Patient-centered Care Model Research Articles

Pharmaco-Multiomics: A New Frontier in Precision Psychiatry

The landscape of psychiatric care is poised for transformation through the integration of pharmaco-multiomics, encompassing genomics, proteomics, metabolomics, transcriptomics, epigenomics, and microbiomics. This review discusses how these approaches can revolutionize personalized treatment strategies in psychiatry by providing a nuanced understanding of the molecular bases of psychiatric disorders and individual pharmacotherapy responses. With nearly one billion affected individuals globally, the shortcomings of traditional treatments, characterized by inconsistent efficacy and frequent adverse effects, are increasingly evident. Advanced computational technologies such as artificial intelligence (AI) and machine learning (ML) play crucial roles in processing and integrating complex omics data, enhancing predictive accuracy, and creating tailored therapeutic strategies. To effectively harness the potential of pharmaco-multiomics approaches in psychiatry, it is crucial to address challenges such as high costs, technological demands, and disparate healthcare systems. Additionally, navigating stringent ethical considerations, including data security, potential discrimination, and ensuring equitable access, is essential for the full realization of this approach. This process requires ongoing validation and comprehensive integration efforts. By analyzing recent advances and elucidating how different omic dimensions contribute to therapeutic customization, this review aims to highlight the promising role of pharmaco-multiomics in enhancing patient outcomes and shifting psychiatric treatments from a one-size-fits-all approach towards a more precise and patient-centered model of care.

A Brief Web-Based Person-Centered Care Group Training Program for the Management of Generalized Anxiety Disorder: Feasibility Randomized Controlled Trial in Spain.

Shared decision-making (SDM) is a crucial aspect of patient-centered care. While several SDM training programs for health care professionals have been developed, evaluation of their effectiveness is scarce, especially in mental health disorders such as generalized anxiety disorder. This study aims to assess the feasibility and impact of a brief training program on the attitudes toward SDM among primary care professionals who attend to patients with generalized anxiety disorder. A feasibility randomized controlled trial was conducted. Health care professionals recruited in primary care centers were randomized to an intervention group (training program) or a control group (waiting list). The intervention consisted of 2 web-based sessions applied by 2 psychologists (VR and YA), based on the integrated elements of the patient-centered care model and including group dynamics and video viewing. The outcome variable was the Leeds Attitudes Towards Concordance scale, second version (LATCon II), assessed at baseline and after the second session (3 months). After the randomized controlled trial phase, the control group also received the intervention and was assessed again. Among 28 randomized participants, 5 withdrew before the baseline assessment. The intervention significantly increased their scores compared with the control group in the total scale (b=0.57; P=.018) and 2 subscales: communication or empathy (b=0.74; P=.036) and shared control (ie, patient participation in decisions: b=0.68; P=.040). The control group also showed significant pre-post changes after receiving the intervention. For a future effectiveness trial, it is necessary to improve the recruitment and retention strategies. The program produced a significant improvement in participants' attitude toward the SDM model, but due to this study's limitations, mainly the small sample size, more research is warranted.

Rethinking chronic care: how blended patient-centered care delivery and innovative financing models can contribute to achieving universal health coverage – a case study of an integrated approach in Kenya

Abstract Universal Health Coverage (UHC) aims to ensure all individuals have access to essential health services without financial hardship. Chronic diseases, like hypertension and diabetes, play a critical role in achieving UHC due to their lifelong management needs. This paper examines the implementation of a digital and mobile-based, patient-centered care model aimed at improving care for hypertensive and diabetic patients in Kenya. Between 2018 and 2019, 1626 patients from 9 clinics in Nairobi, Kiambu, Nyeri and Vihiga counties were enrolled in an integrated non-communicable disease (NCD) care model including self-management devices for home monitoring, a digital health wallet (M-TIBA) for co-payment, and facility-based peer support groups. Follow-up data was collected November–December 2020. Results indicated significantly improved patient outcomes, with 50% of hypertensive and 74% of diabetic patients achieving disease control, compared to 42% and 52% at baseline. Additionally, peer group participation increased adherence to self-monitoring and lifestyle modifications, contributing to better health outcomes. Despite these successes, challenges such as accessing medications and technical issues with digital tools were identified. Financial sustainability and scalability remain critical concerns, particularly in under-resourced settings. The case study highlights the potential of digital health solutions to enhance chronic care and support UHC by improving accessibility and reducing costs. A multifaceted approach, combining digital tools with face-to-face support and addressing structural barriers in healthcare systems, is essential for long-term success. The findings contribute to the broader discourse on integrated care models for NCDs in low-resource settings, underscoring the importance of sustainable financing and innovative care delivery mechanisms.

