Concept Of Patient-centred Care Research Articles

Development and prospects of natural orifice specimen extraction surgery for colorectal cancer: a review article.

The natural orifice specimen extraction surgery (NOSES) procedure is an innovative approach to treating colorectal cancer that offers several advantages. First, the NOSES technique is minimally invasive, reducing the incidence of postoperative complications such as wound infection and fat liquefaction. Second, it provides excellent pain relief and improves cosmetic outcomes by requiring fewer abdominal incisions, thereby increasing patient satisfaction. Additionally, NOSES provides all of the advantages of minimally invasive surgery and enables patients to recover quickly, helping patients return to their normal lives faster. This approach aligns with the concept of patient-centered care and significantly improves patient quality of life. The positive results noted at both short- and long-term postoperative follow-up indicate that NOSES is a valuable option in cancer care. Despite its many benefits, NOSES has also been challenged by bacteriology, oncology, and ethics. This paper presents a review of recent research progress regarding NOSES in the treatment of colorectal cancer. In this article, we examined the advantages and disadvantages of NOSES in clinical practice and discussed potential issues and solutions.

Patient-Centered Diabetes Care: Concept Analysis

Healthcare organizations are constantly aiming to improve the performance of the health services provided for chronically ill people. This is done via the implementation of several models of care. In recent years, the concept of patient-centered care has received increasing attention. Although several definitions of patient-centered care exist in the literature, the conceptualization of this concept for people with diabetes mellitus is poorly understood. This research was conducted to explore and clarify current definitions of patient-centered diabetes care in the context of nursing practice. Rodgers’ evolutionary model of concept analysis method was used to guide this inquiry. Results indicate that, patient-centered care has a holistic perspective: an approach that is vital in the delivery of nursing services that support patients’ choices and autonomy in their healthcare decisions. Findings suggest that, for patients with diabetes mellitus, this approach to care increased efficacy, achieved positive patient outcomes, and resulted in better interactions between patients and their professional teams.

The Patient's Perspective: Does It Align with Dialysis Adequacy?

The concept of patient-centered care puts the individual's health needs and desired health outcomes as the driving forces behind medical decision-making and quality assessment in the healthcare system. Patients with end-stage kidney disease (ESKD) treated by hemodialysis require frequent encounters with the dialysis facility in order to survive. Therefore, their satisfaction with care and perceived patient experience are important aspects that might impact their adherence to the care regimen. The aim of this study was to evaluate patient satisfaction and its association with perceived patient experience and objective clinical quality parameters, across three hemodialysis clinics. A prospective cohort study analyzed the data of 126 patients with ESKD receiving chronic hemodialysis over 9 months in 3 different care facilities. Sociodemographic characteristics, medical history, treatment details, and dialysis adequacy (measures as STDKt/V) were collected. Perceived quality of care, patient satisfaction and clinical outcomes were assessed. Patients differed significantly between sites by age, diabetes status and biochemical parameters. Satisfaction scores varied significantly for 12/14 survey questions and at the site-level, with Site 2 scoring highest. Overall satisfaction did not correlate with Kt/V. At Site 1, a moderate negative correlation was found between satisfaction and Kt/V. Kt/V correlated positively with age but inversely with satisfaction. Hospitalization rates were similar regardless of satisfaction. Mortality trended lower in the highest Kt/V quartile. Achieving clinical quality while optimizing patient satisfaction requires multifactorial approaches tailored to the unique population of the hemodialysis facility. Further research is needed to fully understand factors influencing satisfaction and perceived quality.

The Effect of Health Literacy on Health Status in Patients with Heart Failure: A Path Analysis.

