Importance Of Person-centred Care Research Articles

Experiences of transition to adulthood and transfer to adult care in young adults with type 1 diabetes: A qualitative study.

To explore young adults' experiences of living with type 1 diabetes in the transition to adulthood, including experiences of the transfer from paediatric to adult care. A qualitative approach was used. Ten young adults, six women and four men, aged 19-29 years, participated. Participants were recruited at their regular diabetes clinic from spring 2021 to spring 2022. Semi-structured interviews were transcribed and analysed using qualitative content analysis. Dreaming of being nurtured towards self-reliance was the overarching theme. Personal experiences of the transition to adulthood, including the transfer from paediatric to adult care, were described in terms of struggling to find balance in daily life, dealing with feelings of being different, being gradually supported to achieve independence, and wishing to be approached as a unique person in healthcare. In healthcare, it is important to emphasize not only diabetes-related factors but also emotional and psychosocial aspects of life connected to the transition to adulthood, including the transfer to adult care. The young adults wished to be seen as unique persons in healthcare during their emerging adulthood and should therefore be supported to achieve self-reliance through personal preparations for new challenges and for the consequences of transitioning to adulthood. Specialist nurses can provide appropriate knowledge and leadership. These findings can guide nurse specialists in support for emerging adults to achieve self-reliance and indicate the importance of person-centred care when experiencing transition and transfer. The study adhered to EQUATOR guidelines, and the COREQ checklist for qualitative studies was used as the reporting method.

Assessing the patient's needs and planning effective care.

Nurses have an essential role to play in the assessment and planning of patient care. This is emphasised in the Nursing and Midwifery Council's 2018 Future Nurse proficiency standards. In this article, the author discusses the importance of person-centred care in assessing needs and highlights the need for all nursing interventions to be evidence based. The topics covered include assessing people's needs, care planning, stages of care planning, benefits of care planning, models of care, care pathways, and care clustering in mental health care. The article also highlights the significance of record-keeping.

Perspectives of substitute decision-makers and staff about person-centred physical activity in long-term care.

This paper aims to explore the care processes that best exemplify person-centred care during physical activity (PA) for long-term care (LTC) residents with dementia from the perspectives of substitute decision-makers (SDMs) and LTC home staff. Little is known about how person-centred care is reflected during PA for residents with dementia, or the barriers and benefits to enacting person-centred care during PA. Semistructured interviews were used to collect SDMs and LTC home staffs' perspectives on the importance of person-centred care during PA from two LTC homes in Canada. The McCormack and McCance person-centredness framework was used to guide thematic content analysis of responses. SDM (n = 26) and staff (n = 21) identified actions categorized under the sympathetic presence or engagement care processes from the person-centredness framework as most reflecting person-centred care. Benefits of person-centred care during PA were categorized into three themes: functional and physical, behavioural and communication and psychosocial improvements. Barriers to person-centred care during PA identified were lack of time, opportunities for meaningful activity in LTC setting and staff experiences with resident aggression. Understanding the care processes that are most recognized as person-centred care and valued by SDMs and LTC home staff has implications for education and training. Insights into SDMs' care expectations regarding person-centred care can inform staff about which actions should be prioritized to meet care expectations and can foster relationships to the benefit of residents with dementia. Study participants were not involved in the development of research questions, research design or outcome measures of this study.

The importance of person-centred care and how to achieve it

This article discusses the important concept of person-centred care and how this can be achieved. Following an introduction defining what is meant by this term and contrasting it with the term patient-centred care, the relevant and pertinent parts of the Nursing and Midwifery Council code will then be identified and discussed. The four principles of person-centred care will then be presented. The role of the support worker and nursing associate will be made clear in how the wishes and needs of patients can be gained. Self-awareness, emotional intelligence and communication will be discussed in relation to this. Finally, two potential barriers to the successful achievement of person-centred care will be identified.

Empowerment among adult patients with type 2 diabetes: age differentials in relation to person-centred primary care, community resources, social support and other life-contextual circumstances

BackgroundRising prevalence of type 2 diabetes (T2D), also among younger adults, constitutes a growing public health challenge. According to the person-centred Chronic Care Model, proactive care and self-management support in combination with community resources enhance quality of healthcare and health outcomes for patients with T2D. However, research is scarce concerning the importance of person-centred care and community resources for such outcomes as empowerment, and the relative impact of various patient support sources for empowerment is not known. Moreover, little is known about the association of age with these variables in this patient-group. This study, carried out among patients with T2D, examined in three age-groups (27–54, 55–64 and 65–75 years) whether person-centred care and diabetes-related social support, including community support and possibilities to influence community health issues, are associated with patient empowerment, when considering possible confounding factors, such as other quality of care indicators and psychosocial wellbeing. We also explored age differentials in empowerment and in the proposed correlates of empowerment.MethodIndividuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n = 2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses.ResultsRespondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only.ConclusionPerson-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.

