Person Centeredness Research Articles

“When You Care Enough to Send the Very Best”: Examining the Person-Centered Quality of Message Features Provided in Sympathy Cards

Sympathy cards are a popular channel by which grief support is communicated. In order to better understand the supportive messages used in sympathy cards, a content analysis was performed. The messages found in one hundred cards from major greeting card companies were coded based on their level of person centeredness (Burleson, 1994) and their use of grief management strategies (Marwit & Carusa, 1998). Results indicate sympathy cards typically rely on moderate and high person centered messages. The majority of strategies previously identified by the modified Support-Intended Statements Scale (SISS) were used. However, one unique strategy labeled “difficulty knowing what to say” was identified.

Communication, the Key in Creating Dignified Encounters in Unexpected Sudden Death - With Stroke as Example.

Aim:The aim of this study was to illuminate the communication and its meaning in unexpected sudden death with stroke as example, as experienced by stroke team members and next of kin.Subject and Methods:The study has a qualitative design. Secondary analysis of data from four previous interview studies with stroke team members; physicians, registered nurses, and enrolled nurses from the stroke units (SU) and next of kin of patients who had died due to acute stroke during hospital stay were utilized.Results:Communication is revealed as the foundation for care and caring with the overarching theme foundation for dignified encounters in care built-up by six themes illuminating the meaning of communication in unexpected sudden death by stroke.Conclusion:Communication shown as the foundation for dignified encounters in care as experienced by stroke team members and next of kin enables the patient to come forth as a unique person and uphold absolute dignity in care. Acknowledging the next of kin's familiarity with the severely ill patient will contribute to personalizing the patient and in this way be the ground for a person centeredness in care despite the patients’ inability to defend their own interests. Through knowledge about the patient as a person, the foundation for dignified care is given, expressed through respect for the patient's will and desires and derived through conversations between carers and next of kin.

Effectiveness and cost-effectiveness of integrated care models for elderly, complex patients: A narrative review. Don’t we need a value-based approach?

Introduction The management of patients with complex health and social needs is one of the main challenges for healthcare systems. Integrated care seems to respond to this issue, with collaborative working and integration efforts of the care system components professionals and service providers aimed at improving efficiency, appropriateness and person centeredness of care. We conducted a narrative review to analyse the available evidences published on effectiveness and cost-effectiveness of integrated care models targeted on the management of such elderly patients. Methods MEDLINE, Scopus and EBSCO were searched. We reported this narrative review according to the PRISMA Checklist. For studies to be included, they had to: (i) refer to integrated care models through implemented experimental or demonstration projects; (ii) focus on frail elderly ≥65 years old, with complex health and social needs, not disease-specific; (iii) evaluate effectiveness and/or cost and/or cost-effectiveness; (iv) report quantitative data (e.g. health outcomes, utilization outcomes, cost and cost-effectiveness). Results Thirty articles were included, identifying 13 integrated care models. Common features were identified in case management, geriatric assessment and multidisciplinary team. Favourable impacts on healthcare facilities utilization rates, though with mixed results on costs, were found. The development of community-based and cost-effective integrated systems of care for the elderly is possible, thanks to the cooperation across care professionals and providers, to achieving a relevant impact on healthcare and efficient resource management. The elements of success or failure are not always unique and identifiable, but the potential clearly exists for these models to be successful and generalized on a large scale. Discussion We found out a favourable impact of integrated care models/methods on health outcomes, care utilization and costs. The selected interventions are likely to be implemented at community level, focused on the patient management in terms of continuity of care. Thus, we propose a value-based framework for the evaluation of these services.

Development and validation of the Person-Centeredness of Research Scale.