Managing heart failure (HF) is challenging because of its complexity and high rates of hospitalization, morbidity, and mortality. Effective management requires coordination between patients' abilities and healthcare services; however, low health literacy among patients with heart failure can adversely affect their health status. Therefore, the understanding relationship between health literacy and health status would provide the evidence for developing future intervention. This analytical study explored multilevel factors influencing health literacy and health status in patients with heart failure (HF) who underwent health service delivery at outpatient clinics. The sample consisted of 453 patients with HF from 12 hospitals located in five regional areas (north, south, east, northeast, central, and Bangkok) in Thailand. A hypothetical model was used to test the association between comorbidity, social support, patient-centered care, health service delivery, health literacy, and health status. Path analysis was used to analyze the data. The results indicated that 40.8% of patients with HF exhibited low or inadequate levels of health literacy, yet perceived their health status as good, with an average of 25.2±19.8 points. Health service delivery by a cardiologist and nurse case manager directly influences health literacy. Comorbidity had a direct impact on health status, whereas social support, patient-centered care, and the aforementioned health service delivery indirectly affected health status through health literacy. Importantly, health literacy status directly influences health status. Comorbidity, social support, patient-centered care, and health service delivery were related with health literacy and high level of health literacy could influence the better health status. To increase the quality of health care services, health care providers should promote health literacy and integrate the concept of patient-centered care for HF patients at outpatient clinics. Recommendations include the training of nurses as case managers.

The role of moral integrity in the association between moral self and moral sensitivity among nurses: A mediation model.

Aim: This study aimed to investigate the relationship between moral self, moral integrity, and moral sensitivity in decision-making among nurses. Background: nurses face moral dilemmas almost on a daily basis. Studies have demonstrated that nurses with high moral sensitivity make thoughtful decisions and exhibit professional responsibility. The current study seeks to examine personality variables that may be related to moral sensitivity among nurses. Design: A cross-sectional study. Ethical considerations: This study was approved by the IRB of the authors University's ethics committee (number: AU-HEA-LO-20220317). Written consent was obtained from all participants. Methods: A structured questionnaires were administered to a sample of 187 Israeli nurses. Results: The degree of nurses' moral self, moral integrity and moral sensitivity was relatively high. "Patient-centered care" was found to be the most significant component of moral sensitivity. The next component is "Using knowledge bases," followed by "Exercising professional judgment." While the concept of patient-centered care was found to be related to the nurses' moral self, the other components were found to be related to their moral integrity. The mediation model found that moral integrity mediates and even strengthens the moral self in its connection with moral sensitivity. Conclusions: Understanding the role of moral self and moral integrity in explaining moral sensitivity, can contribute to achieving a desirable combination of "the good and the right" in nursing practice, thereby enhancing nurses' work. From a practical perspective, these findings are also relevant to nursing education. Nursing education plays a pivotal role in fostering moral and ethical decision-making in both clinical aspects and ethical moral sensitivity. Strengthening the moral self and moral integrity among nursing students can aid in making balanced and morally sensitive decisions while also building moral and ethical support systems to assist students in distressing and emergency situations.

Storytelling as an educational strategy for midwifery students: A qualitative study.

Narratives can provide a framework to teach the concepts of patient-centered care to the students. This article describes the experiences of midwifery students from employing of purposive storytelling as a teaching strategy in the education program. This qualitative study used an in-depth interview method to collect the experiences of midwifery students engaged in a narrative medicine training program. The narrative-based teaching activities focused on three patients to teach four themes (clinical manifestations, treatment options, prevention strategies, and ethics), and related to MMR (maternal mortality rate) concept offered to students from Guilan University of Medical Sciences in 2022-2023. At the end of the course, all students were invited to provide experiences regarding the teaching method. Conventional content analysis was performed simultaneously with data collection. Four-dimension criteria (Lincoln and Guba) were used to evaluate the rigor of the findings. Data analysis led to the extraction of three main categories and eight sub-categories: effective learning (extended learning, a safe learning environment, and boosted motivation for midwifery role), challenges on the way of learning (contagious sadness, shattered cohesion, and executive monopoly), and challenges on the way of performance improvement (the necessity of interdisciplinary education and the inevitability of a strong foundation). Narrative-based teaching may improve the learning experience of students, but it is not possible to train all the course content by this method, and it should ideally be a supplement to other educational methods, such as lecturing.