Patient Acceptability of the First Integrative Pediatric Oncology Unit in Spain-The Pediatric Cancer Center Barcelona Experience: A Retrospective Study.

Pediatric cancer patients and their families are increasingly combining conventional treatment with complementary therapies. These therapies are not covered by most public healthcare systems, and Spain is not an exception. To address this need, the Pediatric Cancer Center Barcelona, at the Hospital Sant Joan de Déu (Spain), established the first integrative pediatric oncology unit in 2019. The objective of this study is to describe the feasibility of implementing a pediatric integrative oncology unit, in terms of the acceptance of the interventions, as well as to present initial data on the care activities; Methods: This is a retrospective single-center study, conducted in the Pediatric Cancer Center Barcelona, at the Hospital Sant Joan de Déu. Data from patients during a two-year period were collected by reviewing medical records in a pseudonymous manner; Results: From 1 September 2019 to 30 September 2021, the unit was visited by 433 patients. The median age of patients was 9 years [range 0-34 years], with 266 boys (61.4%) and 167 girls (38.6%). Of these patients, 90.1% were in active treatment, 7.6% were survivors, and 2.3% were at the end of life. Acupuncture was recommended to 227 patients, with a 94.7% acceptance rate. Aromatherapy was recommended to 114 patients, with a 100% acceptance. The reflexology team visited 129 patients, delivering a total of 414 sessions, with a 96.1% acceptance.; Conclusions: The findings of our study support the feasibility of implementing an Integrative Pediatric Oncology Unit within a patient-centered care model in a comprehensive pediatric cancer center. The high acceptance rates of various complementary therapies highlight their potential role in enhancing supportive care for pediatric oncology patients.

Advancing Patient-Centered Care: A Nationwide Analysis of Hospital Efficiency and Morbidity Using Innovative Propensity Score Techniques.

Introduction The patient-centered care model emphasizes patient autonomy in recovery, acknowledging each individual's unique journey. Despite challenges in the healthcare system, this model has gained traction nationwide. Advances in healthcare technology have highlighted obstacles to independent decision-making. This study addresses these issues by emphasizing the need for consistent access to health information, which is crucial for empowering patients. We aim to proactively identify information gaps and propose new insights for better data precision and synchronization protocols. Our analysis of nationwide hospital length of stay (LOS) data demonstrates data-driven interventions tailored to patients' needs, aiming to improve the hospital experience and reduce care fragmentation. Methods We examined the complex nature of hospital LOS and various variables across nationwide healthcare settings using CMS data from 2011 to 2021. To enhance our national findings, we incorporated a local perspective by analyzing LOS data from Arrowhead Regional Medical Center (ARMC) and its associated diagnosis-related groups (DRGs). We employed a propensity score to adjust for variables and proactively drive realistic predictions of hospital outcomes. This methodological approach emphasizes the importance of using tools that can be scaled from localized settings to a broader national context. Furthermore, our study highlights the critical need for continuous quality assessment of hospital LOS. This includes measuring LOS and developing innovative tools capable of predicting, analyzing, intervening, and prompting actions based on insights gained from data analysis. The study aims to achieve several core objectives by integrating these components: enhancing patient empowerment through improved communication, refining LOS assessment through innovative techniques, and developing predictive tools to inform clinical practice and policy. Ultimately, this research contributes to a more patient-centered approach to managing inpatient care, improving patient outcomes and satisfaction. Results Our study aspires to transform three pivotal domains that can enhance patient autonomy, optimize hospital recovery, and elevate the overall experience. First, the cost of care reveals that prolonged hospital stays and escalating expenses are often linked to more severe health consequences. Second, our analysis uncovers the intricate relationship between hospital outcomes, such as mortality and readmissions, showing that shorter hospital stays can diminish patients' risk of complications. However, we must tread carefully, as this approach may lead to premature discharges. Lastly, providers can gain more precise insights into these interconnected outcomes by leveraging data tools such as propensity scores. We advocate for the dissolution of care fragmentation through robust health information exchange (HIE), and the adoption of innovative strategies such as blockchain and advanced machine learning (ML) techniques that rise to contemporary medicine and adapt to the growing patient needs.

