Abstract
BackgroundGendered disparities in health care delivery and outcomes are an international problem. Patient-centred care (PCC) improves patient and health system outcomes, and is widely advocated to reduce inequities. The purpose of this study was to review published research for frameworks of patient-centred care for women (PCCW) that could serve as the basis for quality improvement.MethodsA scoping review was conducted by searching MEDLINE, EMBASE, CINAHL, SCOPUS, Cochrane Library, and Joanna Briggs index for English-language quantitative or qualitative studies published from 2008 to 2018 that included at least 50% women aged 18 years or greater and employed or generated a PCCW framework. Findings were analyzed using a 6-domain PCC framework, and reported using summary statistics and narrative descriptions.ResultsA total of 9267 studies were identified, 6670 were unique, 6610 titles were excluded upon title/abstract screening, and 11 were deemed eligible from among 60 full-text articles reviewed. None were based on or generated a PCCW framework, included solely women, or analyzed or reported findings by gender. All studies explored or described PCC components through qualitative research or surveys. None of the studies addressed all 6 domains of an established PCC framework; however, additional PCC elements emerged in 9 of 11 studies including timely responses, flexible scheduling, and humanized management, meaning tailoring communication and treatment to individual needs and preferences. There were no differences in PCC domains between studies comprised primarily of women and other studies.ConclusionsGiven the paucity of research on PCCW, primary research is needed to generate knowledge about PCCW processes, facilitators, challenges, interventions and impacts, which may give rise to a PCCW framework that could be used to plan, deliver, evaluate and improve PCCW.
Highlights
Gendered disparities in health care delivery and outcomes are an international problem
Patientcentred care (PCC) is considered a key element of high quality health care because it has been associated with patient and health system outcomes [11,12,13]
A scoping review of 19 studies published from 1994 to 2011 identified 25 unique frameworks or models of PCC; common domains pertained to the patient-provider relationship, partnership, and health promotion [14]
Summary
Gendered disparities in health care delivery and outcomes are an international problem. The purpose of this study was to review published research for frameworks of patient-centred care for women (PCCW) that could serve as the basis for quality improvement. As a result of ongoing gender bias that influences women’s health care and outcomes, one of the 17 goals in the United Nations report, Gender Equality in the 2030 Agenda for Sustainable Development, is to promote women’s health and well-being by ensuring that women have universal access to comprehensive health care that is responsive to gender and the life course [9]. A scoping review of 19 studies published from 1994 to 2011 identified 25 unique frameworks or models of PCC; common domains pertained to the patient-provider relationship (sharing information, empathy, empowerment), partnership (sensitivity to needs, relationship-building), and health promotion (collaboration, case management, resource use) [14]. A systematic review of 26 studies published from 1992 to 2008 identified 13 unique instruments to assess PCC, further underscoring variability in how PCC is conceptualized [15]
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