Outpatient oncology settings: the distinctive contribution of supportive design to patient experience and wellbeing

ABSTRACT The concept of patient-centred care is increasingly shaping healthcare practices, particularly within oncology settings. Its implications extend to a hospital's constructed environment and how it is designed, yet few studies have explored patient experience of such sensitive settings, and even fewer have examined outpatient oncology facilities. This study researched how the hospital built environment affects cancer patient wellbeing using in-depth interviews with 24 patients across Australia and Egypt. Analysis of patient-narrated experiences shed light on the potential latent impact of the built environment on patient health-related outcomes, such as pre-treatment anxiety and treatment-induced sensitivities and stresses. Three overarching themes were identified, including the built environment capacity to contribute to incidences of positivity; balancing the unavoidable (necessary) presence in the hospital; and encouraging reasons to return – potentially enhancing treatment compliance. The study further demonstrates how such support may contribute to experiencing a desired climate of patient-centred care, affording additional grounds for patients to cope with the potential burdens of treatment and its side effects.

Promoting patient-centered care in nursing education and the consequences of the Covid-19 pandemic. Results of a survey of nursing school principals in Germany

Background: Patient-centered care is largely determined by the manner in which patients and health care professionals such as nurses interact and communicate. To enable nurses to become familiar with the concept of patient-centered care and to learn concrete approaches to action, the training and qualification phase plays a central role. Although aspects of patient- and person-centered care can be found in the curricula of nursing training, it is unclear to what extent the associated competencies are being taught in nursing schools. Therefore, the aim of the study was to assess the educational goals and expected competencies acquired in nursing training regarding patient-centered care. In addition, it was investigated whether the acquisition of competencies changed during the Covid-19 pandemic.
 Methods: An online survey was conducted from March to April 2022 among members of the management team of German nursing schools. The questionnaires of N=347 respondents could be included in the analysis. Educational goals were assessed by a self-developed scale with nine items that could be rated on a 4-point Likert scale. The expected acquisition of competencies for patient-centered care were assessed on three subscales rated on a 5-point Likert scale. These focused on I) patient-centered decision making, II) patient-centered communication and interaction an III) patient-centered attitude. Information on sociodemographics, characteristics of the nursing school and digital health literacy was also obtained.
 Results: Members of the management team of nursing schools rated education goals regarding to patient centered care as important, with an general mean score of 3.6 (SD .34). Significant age or regional differences could not be found. However, there was a significant difference in gender: Female members of the school management team rated the educational goals as significantly more important overall than male members. The overall mean score in expected acquisition of competencies ranged in the subscales between 3.2 (SD 6.1) and 3.6 (SD .63). No significant sex, age or regional differences could be identified. Regarding the Covid-19 pandemic, about one third of the respondents stated that the acquisition of competences among nursing students has declined in the following aspects: involvement of patients in decision making, participation of patients in care situations as well as needs-based information, counselling, advice and education of patients.
 Conclusion: The results indicate that members of the management team of nursing schools highly value patient-centered care as an educational goal. However, they rated the nursing students' acquisition of competency on this issue as mid-level. The Covid-19 pandemic also contributed to a decline in patient-centred care competencies in a significant proportion. These findings should be further researched in future studies and there is as well the need for improving training and qualification programmes in nursing education regarding patient-centred care.

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Significance of Non-Statistically Significant Results in the Prediction of Oral Health-Related Quality of Life in Orthodontic Patients: A Survey Using Two Linking Questionnaires