Spiritual Care Interventions for Adult Patients in Intensive Care Units: A Scoping Review Protocol.

Caring for patients in intensive care units (ICUs) requires healthcare workers to recognize the importance of a spiritual care approach in these settings. Moving toward a holistic and patient-centered care model that incorporates spiritual care is essential for enhancing patients' healing process. The disease-centered approach of ICU and the perceived deficit of spiritual care highlight the need to add knowledge on integrating spiritual care interventions into daily ICU practices. The aim of this scoping review will be to develop a comprehensive overview of the characteristics of spiritual care interventions for adult patients in ICU according to JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The inclusion criteria will be informed by the types of participants, concept and context, and types of evidence sources. Quantitative, qualitative and mixed methods studies, editorials, opinion papers and gray literature will be included. Databases such as PubMed (National Library of Medicine), CINAHL, Academic Search Complete, Psychology and Behavioral Sciences Collection, APA PsycINFO, Cochrane Central Register of Controlled Trials (via EBSCOhost), Scopus and Web of Science Core Collection will be searched. No date limit will be set. Titles and abstracts that meet the inclusion criteria, full texts of eligible studies and reference lists of all selected sources will be screened by 2 independent reviewers. Data will be extracted using customized tools, presented in diagrammatic or tabular format and summarized in a final narrative synthesis report. This research represents the first effort to develop a comprehensive overview of the characteristics of spiritual care interventions exclusively targeting adult patients in ICU settings. The findings will offer a thorough review of these interventions, including their main attributes, providers, resources, associated outcomes and assessment tools. Consequently, this knowledge can enhance the spiritual dimension of patient-centered care in the ICU, thereby promoting a shift from the traditional biomedical model to a more holistic perspective and establishing a new standard in critical care.

Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients.

Kidney transplantation (KT), although the best treatment option for eligible patients, entails maintaining and adhering to a life-long treatment regimen of medications, lifestyle changes, self-care, and appointments. Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs. Even when transplants are successful, for some patients the adjustment to life post-transplant can be challenging and psychological difficulties, economic challenges and social isolation have been reported. About 50% of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care. This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation. A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes. We propose the "supportive care in transplantation" care model to operationalize a patient-centered approach in transplantation. This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates. Multi-dimensionality, multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model. We conclude by proposing the potential advantages of this approach to patients and healthcare systems.

Critical Analysis of Leadership Strategies, Hospital Efficiency, And Patient-Centered Care Models

The healthcare industry is still developing; the directional trends have started to lean towards better hospital management strategies that would result in better patient care. In this paper, I critically review different leadership approaches in hospital contexts with success in organizational effectiveness and patient care delivery systems. Issues like leadership styles, including transformational, transactional, and servant leadership, logistical factors and clinical implications, and patient satisfaction are discussed on the operational level. Qualitative interviews are conducted Using qualitative and quantitative study methods, with results being statistically compared with corresponding quantitative hospital variables such as patient satisfaction, staff turnover, and readmission rates. The research indicates that the study has provided recommendations showing that Michigan Organizational QL is essentially predictive of cross-functional team collaboration and can be used to predict patient-centered care models. Finally, the paper contemplates the best recommendations that healthcare administrators and policymakers should consider embracing in order to raise standards in the direction, quality, and productivity of hospitals and care outcomes through purposes that embrace patient-centered care.