Delivery of the Dementia Friends programme on the MPharm degree course: a qualitative exploration of pharmacy students’ perspectives

Abstract Introduction A person-centred approach to dementia care has been advocated1, but limited literature exists on integration of this into pharmacist undergraduate education. The Alzheimer’s Society Dementia Friends programme was developed to change peoples’ perceptions and promote understanding of living with dementia. In 2019, the School piloted provision of Dementia Friends training; Level 3 MPharm students (n=102) were invited by email to participate as an optional part of a Clinical Therapeutics module. Sixty-three students (61.8%) attended the workshop, which combined Dementia Friends training with an interactive session facilitated by a person living with dementia (PLWD). Aim To explore undergraduate pharmacy students’ views and experiences of the Dementia Friends pilot. Methods All students who had attended the workshop were invited by email to participate in a focus group during February 2020. Participants provided written informed consent. The topic guide focused on students’ views of workshop delivery, improvements that could be made, their understanding of person-centred care, and the impact of the workshop on their clinical practice. The focus group was audio-recorded, transcribed verbatim, and analysed using thematic analysis. Results One focus group was conducted with eight students. Three overarching themes were identified: learning from an expert patient; importance of person-centred care; and dementia education during MPharm degree. Students valued the opportunity to learn from a PLWD and felt it allowed them to relate the condition to a real person: “it felt more personal so you could really connect with them [PLWD] and understand their experience”. Hearing about the ‘lived experience’ helped to contextualise learning from other methods of delivery, e.g. lectures: “you don’t know what’s going on in someone else’s life, and sometimes we’re all a bit quick to judge, I think [the workshop] put that into perspective”. Students described having greater understanding of person-centred care and taking a holistic approach to pharmaceutical care provision for PLWD: “it’s very important to take into account their quality of life…we can focus on the clinical but looking at the person as a whole actually helps their treatment” and “one of the things I found most interesting was that they might not remember the interaction but they will [retain] the feeling or emotion”. Students reported feeling more confident in engaging with PLWD following the workshop, which is something they would not have had the opportunity to learn from lectures alone: “If we hadn’t had that dementia training, I feel like I would still have no confidence chatting to dementia patients”. Students suggested that future Dementia Friends training should be delivered earlier in the MPharm degree course. Conclusion This study has shown that Dementia Friends training complemented students’ existing knowledge of dementia and increased their confidence to communicate with PLWD. The use of an expert patient was an effective way of supporting MPharm students to develop a person-centred approach to their professional practice. The study was limited to one university so findings may not be generalisable. However, these data provide a good basis for future development and evaluation of Dementia Friends training provision to MPharm students.

\u201cWhat counts can\u2019t always be measured\u201d: a qualitative exploration of general practitioners\u2019 conceptualisation of quality for community pharmacy services

BackgroundThe expansion of community pharmacy services is one solution to relieve pressure on general practice in the United Kingdom (UK). There is a paucity of research of general practitioners’ (GPs’) perspectives of quality of care in the community pharmacy sector.The purpose of this study was to explore GPs’:Conceptualisation of quality for community pharmacy services, including the management of acute (low acuity) conditions and defining indispensable aspects of the patient experience (‘always events’)Opinions regarding whether and how to measure quality in the community pharmacy sectorMethodSemi-structured interviews were conducted with GPs in the UK. GPs were recruited using the snowballing technique and professional networks. Interviews were audio-recorded, transcribed and analysed using an interpretive approach.ResultsInterviews were completed with 20 GPs from Scotland (n = 8) and England (n = 12). Multidimensional and inter-related concepts of quality were identified; most dimensions related to patient benefit, as well as impact on GP workload or other health service provision. Interviewees cautioned that “what counts can’t always be measured”. GPs’ expectations of quality often mirrored those of their own sector, but were ambivalent about the adoption of a quality outcome framework-type approach. Pharmacist involvement was expected to ensure quality in the management of ‘acute consultations’, however, GPs lacked awareness of community pharmacy personnel type, roles and training. Interviewees’ perceptions of quality varied by pharmacy type; independent pharmacies were sometimes associated with higher quality service delivery than larger chain organisations.ConclusionsQuality frameworks for community pharmacy services could be partly informed by GP experience and expectations, but need to be contextual to reflect differences between both settings. The importance of person-centred care, consistency and continuity was emphasised together with the need for competent personnel and privacy of interactions.