Patients with a fixed orthodontic appliance may have difficulties in maintaining good oral health-related quality of life (OHRQoL), and evaluating self-perceived OHRQoL in orthodontic patients could be challenging for their orthodontists. Therefore, this research was conducted to investigate whether orthodontic postgraduates would accurately evaluate the OHRQoL of their patients. Two self-administered questionnaires were designed for patients to rate their OHRQoL and for their orthodontic postgraduates to evaluate them on OHRQoL. All pairs of patients and their orthodontic postgraduates were requested to independently complete the questionnaires. Pearson's correlation and multiple linear regression were performed to determine the relationships of the variables and to identify significant predictors on OHRQoL, respectively. There were 132 pairs of orthodontic patients and their residents who completed the questionnaires. There were no significant correlations between OHRQoL perceived by patients and evaluated by their orthodontic postgraduates in all aspects of treatment needs and dietary difficulties (p > 0.05). In addition, the regression model demonstrated no significant predictors for the self-perceived treatment needs and dietary difficulties of orthodontic patients. There seemed to be challenges for orthodontic postgraduates to evaluate their patients' oral health-related quality of life. Therefore, the OHRQoL measures should be increasingly implemented in orthodontic education and practice in order to enhance the concept of patient-centered care.

Patient-centered care in the Middle East and North African region: a systematic literature review

BackgroundThe need for patient centered care (PCC) and its subsequent implementation has gained policy maker attention worldwide. Despite the evidence showing the benefits and the challenges associated with practicing PCC in western countries there has been no comprehensive review of the literature on PCC practice in the Middle East and North African (MENA) region, yet there is good reason to think that the practices of PCC in these regions would be different.ObjectivesThis paper summarizes the existing research on the practice of PCC in the MENA region and uses this analysis to consider the key elements of a PCC definition based on MENA cultural contexts.MethodsFive electronic databases were searched (EMBASE, Cochrane, Medline, CINAHL and Scopus) using the search terms: patient OR person OR client OR consumer AND centered OR centred AND care. The MENA countries included were Bahrain, Iran, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Israel, Qatar, Saudi Arabia, Syria, United Arab Emirates, Yemen, Algeria, Egypt, Libya, Morocco, Tunisia, Djibouti, Pakistan, Sudan, and Turkey. Identified papers were imported to Covidence where they were independently reviewed against the inclusion criteria by two authors. The following data were extracted for each paper: author, year, location (i.e., country), objectives, methodology, study population, and results as they related to patient centred care.ResultThe electronic search identified 3582 potentially relevant studies. Fifty articles met the inclusion criteria. Across all papers five themes were identified: 1) patient centered care principles; 2) patient and physician perceptions of PCC; 3) facilitators of PCC; 4) implementation and impact of PCC; and 5) barriers to PCC.ConclusionThe preliminary findings suggest that the concept of PCC is practiced and supported to a limited extent in the MENA region, and that the implementation of PCC might be impacted by the cultural contexts of the region. Our review therefore highlights the importance of establishing patient-centered care definitions that clearly incorporate cultural practices in the MENA region. The elements and impact of culture in the MENA region should be investigated in future research.

Kemampuan Perawat Dalam Menerapkan Patient Centered Care Di RSUD Dr. M. Haulussy Ambon

Patient-focused services or commonly called Patient Centered Care (PCC) have become the main focus in providing health care today. The PCC concept was first introduced by Picker in 1988 through the Picker Institute Europe in England. Regional General Hospital (RSUD) Dr. M Haulussy Ambon is a hospital that has been accredited and is required to be able to implement PCC in its services. Purpose this study was to determine the ability of nurses to apply PCC at RSUD dr. M. Haulussy Ambon. The research design used is descriptive quantitative using observational. The population in this study were nurses at RSUD Dr. M Haulussy Ambon as many as 302 nurses. The number of samples is 113 respondents. data collection techniques using a questionnaire. Results: Most of the nurses' ability to apply PCC showed good results but there were still a number of PCC dimensions that had sufficient results. The PCC dimensions that get good results are respecting patient choices and assessments, physical comfort, information and education, service coordination, and involving family and friends. It can be concluded that most nurses are capable of implementing PCC.