Patient-Reported Outcomes Measurement Information System as a Clinical Tool for Capturing the Patient Perspective in Pediatric Inflammatory Bowel Disease: A Narrative Review.

Inflammatory bowel disease (IBD) is an immune-mediated chronic disease with a significant impact on quality of life. In pediatric patients, diagnosing and managing IBD is particularly challenging, and IBD often presents as a more severe and progressive disease. Patient-reported outcomes (PROs) are measures of treatment and disease management outcomes reported by patients and/or caregivers. These measures evaluate several aspects of disease management from the patient/caregiver perspective, emphasizing the patient's real-life experience with the disease and its treatment. PROs represent a model of patient-centered care, facilitating better-informed healthcare decisions. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to promote the use of PROs among patients with chronic conditions. Its primary objective is to provide PROs for research and clinical practice throughout the lifespan. The PROMIS is a non-disease-specific instrument for both adults and pediatric patients assessing domains of physical, psychological, and social health, as well as quality of life (QOL). These instruments are designed to be applicable to a wide range of chronic diseases. Despite the initial expectation concerning PROs in assessing pediatric IBD outcomes, objective data in this area have only recently begun to emerge. This narrative review, based on a selection of reliable articles recognized by PubMed and Cochrane Library, aimed to identify and summarize previously published evidence of the usefulness of PROs, particularly the PROMIS, in IBD patients and in the pediatric population. We present an updated perspective, including identification of their general applications and most relevant previous studies, in the mentioned areas and identify knowledge gaps.

Innovations in coeliac disease diagnosis and treatment

This article provides healthcare professionals, particularly gastroenterology nurses, with a forward-looking perspective on the management of coeliac disease that emphasises an evolving, patient-centred approach. This article also examines emerging advancements in diagnosis, treatment and management, alongside their implications for nursing practice. Current diagnostic methods, while considered the gold standard, remain invasive and burdensome for patients. However, recent innovations, including no-biopsy strategies and biomarkers such as serum interleukin-2 (IL-2) and HLA-DQ–gluten tetramers, present less invasive alternatives. Advances in imaging techniques and artificial intelligence promise to further enhance diagnostic accuracy. Therapeutic developments, such as enzyme-based treatments and immune modulators, offer potential to reduce dependency on a strict gluten-free diet, thereby improving patients’ quality of life. The integration of digital health tools, telemedicine and psychological support highlights the importance of a holistic, patient-centred care model. Gastroenterology nurses play a pivotal role in implementing these advancements, particularly through education, community engagement and multidisciplinary collaboration. This article also addresses critical ethical considerations, including equitable access to care and the psychological impact of genetic screening, to ensure that all patients can benefit from these innovations.

Health Professionals on Cross-Sectoral Collaboration Between Mental Health Hospitals and Municipalities: A Critical Discourse Analysis.

This study investigates the role of language in cross-sector collaboration between mental health hospitals and municipalities, focusing on the challenges of maintaining continuity of care and integrating patient-centered approaches. Using Fairclough's framework for critical discourse analysis, we examined focus group interviews with 21 healthcare professionals, including nurses, social workers, and psychiatrists, to identify key themes and patterns in how cross-sector collaboration is discussed. The analysis revealed a dominant medicalized discourse in hospital settings, which often emphasized structured care processes like treatment plans and medication management, overshadowing more flexible, patient-centered approaches common in community-based services. Power dynamics were evident, with hospital professionals frequently positioned as active agents, while patients and community-based workers were portrayed in more passive roles. Although efforts to involve patients in decision-making were noted, these were often controlled by professionals, reflecting a mediated approach to patient empowerment. The findings highlight the cultural and structural divides between hospital and community services and suggest the need for improved communication strategies, integrated care pathways, and a shift toward more inclusive, patient-centered care models. Addressing these discursive barriers is crucial for achieving more effective, integrated, and patient-centered care, ultimately improving outcomes for patients.