Through the lens of work-integrated learning: Staff experiences of participating in person-centredness coach training in a Swedish hospital

Background/Objective: Over the past decade, many scientific articles have focused on the importance of person-centred care (or person centredness) in the health care sector. In practice, however, person centredness is difficult to operationalise. Thus, the role of “person-centredness coach” was created in a Swedish hospital to provide information, education, and reflection on person centredness. The aim was to describe this new role of a person-centeredness coach, and how the coaches experienced the development of a person-centred working method.Methods: Qualitative semi-structured individual interviews were conducted with nine nursing staff. The data were analysed using inductive content analysis.Results: The analysis resulted in three categories with seven subcategories: an eye opener (with the subcategories of a welcome change and person centredness throughout the organisation); an obstacle with potential (with the subcategories of theoretical vs. practical development of person centredness, difficulties in developing person centredness and proposals for promoting patient participation); and a challenging role (with the subcategories of necessary but a role that takes a long time to develop and the importance of favourable conditions).Conclusions: The person-centredness coaches believed that the person-centred approach was important and that it should be the foundation of all care work within health care but, despite this, had difficulty in integrating person centredness into their practice. The person-centredness coaches found the coach training rewarding. They perceived that, from a learning perspective and through the lens of work-integrated learning, the results could be related to creating praxis, which may be seen as a development area for further research in operationalising person centredness.

'There's more to a person than what's in front of you': Nursing students' experiences of consumer taught mental health education.

Holistic and person-centred nursing care is commonly regarded as fundamental to nursing practice. These approaches are complementary to recovery which is rapidly becoming the preferred mode of practice within mental health. The willingness and ability of nurses to adopt recovery-oriented practice is essential to services realizing recovery goals. Involving consumers (referred herein as Experts by Experience) in mental health nursing education has demonstrated positive impact on the skills and attitudes of nursing students. A qualitative exploratory research project was undertaken to examine the perspectives of undergraduate nursing students to Expert by Experience-led teaching as part of a co-produced learning module developed through an international study. Focus groups were held with students at each site. Data were analysed thematically. Understanding the person behind the diagnosis was a major theme, including subthemes: person-centred care/seeing the whole person; getting to know the person, understanding, listening; and challenging the medical model, embracing recovery. Participants described recognizing consumers as far more than their psychiatric diagnoses, and the importance of person-centred care and recovery-oriented practice. Understanding the individuality of consumers, their needs and goals, is crucial in mental health and all areas of nursing practice. These findings suggest that recovery, taught by Experts by Experience, is effective and impactful on students' approach to practice. Further research addressing the impact of Experts by Experience is crucial to enhance our understanding of ways to facilitate the development of recovery-oriented practice in mental health and holistic and person-centred practice in all areas of health care.

Through the patient's eyes - the importance of person-centred care in oral cancer.

This opinion paper highlights the value which patients place on the delivery of a person-centred approach within dentistry. Excerpts from a qualitative interview are used to illustrate the level of importance afforded to the soft skills, as viewed through the eyes of a patient with experience of oral cancer. The role of the general dental practitioner in supporting patients with oral cancer is highlighted. Attention is drawn to the importance of the dentist-patient relationship and how this can support identification of risk; delivery of preventative advice; early detection and onward referral; and the provision of ongoing pastoral support. Continuity of care is identified as a key factor in delivering high quality person-centred care where the focus should be on the individual and not the disease.

The importance of person-centred care and co-creation of care for the well-being and job satisfaction of professionals working with people with intellectual disabilities.

Person-centred care and co-creation of care (productive interactions between clients and professionals) are expected to lead to better outcomes for clients. Professionals play a prominent role in the care of people with intellectual disabilities at residential care facilities. Thus, person-centred care and co-creation of care may be argued to lead to better outcomes for professionals as well. This study aimed to identify relationships of person-centred care and co-creation of care with the well-being and job satisfaction of professionals working with people with intellectual disabilities (PWID). A cross-sectional survey was conducted in 2015 among professionals working at a disability care organisation in the Netherlands. All 1146 professionals involved in the care of people with intellectual disabilities who required 24-hours care were invited to participate. The response rate was 41% (n = 466). Most respondents (87%) were female, and the mean age was 42.8 ± 11.5 years (22-65). The majority of respondents (70%) worked ≥22 hours per week and had worked for the organisation for ≥5 years (88%). Most of the respondents (76.8%) were direct care workers either in residential homes (59.3%) or in day activities (17.5%). After controlling for background variables, person-centred care and co-creation of care were associated positively with job satisfaction and well-being of professionals. The provision of person-centred care and co-creation of care may lead to better well-being and job satisfaction among professionals working with PWID. This finding is important, as such professionals often experience significant levels of work stress and burnout.

Getting home care right.