A poverty simulation to enhance nursing student knowledge, skills, and attitudes toward people living in poverty

Poverty is a reality for many individuals and families. Unless one has lived in a poverty situation, it can be difficult to understand the challenges people face. This study was a quasi-experimental study with a pre- and post-test design (36 select-items from four-established instruments) that measured students' self-perceived knowledge, skills, and attitudes towards people living in poverty. All undergraduate, pre-licensure, senior-level nursing students enrolled in a community nursing course (fall 2018-fall 2019, n = 254) participated in a face-to-face interactive Community Action Poverty Simulation (CAPS) with a focus on the QSEN concept of patient-centered care. The winter 2020 semester, the simulation was not offered because of the coronavirus pandemic; these students (n = 96) served as a comparison group. Paired-samples t-tests revealed knowledge, skill, and attitude mean scores, were improved for all students with the exception of social justice attitudes (improved only for the non-simulation group). Independent-samples t-tests revealed simulation students had higher knowledge, skill, and attitude scores on the Adapted CAPS Assessment and Active Learning Measure. Non-simulation participants had higher Political Awareness scores. These results indicated the CAPS appears to be an effective simulation to change students' self-perceived knowledge, skills, and attitudes regarding people whose incomes are low or who are living in poverty.

Clinician documentation of patient centered care in the electronic health record.

BackgroundIn this study we sought to explore the possibility of using patient centered care (PCC) documentation as a measure of the delivery of PCC in a health system.MethodsWe first selected 6 VA medical centers based on their scores for a measure of support for self-management subscale from a national patient satisfaction survey (the Survey for Healthcare Experience-Patients). We accessed clinical notes related to either smoking cessation or weight management consults. We then annotated this dataset of notes for documentation of PCC concepts including: patient goals, provider support for goal progress, social context, shared decision making, mention of caregivers, and use of the patient's voice. We examined the association of documentation of PCC with patients’ perception of support for self-management with regression analyses.ResultsTwo health centers had < 50 notes related to either tobacco cessation or weight management consults and were removed from further analysis. The resulting dataset includes 477 notes related to 311 patients total from 4 medical centers. For a majority of patients (201 out of 311; 64.8%) at least one PCC concept was present in their clinical notes. The most common PCC concepts documented were patient goals (patients n = 126; 63% clinical notes n = 302; 63%), patient voice (patients n = 165, 82%; clinical notes n = 323, 68%), social context (patients n = 105, 52%; clinical notes n = 181, 38%), and provider support for goal progress (patients n = 124, 62%; clinical notes n = 191, 40%). Documentation of goals for weight loss notes was greater at health centers with higher satisfaction scores compared to low. No such relationship was found for notes related to tobacco cessation.ConclusionProviders document PCC concepts in their clinical notes. In this pilot study we explored the feasibility of using this data as a means to measure the degree to which care in a health center is patient centered. Practice Implications: clinical EHR notes are a rich source of information about PCC that could potentially be used to assess PCC over time and across systems with scalable technologies such as natural language processing.

The Implementation of PROMs/PREMs in the Assessment of Orthodontic Treatment Outcomes: A Questionnaire Survey.

ABSTRACTObjectives:The aim of this study was to explore the impact of self-perceived treatment outcomes and experiences on psychological aspects, reflecting the importance of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in orthodontic practice.Materials and Methods:A questionnaire was constructed using the PROMs/PREMs concepts. It contained five parts: “Demographic data”, “Self-perceived esthetics”, “Self-perceived functional concern”, “Satisfaction of treatment procedures”, and “Psychological aspect”. The questionnaire was piloted in five experts and 50 orthodontic patients to ensure its quality, using content validity, test-retest reliability, and Cronbach’s alpha. The validated version was provided to patients who had a complete fixed appliance orthodontic treatment. These data were analyzed using descriptive statistics, Mann-Whitney U test, and Spearman correlation. In addition, a multiple linear regression was used to analyze whether there were any influential factors on a psychological aspect. Statistical significance was taken at P < 0.05.Results:A total of 271 respondents completed the questionnaire. They tended to have positive perceptions toward the outcomes of orthodontic treatment. There was a significant difference in self-perceived esthetics between the male and female groups. Self-perceived esthetic and functional concerns as well as satisfaction of treatment procedures were found to have significant correlations with the psychological aspect. Sex and self-perceived esthetics were also found to be significant predictors of the psychological aspect.Conclusion:PROMs/PREMs should be considered as an important tool to assess treatment outcomes in orthodontic practice. There appeared to be significant impact of self-perceived esthetics on psychological aspects. Consequently, PROMs and PREMs should be introduced in orthodontic postgraduate programs to enhance the concept of patient-centered care in orthodontic practice.