Enhancing Patient-Centered Care Through Process Improvement: A Systematic Review of patient Satisfaction Outcomes

Patient-centered care has become a cornerstone in modern healthcare, focusing on personalized, respectful, and effective treatment that meets patients' unique needs and preferences. Process improvement methodologies, such as Lean, Six Sigma, and workflow optimization, have been increasingly adopted to streamline healthcare operations, reduce inefficiencies, and improve the quality of care. However, the specific impact of these methodologies on patient satisfaction within patient-centered care frameworks remains to be systematically evaluated. This systematic review aims to examine the effects of Lean, Six Sigma, and workflow optimization on patient satisfaction outcomes in patient-centered care settings, offering evidence-based insights for healthcare providers and policymakers.A comprehensive search was conducted across multiple databases, including PubMed, CINAHL, and Cochrane Library, to identify studies published from 2016 onward that evaluated patient satisfaction outcomes related to Lean, Six Sigma, and workflow optimization within patient-centered care models. Eligible studies were screened, assessed for quality, and analyzed based on patient satisfaction outcomes. Data extraction and quality assessments followed PRISMA guidelines.Findings from the selected studies indicate that process improvement methodologies positively impact patient satisfaction, with notable improvements in wait times, care coordination, and communication quality. Lean and workflow optimization showed a significant reduction in bottlenecks, while Six Sigma was associated with error reduction and standardized practices, contributing to higher patient satisfaction scores.Lean, Six Sigma, and workflow optimization methodologies offer promising avenues to enhance patient-centered care by improving patient satisfaction metrics. These methodologies provide healthcare organizations with structured approaches to meet patient needs more effectively and consistently, reinforcing the critical role of process improvement in achieving high-quality, patient-centered healthcare.

Adaptive digital and non-digital self-management in permanent enterostomy patients: A qualitative study based on the Chronic Illness Trajectory framework

PurposeTo examine the adaptive self-management strategies of enterostomy patients across different health trajectory phases and explore how patients utilize a combination of digital tools and traditional practices to manage their condition effectively within the Chronic Illness Trajectory Framework (CITF). MethodsParticipants were recruited from Qingdao Municipal Hospital's Stoma Clinic between October 2022 and August 2024. A total of 26 adults who had undergone permanent enterostomy surgery at least six months prior were selected through purposeful sampling to capture diverse experiences across different health trajectory phases. Semi-structured interviews were conducted, and data were analyzed using thematic analysis, with saturation reached when no new insights emerged. ResultsThree primary trajectory types emerged: (1) Living with a Stable Enterostomy Condition, where structured routines and preventive practices helped patients maintain health stability; (2) Experiencing Cycles of Deterioration and Recovery, characterized by proactive monitoring and recovery practices, often supported by family and telemedicine; and (3) Responding to Unstable Changes, requiring immediate actions, real-time adjustments, and crisis planning, with patients relying on both wearable monitors and established self-care routines. Across all phases, a balanced use of digital and non-digital methods enhanced adaptability and resilience. ConclusionThe findings underscore the importance of phase-specific, adaptive self-management strategies that blend digital innovations with foundational self-care practices. CITF offers a valuable framework for clinicians to assess patients’ trajectory phases and provide tailored support that aligns with their unique health needs. This approach can promote patient autonomy, improve quality of life, and inform the development of comprehensive, patient-centered care models for enterostomy and other chronic conditions.

Patient-Centered Care Models in Primary Healthcare: A Systematic Review of Implementation and Outcomes

This systematic review evaluates the implementation and outcomes of patient-centered care (PCC) models in primary healthcare settings. Patient-centered care is a foundational approach in primary healthcare, emphasizing patient preferences, needs, and values to improve the quality of care and health outcomes. A comprehensive literature search was conducted across PubMed, Cochrane, and MEDLINE databases, focusing on studies that assessed the impact of PCC models such as the Patient-Centered Medical Home (PCMH) and shared decision-making. Forty studies met the inclusion criteria, covering a range of patient populations and healthcare settings. Findings indicate that PCC models enhance patient satisfaction, improve health outcomes, and increase patient engagement in care. Additionally, these models positively impact provider satisfaction and may reduce healthcare costs by lowering emergency visits and hospitalizations. However, challenges in implementation, including provider workload and resource needs, were commonly reported. This review underscores the effectiveness of PCC models in primary care and highlights the need for structured, resource-supported implementation strategies. Further research is recommended to optimize PCC approaches across diverse populations and healthcare systems.