❛Even if they are not in regular contact with many of those receiving home care, community nurses can help support the knowledge needs of home care workers.❜ At last, the National Institute for Health and Care Excellence (NICE) with the support of the Social Care Institute for Excellence (SCIE) has published guidance (NICE, 2015) setting out the principles for high-quality home care together with the essential elements of acceptable home-care delivery, including the use of telecare. The guidance also recommends close joint working between health-care staff and those delivering home care, with particular reference to medications and other aspects of health support, so that home care workers are able to provide the necessary high-quality, person-centred support to maximise the health and wellbeing of their clients. The growing need for and expansion of home-care services is inevitable as the population ages. Yet, there are major concerns about the sustainability of the current levels of recruitment and retention across the UK, in part reflecting the rising expectations of the workforce (Hussein et al, 2015). Hussein et al’s study, using a national dataset 2008–2010 and comprising 2964 employers, found that although vacancy rates had fallen slightly, the workforce was characterised by high turnover with variability across individual employers. They particularly noted that the home-care workforce had lower stability and higher vacancy rates than those working in care homes, which bodes ill for meeting the future needs of the growing population of older people living in their own homes. The NICE (2015) guidance emphasises the importance of person-centred care, which supports the preferences and aspirations of those receiving care while recognising the higher risk of unmet social care needs of people with cognitive impairments or among those living alone. The importance of respectful care with the involvement of clients and their carers in decision making is stressed, together with the agreement of mutual expectations regarding care delivery. A major challenge for care providers is continuity of care when there are multiple visits each day, but it is the basis for relational trust; moreover, for many, the face-to-face contact is crucial for their psychological wellbeing. For the first time, a minimum visit time of 30 minutes is recommended, but visits may need to be longer where the care visits comprise many activities, including supporting a client’s eating and drinking. Community nurses are also important contributors to supporting people in their homes. Even if they are not in regular contact with many of those receiving home care, community nurses can help support the knowledge needs of home-care workers with regard to medications, pain management, and skin care, in addition to the health conditions of their clients, such as heart failure; diabetes mellitus; neurological conditions; physical disabilities; and mental health problems such as anxiety, depression, cognitive impairment, and dementia. They may also help to undertake the risk assessment and contribute to the risk plan. The NICE (2015) guidance also makes clear that telecare should not replace human contact, but it may be used as an adjunct offering reassurance to the client and/or their carer between visits or other social contacts. Indeed, a recent, large longitudinal study (Teo et al, 2015), involving 11 065 people aged 50 years and over, found that the probability of depressive symptoms increase as face-to-face contacts of children, other family members, and friends decrease. They also found that telephone, written, and email contacts had no benefit in preventing depressive symptoms, and are therefore not a substitute for face-to-face contact with older people. With the Christmas–New Year period approaching, community nurses should be especially watchful of their older clients who have few or no contacts with their family members or friends. BJCN

Richard Mahony — the misfortunes of younger onset dementia

Henry Handel Richardson's 1929 novel Ultima Thule, the third volume of The fortunes of Richard Mahony, portrays the final years of Mahony's failed 19th century colonial venture and the psychological challenges he faced. The novel graphically describes the onset and evolution of younger onset dementia, modelled on the author's own experiences with her father, who died of general paresis of the insane. The issues on which Richardson focuses, including Mahony's depression and suicidal despair, the difficulties of understanding behavioural change without a diagnosis, the impact of parental dementia on young children and the spouse, and the importance of person-centred care in dementia, remain relevant today.

Medication Management for Community-dwelling Older People with Dementia and Chronic Illness

The purpose of this paper is to report the findings of an integrative review of the literature on medication management for individuals who live in the community and have both chronic illness and mild to moderate dementia. The aim of the review was to summarise what is known about this topic, evaluate and compare previous research on the topic of medication management for people with dementia, and locate gaps in current work, thus pointing to directions for future research. Dementia is a national health priority for Australia. A significant component of community care for people with dementia is the management and administration of the medications required for other chronic conditions. Medication management is a broad term that encompasses several aspects, such as client-centred medication review, rational prescribing and support, repeat prescribing, client information/education, capacity to communicate with multiple health providers and having access to medicines. Cognitive impairment has been associated with medication management issues so it is important to ensure quality outcomes of medicine use by community-dwelling older people with dementia. The literature revealed a number of issues, such as the importance of person-centred care, the need for the coordination of care, and consumer partnerships in medication management. These are all important considerations in planning primary care services to support people with dementia and chronic illnesses. People with dementia who have chronic illness require coordinated, tailored, and flexible care processes in the community. There exists a range of services and programs such as home medicine reviews to support people living in the community with chronic illness and dementia; however, there is little coordination of care and evaluation of interventions is, at best, inconsistent. Currently, Australia lacks an integrative primary health care (PHC) framework, within which consumer involvement in decision-making and/or care planning is valued and sought. Current services are limited in the degree to which there is collaboration between key partners and Australian PHC initiatives are fragmented and have limited impact on service delivery.