A-qualitative-study-exploring-pharmacists-perspectives-on-the-conceptualization-and-operationalization-of-patient-centred-care-in-the-hospital-pharmacy-setting

Objective: The objectives of this study were to determine how hospital pharmacists in a developing country interpret the term "patient-centred care (PCC)", how it was or can be operationalized in hospital pharmacy practice, and barriers faced in delivering such care. Method: A generic qualitative approach was utilized. Semi-structured interviews were conducted with purposively sampled pharmacists from a Malaysian tertiary referral hospital until data saturation, using an interview guide informed by relevant literature. Interviews were audio-recorded and transcribed verbatim, with resultant transcripts subsequently coded and analysed using thematic analysis technique. Result: Fifteen pharmacists were interviewed. Hospital pharmacists conceptualized the basic spirit of PCC as "putting patients first". On the operationalization of PCC in pharmacy services, one theme/viewpoint was that all processes of care that are patient-oriented, including efforts that facilitate patient convenience, improve ecosystem of care and access of care should be considered as PCC. A contrasting theme only regard pharmacy services demonstrating specific elements, such as provision of individualized therapy, holistic in nature and enable building of rapport and trust between patient and pharmacist, as being consistent with PCC principles. Improving pharmacists' communication skills, patients' health literacy and over-reliance on clinicians as well as resource limitations are deemed integral for successful implementation of PCC services. Conclusion: Beyond the concept of putting patients first, there was confusion on the exact concept of PCC and its subsequent operationalization in hospital pharmacy practice. Development of a pharmacy specific PCC framework to serve as a universal blueprint to guide operationalization is recommended.

Optimization of Direction and Control Functions in Improving SOAP Writing in CPPT at X Hospital

The provision of patient care in hospitals is carried out based on the concept of Patient-Centered Care (PCC). One of the dimensions of this PCC is the coordination and integration of care services. The integration of care services is carried out horizontally and vertically. The care provider professionals work as intra and interdisciplinary with interprofessional collaboration, assisted by an integrated patient development record written in SOAP form. As the most caregivers in hospitals, nurses must correctly record and document every patient's progress so that other professions can quickly use them. The phenomenon that occurs, doctors do not read or do not believe in the writings of nurses. Hospital X is a type a hospital, specifically in the intensive care unit; the average BOR in the last three months is 69.71%. Based on the observations, it was found that the writing of SOAP on integrated patient development records was not the same for every NurseNurse and not following the standards. So it is necessary to optimize the direction and control function of the Charge Nurse and the head of the room for writing SOAP on integrated patient development records to comply with Nursing Care Standards and SOPs for Hospital X. The method used is a pilot project, starting from data identification, problem analysis, problem priority setting, Plan Preparation of Action (POA), implementation, and evaluation. Data were collected by interview, observation, and survey methods using a google form containing questions about the knowledge and perceptions of nurses on writing SOAP on the integrated patient development record. With the direction and control/control, each level of the manager is expected to achieve organizational goals and improve the deviations found. For this reason, it is hoped that the hospital can accelerate the implementation of EMR synchronized with the nursing care standards that have been arranged and continue to carry out regular supervision in writing SOAP on the integrated patient development record.

Diversity of interpretations of the concept "patient-centered care for breast cancer patients"; a scoping review of current literature.