Aim:Person-centeredness shifts the focus of healthcare and research to the needs and priorities of patients and communities, and may improve health outcomes. There are no instruments available, however, with which we can assess the degree to which research is indeed person-centered. Our aim was to develop and validate a quantitative instrument to rate person-centeredness of research.Materials & methods:Scale development and validation entailed a multistep approach that led to the seven-item Person Centeredness of Research Scale (PCoR Scale) that uses a 5-point Likert rating scale. The scale was validated using ratings of the Patient-Centered Outcomes Research Institute-funded research abstracts or abstracts submitted to a translational science meeting.Results:Psychometric properties of the PCoR Scale showed high internal consistency (α = 0.96). All seven items were highly correlated with the total score (rs range from 0.63 to 0.90). An exploratory factor analysis demonstrated that all of the items loaded on a single factor, explaining 80% of the variance. The Patient-Centered Outcomes Research Institute-funded research abstracts had a mean PCoR Scale score of 6.52 (±8.01) that was significantly higher than the abstracts submitted to the translational science meeting (-2.56 (±9.18); t = 8.09; p < 0.0001). Inter-rater reliability in the validation of the revised instrument was high (Intraclass Correlation Coefficient [ICC](group1) = 0.89; ICC(group2) = 0.95).Conclusion:This brief, quantitative rating scale is the first to assess the main constructs that describe person-centeredness of research products. The PCoR Scale can be used to assess person-centeredness in research products; for example, by funders evaluating proposals, data networks evaluating data requests or researchers evaluating their research designs.

DIFFICULTIES WITHIN THE CULTURALLY SENSITIVE TRANSLATION OF THE PELI

Regardless of healthcare setting, person-centered care remains an important issue globally. One way to stimulate person centeredness is the integration of a preference based approach. Currently there is no comparable instrument to the PELI in German. As part of the project PELI-D the PELI USA-version for Nursing Homes will be (1) culturally sensitive translated into German applying ISPOR-Task Force recommendations; (2) tested for reliability and feasibility in three different care settings. Translating an existing item based instrument like the PELI is a complex task. Culturally sensitive translation requires consideration of different care systems and structures, specific wordings, phrases, lack of corresponding words, limited comprehensibility, grammatical issues and unfamiliarity with the content meaning of the item. We will present current experiences of our systematic translation process (e.g., Cognitive Interviews) and discuss setting specific and linguistic difficulties experienced by the caregivers and the people who receive care.

A National Program to improve person centeredness in hospital through a partnership with citizens

A National Program to improve person centeredness in hospital through a partnership with citizens

Verbal Person Centeredness in Interaction: Connecting Micro- and Macro-Level Operationalization

Verbal person centeredness (VPC) is a long-dominant conceptualization of quality in supportive communication, but prior work provides limited guidance for researchers seeking to examine its impact in interaction. This study examined the extent to which overall VPC for an interaction is predicted by support providers’ specific behaviors. In a laboratory setting, pairs of friends (320 dyads) discussed a problem that one of them was currently experiencing. Transcripts of these interactions were coded by separate research teams for overall VPC of support provision and for the topic, function, and experiential focus of each discrete thought-unit produced by the support provider. Regression analyses showed that VPC was predicted by units representing specific, theoretically interpretable combinations of topical, functional, and experiential focus. The findings provide evidence of validity for procedures used to code VPC for supportive interactions while also displaying ways in which person centeredness is accomplished somewhat differently in interaction than in discrete messages.

Mapping the terrain of person-centered supportive conversations

ABSTRACTThis study explores the conversational terrain of supportive conversations that vary in person centeredness (PC). Our team transcribed and unitized 223 conversations in which a discloser talked about an upsetting event to a listener trained to exhibit either low (LPC), moderate (MPC), or highly person-centered (HPC) comfort. Each utterance was coded for PC with a modified version of the traditional nine-level hierarchy. HPC-coded turns comprised 24% of HPC conversations, while LPC-coded turns comprised almost half of LPC conversations. Over 95% of turns in MPC conversations were classified as MPC. Additionally, turn-level coding and global ratings of PC differentially predicted outcomes. We discuss the implications of these conversational profiles in the context of how the PC content of conversations might aid in cognitive reappraisal.