Implementing a Digital Platform for Recurrent Urinary Tract Infections.

A patient-centered care model is needed for recurrent urinary tract infection (UTI) management. The aim of this study was to develop a conceptual model for a digital platform to implement evidence-based guidelines for recurrent UTI management. This was a qualitative, 3-stage mixed methods study that included (1) developing an evidence-based prototype texting platform; (2) qualitative feedback from recurrent UTI patients using the platform; and (3) quantitative data on acceptability (proportion of patients engaging with the platform), accuracy (proportion of patient messages interpreted accurately by the platform), and usability (score 0-100). Thirty-one women with recurrent UTI (median age, 71 years; range, 60-74 years) participated in testing over 4 months. The prototype platform was modified through iterative rounds of qualitative and quantitative analysis until engagement ≥85%, accuracy ≥90%, and usability score of ≥80 were achieved in 10 patients. Qualitative feedback indicated that patients valued rapid access to treatment through fewest possible health encounters during an acute episode, evidence-based education about prevention, and ability to participate in self-management with support from health care providers. Based on this feedback, a conceptual model consisting of 3 main components was developed: (1) an algorithm to triage acute symptoms, (2) educational videos emphasizing prevention strategies, and (3) supportive messages. Patient feedback identified 4 key implementation outcomes-usability, acceptability (engagement), fidelity (accuracy), and cost-and 3 clinical outcomes-self-efficacy, health care utilization, and rate of unnecessary antibiotics for testing the model. The proposed model can be used to implement and test a patient-centered evidence-based digital platform for the management of recurrent UTI.

Improving Patient Care Through Collaborative Re-envisioning of the Model of Critical Care.

Advanced medical therapies enable people to live longer with multiple comorbidities, increasing the acuity and complexity of care required upon admission into the intensive care unit. This, coupled with the shift toward a less experienced nursing workforce as skilled nurses retire or leave the critical care environment, prompted the need to re-envision how critical care is delivered. The purpose of this quality improvement project was to embed the values of staff and patient partners in a re-envisioned critical care model, which aligns the provision of high-quality care with staff skill mix and patient needs. Through a series of clinical nurse specialist-led engagement sessions with patients, families, and the members of the healthcare team who work in this environment every day, we talked about what is important in critical care. We used their words and thoughts to inform and shape a new sustainable model of critical care. The 4 components identified as essential to achieving this vision include an acuity-complexity-based approach to care, a transition from separate high-acuity and intensive care areas to integrated units, development of a career pathway to advance practice, and exploration of opportunities to optimize the scope of the interprofessional team. Embedding the values and experience of the people directly connected with providing and/or experiencing critical care increases the likelihood of success in developing, implementing, and sustaining a new model of care. This multifaceted approach resulted in 4 distinct components with achievable outcomes that support this re-envisioned patient-centered sustainable model of critical care.

РЕГИОНАЛЬНЫЙ МОНИТОРИНГ ФАКТОРОВ РИСКА РАЗВИТИЯ ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙ ПОСЛЕ ПЕРЕНЕСЕННОГО COVID-19

Annotation. Chronic non-communicable diseases (NCD) represent a major public health problem in recent decades. NCD kill 41 million people annually, accounting for 74% of all deaths worldwide. WHO predicts that the total number of deaths from NCD will rise to 55 million by 2030 unless drastic measures are taken. Cardiovascular disease, cancer, chronic respiratory disease and diabetes are the four leading causes of premature mortality among NCD. Multimorbidity affects 65% of people over 65 years of age, requiring more patient-centred and complex models of care. The aim of the study was to conduct regional monitoring of risk factors for chronic noncommunicable diseases in geriatric patients. Outpatient charts of 152 patients aged 60 years and older who had undergone COVID-9 and had undergone an in-depth adult check-up were used for the study. The average age of the patients who underwent the dispensary was 70.0±5.7 years. Questionnaire survey of 152 patients aged 65 years and older to identify NCD and senile asthenia showed that the highest proportion of patients had risk factors for cardiovascular diseases - 63.2%, osteoporosis - 40.8%, GI diseases - 28%, senile asthenia - 27% and polypragmasia - 20.4%. 32.2% of respondents noted a decrease in memory, perception of material, impaired comprehension, loss of ability to distribute time, 30.9% experienced a decrease in mood, loss of energy, depressive state, 24.3% each experienced vision and hearing problems that impair the quality of life, and 22.4% of persons over 65 experienced difficulty in walking. Based on the results of the study, data collection modules based on the STEPS system were identified for the step-by-step assessment of risk factors for the development of chronic non-communicable diseases, and a model for a comprehensive approach to improving the health of citizens aged 60 years and older, who have the highest risk of developing NCD, was proposed.