Patient-centered care is considered a vital component of good quality care for breast cancer patients. Nevertheless, the implementation of this valuable concept in clinical practice appears to be difficult. The goal of this study is to bridge the gap between theoretical elaboration of "patient-centered care" and clinical practice. To that purpose, a scoping analysis was performed of the application of the term "patient-centered care in breast cancer treatment" in present-day literature. For data-extraction, a literature search was performed extracting references that were published in 2018 and included the terms "patient-centered care" and "breast cancer". The articles were systematically traced for answers to the following three questions: "What is patient-centered care?", "Why perform patient-centered care?", and "How to realize patient-centered care?". For the content analysis, these answers were coded and assembled into meaningful clusters until separate themes arose which concur with various interpretations of the term "patient-centered care". A total of 60 publications were retained for analysis. Traced answers to the three questions "what", "why", and "how" varied considerably in recent literature concerning breast cancer treatment. Despite the inconsistent use of the term "patient-centered care," we did not find any critical consideration about the nature of the concept, regardless of the applied interpretation. Interventions that are supposed to contribute to the heterogeneous concept of patient-centered care as such, seem to be judged desirable, virtually without empirical justification. We propose, contrary to previous efforts to define "patient-centered care" more accurately, to embrace the heterogeneity of the concept and apply "patient-centered care" as an umbrella-term for all healthcare that intends to contribute to the acknowledgement of the person in the patient. For the justification of measures to realize patient-centered care for breast cancer patients, instead of a mere contribution to the abstract concept, we insist on the demonstration of desirable real-world effects.

Working around a patient, core concept of the patient-centered care with a focus on diabetes mellitus and associated chronic wounds; A review

Management of chronic diseases is a challenging task in current medical practice and treatment of such conditions and their complications is not very straight forward as we deal with multiple clinical problems. This review article provides an overview of the core concept of patient-centered care, effects of diabetes mellitus (DM) on wound healing, and implication of the multidisciplinary team concept for such patients. The literature was searched using “wounds”, “chronic wound healing”, “multidisciplinary team and chronic wound healing” and “patient-centered care and wound healing” as keywords on PubMed as the main source of search. Every chronic disease can involve many health professionals at various stages. The patient-centered approach is a concept that is proving beneficial clinically. This concept considers patient as a center of the circle, and every facility is connected and based upon the patient’s needs. In this article, we have briefly explained implication of such multidisciplinary teams by considering DM management, with a focus on chronic wounds. DM is one of the systemic diseases which puts a significant financial as well as health quality related burden on health systems worldwide. Out of these complications, diabetic foot ulcers (DFUs) and effects of DM on wound healing are extremely important. This clinically important concept of making “teams” to manage various chronic diseases should be investigated in various clinical settings. The data from further research should be analysed to standardize this globally for different categories of wound patients.

Rare disease care pathways in the EU: from odysseys and labyrinths towards highways.

Care pathways (CPW) are used worldwide to structure care processes within the patient-centered care concept. Rare diseases (RD), defined as those affecting less than 5 persons per 10,000 and including up to 10,000 different diseases, present unique challenges to CPW development due to their rarity and a large number of disease entities, chronic and frequently disabling nature, heterogeneous manifestation, multisystem involvement, and complexity in diagnostics and treatment. However, failure to develop RD CPWs eventually leads to long diagnostic odysseys, limited and unequal access to RD treatments, and a huge burden of complex care coordination that lies on the shoulders of patients and their families, imposing many personal, professional and social life difficulties, and diminishing their quality of life. In the development of RD CPW, there is a need to ensure smooth horizontal and vertical care integration, multiple transitions, and long-term care coordination across many geographically distant care providers and to find a fine balance between centralized expertise-based, complex, highly specialized services and possibilities for local care provision, patient empowerment and self-management, and digital healthcare. Established in 2017, European Reference Networks may have a high added value through an increase in accessibility and quality of services, economies of scale, scope and speed in the development of lacking evidence-based, educational and other resources for RD CPW, and speeding up innovation development and translation into RD CPW. However, their full benefits may only be reaped through a pan-European collaboration, universal acceptance of common European values and open-mindedness for sometimes disruptive innovation in the provision of healthcare across all Member States of the European Union.