivers of the project—desire, interest, professional advancement (surely not money). The EBM paper presents an image. My paper interrogates the objectivity of the subject-object distinction, arguing that it is based on the subject, from Descartes, “I think, therefore I am”. The subject-object distinction, fundamental to science / EBM, is not used by Martin Heidegger. He depicts people immersed in the environment, coping, they hope. Their world is a world that matters , a world of joy and sorrow. Absent is the contrived distinction between subject and object, yielding a detached, “objective” universe, set up for scientists to study and gain knowledge of. Deleuze and Guattari do not read an EBM paper to ascertain its meaning. Rather they analyse how meaning is set up. They would note how the conceptual structure and language created an experimental subject depicted in biomedical terms. They would note the use of fixed terms, fossilised, such as experimental subject , rather than as a continually evolving process. Derrida tells us that, although God and metaphysics have been pushed off the conceptual cliff in out scientific age, we still read with misty, metaphysical eyes. We read in the myth of truth, based on origins and centres, about the real universe. We read in the coherence of the paper, and the reliability of reason. We think that words have fixed meanings, and that all readers understand the same as all authors intend.
{"title":"A Postmodern View of Evidence-based Medicine (EBM): Barthes. Heidegger, Deleuze and Guattari, and Derrida.","authors":"Brian Walsh","doi":"10.5750/ijpcm.v5i4.531","DOIUrl":"https://doi.org/10.5750/ijpcm.v5i4.531","url":null,"abstract":"The language of an EBM paper screams objectivity . The personal interests of the authors are skilfully expunged. These are men and women of science! Taken out altogether are the drivers of the project—desire, interest, professional advancement (surely not money). The EBM paper presents an image. My paper interrogates the objectivity of the subject-object distinction, arguing that it is based on the subject, from Descartes, “I think, therefore I am”. The subject-object distinction, fundamental to science / EBM, is not used by Martin Heidegger. He depicts people immersed in the environment, coping, they hope. Their world is a world that matters , a world of joy and sorrow. Absent is the contrived distinction between subject and object, yielding a detached, “objective” universe, set up for scientists to study and gain knowledge of. Deleuze and Guattari do not read an EBM paper to ascertain its meaning. Rather they analyse how meaning is set up. They would note how the conceptual structure and language created an experimental subject depicted in biomedical terms. They would note the use of fixed terms, fossilised, such as experimental subject , rather than as a continually evolving process. Derrida tells us that, although God and metaphysics have been pushed off the conceptual cliff in out scientific age, we still read with misty, metaphysical eyes. We read in the myth of truth, based on origins and centres, about the real universe. We read in the coherence of the paper, and the reliability of reason. We think that words have fixed meanings, and that all readers understand the same as all authors intend.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"410 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123537763","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}
Vibeke Høgh, E. Cummings, S. Riahi, S. Lundbye-Christensen
Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey of a person recently diagnosed with atrial fibrillation. Data sources include field notes, transcripts, medical records, letters, and scores from standardized questionnaires. A phenomenologically inspired approach for qualitative data analysis and a descriptive approach for discovering exceptional changes in scores from questionnaires are used. The patient journey in the study consists of; 38 visits to general practice, five visits to the outpatient clinic, and two radio frequency ablations at hospital. Four central themes; balancing responsibilities, navigating the system, adjusting to the situation, and recognizing bodily reactions, are elaborated. In conclusion, hope for a better future is evident throughout the journey. Difficulties of balancing responsibility, conflicting information and lack of support and connection between general practice and the hospital result in putting the participant’s dignity at stake. Despite two ablations the participant is affected in his daily life and family life due to physical limitations. Along the study adjustment to the situation is seen, and his new status as grandfather is surprisingly seen to facilitate this adjustment.
{"title":"A Year in the Life of a Person Recently Diagnosed with Atrial Fibrillation in Denmark","authors":"Vibeke Høgh, E. Cummings, S. Riahi, S. Lundbye-Christensen","doi":"10.5750/IJPCM.V5I4.533","DOIUrl":"https://doi.org/10.5750/IJPCM.V5I4.533","url":null,"abstract":"Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey of a person recently diagnosed with atrial fibrillation. Data sources include field notes, transcripts, medical records, letters, and scores from standardized questionnaires. A phenomenologically inspired approach for qualitative data analysis and a descriptive approach for discovering exceptional changes in scores from questionnaires are used. The patient journey in the study consists of; 38 visits to general practice, five visits to the outpatient clinic, and two radio frequency ablations at hospital. Four central themes; balancing responsibilities, navigating the system, adjusting to the situation, and recognizing bodily reactions, are elaborated. In conclusion, hope for a better future is evident throughout the journey. Difficulties of balancing responsibility, conflicting information and lack of support and connection between general practice and the hospital result in putting the participant’s dignity at stake. Despite two ablations the participant is affected in his daily life and family life due to physical limitations. Along the study adjustment to the situation is seen, and his new status as grandfather is surprisingly seen to facilitate this adjustment.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124707666","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: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable. Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization. Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access; addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making. Conclusions: Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on pe ople -centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is a n essential contribution of nurses to people - centered PHC . Nurses’ contributions can be optimised through p ositive practice environments, a ppropriate workforce planning and implementation and adequate education and quality control though strong regulatory principles and frameworks. P eople-cent e red approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people - centered PHC.
{"title":"Nursing Profession’s Contribution to Person- and People-Centered Primary Health Care","authors":"Yukiko Kusano, Erica Ehrhardt","doi":"10.5750/IJPCM.V5I4.552","DOIUrl":"https://doi.org/10.5750/IJPCM.V5I4.552","url":null,"abstract":"Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable. Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization. Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access; addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making. Conclusions: Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on pe ople -centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is a n essential contribution of nurses to people - centered PHC . Nurses’ contributions can be optimised through p ositive practice environments, a ppropriate workforce planning and implementation and adequate education and quality control though strong regulatory principles and frameworks. P eople-cent e red approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people - centered PHC.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125402127","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","authors":"C. Woodhead","doi":"10.5750/IJPCM.V5I4.556","DOIUrl":"https://doi.org/10.5750/IJPCM.V5I4.556","url":null,"abstract":"","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123157873","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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