A Framework for Bariatric Surgery Patient Care: Patient and Professional Perceptions

Abstract Introduction A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework to support a long-term follow-up service, may decrease rates of complications, help the recognition of the complexity of this chronic disease, and provide a comprehensive bariatric surgery process analysis. This study aimed to analyze patients’ and professionals’ experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment. Methods This qualitative study was conducted in a bariatric surgery center in south Portugal. Seven health professionals participated in one focus group, and sixteen patients participated in one of the three focus groups. Patients’ focus group script had eleven open main questions with follow-up questions to probe for more information, addressing motivations, experiences with the pre-surgery and post-surgery process, and perceptions of lifestyle changes. Results Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of post-surgery life, and the financial support for physical activity programs. Conclusions This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. New bariatric surgery programs should incorporate a diverse health team, focusing on patient support in the long-term follow-up. This team should be led by a dedicated case manager and include physical activity specialists. Key messages • The positive effects of bariatric surgery go beyond weight loss, reinforcing the importance of developing a new conceptual framework based on a patient-centered care model. • A case manager specialist on the bariatric surgery process may be the key to improving the long-term benefits of bariatric surgery.

Healing Through Dialogue: Exploring Culturally Sensitive Physician-Patient Communication in Urban and Peri-urban Minna, Nigeria, for Addressing Postpartum Depression

The research was on physician-patient communication. Specifically, the study investigated the communication relationship between physicians and mothers experiencing postpartum depression (PPD) in urban and peri-urban areas of Minna, Nigeria. The study aimed to understand the nature of communication strategies used by physicians, their effectiveness in aiding recovery, and the challenges hindering effective communication. The study fills a research niche on how different forms of communication with patients influence the recovery of postpartum depressed mothers in Minna, Nigeria, and how healthcare professionals may need to promote culture-sensitive communication. The study was anchored on the patient-centered care model. In-depth interviews (IDI) and focus group discussions (FGD) were adopted as the primary research methods. The study had a total of 204 respondents, 196 nulliparous, primiparous, and multiparous women with PPD for FGD, and 8 medical experts for in-depth interviews. Findings showed that empathy and informal interactions were used as mothers responded positively to physicians who addressed them with a smile, concern, and active listening. Further findings revealed that effective communication led to better outcomes. Participants felt that open-ended questions, patient involvement in treatment plans, and emotional expressions encouraged by physicians led to improved well-being. The basis for the measurement of effective communication for improved health outcomes was measured through self-reported improvements from the mother. Also, cultural sensitivity, utilisation of interpreters, and readily available information resources in hospitals were identified as crucial for addressing communication and cultural barriers. The researcher concluded that physician communication style significantly impacts PPD recovery and, therefore, recommended that healthcare institutions should create supportive environments and train professionals in cultural sensitivity. Dedicated resources like information desks and support groups can empower mothers with PPD. The implications of the study highlight the importance of communication in PPD treatment and suggest actionable strategies for healthcare institutions to improve their interaction with mothers experiencing this critical mental health condition in Minna and similar settings.

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights.

According to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations. We developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment. We identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient's autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient's preferences. Patient-centered care supports personalized decision-making, in which the physician's approach varies according to the patient's situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient's principles or a change in the primary goal of care.