KONSTRUKCIJA UPITNIKA PODRŠKE TUGUJUĆIMA: PROVERA FAKTORSKE STRUKTURE I METRIJSKIH KARAKTERISTIKA

Socijalna podrška tugujućim osobama predstavlja važnu psiho- lošku oblast, koja se u nekoliko poslednjih decenija nalazi u foku- su sve većeg broja empirijskih studija. Međutim, u domaćoj nauci fenomen pružanja verbalne podrške ožalošćenima tek počinje da se uvodi u repertoar istraživačkih problema. Stoga je osnovni cilj ovog istraživanja bio pionirski poduhvat, koji je podrazume- vao konstruisanje upitnika za ispitivanje suportivnog potencijala poruka koje neposredno socijalno okruženje uobičajeno upućuje pojedincima u procesu žaljenja zbog smrti bliske osobe. Pored Upitnika podrške tugujućima, u radu su prikazane faktorska struk- tura, kao i psihometrijske karakteristike novokonstruisanog instru- menta. Drugi cilj istraživanja odnosio se na utvrđivanje stepena (ne)korisnosti različitih poruka upućenih ožalošćenima, a ispitan je i odnos između doživljene korisnosti poruka i stepena njihove usmerenosti na tugujuću osobu. Istraživanje je sprovedeno na prigodnom uzorku od 301 ispitanika. Dobijeni rezultati ukazuju na to da se radi o validnom i pouzdanom instrumentu, čija se kom- pozitn1a struktura sastoji od pet dimenzija: Socijalna podrška, Minimiziranje osećanja tugujućeg, Isticanje religijske perspektive, Komplimentiranje i normalizacija osećanja tugujućeg i Nuđenje konkretne pomoći. Drugi deo rezultata potvrđuje očekivanje da stepen usmerenosti na osobu predstavlja odgovarajuće teorijsko objašnjenje različitog intenziteta delotvornosti poruka upućenih osobama u procesu tugovanja.

The Stuff That Verbal Person-Centered Support Is Made of: Identifying Linguistic Markers of More and Less Supportive Conversations

Although the functions of messages varying in verbal person centeredness (PC) are well-established, we know less about the linguistic content that differentiates messages with distinct levels of PC. This study examines the lexicon of different levels of PC comfort and seeks to ascertain whether computerized analysis can complement human coders when coding supportive conversations. Transcripts from support providers trained to enact low, moderate, or high levels of PC were subjected to the Linguistic Inquiry and Word Count (LIWC) dictionary. Results reveal that several categories in the LIWC dictionary vary systematically as a function of conversational PC level. LIWC categories, particularly pronouns, social process, cognitive process, anxiety, and anger words, reliably predict which level of the PC hierarchy an interaction represents based on whether a conversation was designed to be high, moderate, or low in PC. The implications are discussed in the context of the lexicon of conversations that vary in PC.

Quality after the QOF? Before dismantling it, we need a redefined measure of ‘quality’

The Quality and Outcomes Framework (QOF) for UK general practice is one of the largest health-related pay-for-performance (P4P) schemes in the world.1 In 2004, the scheme initially had a positive impact on quality of care, primarily achieved via establishment of procedural baselines in the clinical management of incentivised (mostly chronic) diseases. It reduced between-practice variation in care delivery while also improving disease registers, recording of clinical activities, and adoption of electronic medical record systems, leading to an explosion in general practice data and research.1,2 Despite some successes, recent years have seen accelerated debate concerning the removal of QOF. One major criticism is that QOF does not incentivise person-centred care for people with complex conditions,2,3 who require individualised support. This is not captured in the vast majority of indicators, which are based on clinical guidelines. For example, continuity of care — a critical function of primary care — is valued by patients and associated with improved experience, outcomes, adherence, and preventive medicine, and it may be associated with reduced hospital admissions, death rates, and cost of secondary care/hospitalisation.4 It can be considered a marker of a holistic approach, which is considered essential for the increasing numbers of people with multimorbidity and complex healthcare needs.5 Yet it is currently in decline,6 was reduced after the introduction of QOF,7 and is not being captured by QOF. In an environment of increasing patient complexity and a drive towards person centeredness, QOF — with its current focus on process indicators — is perceived by many as increasingly anachronistic. A recent systematic review summarised that ‘QOF is unlikely to advance progress towards the vision of the Five Year Forward View for …

Communicating grief and loss online: Evaluating person-centered support messages

ABSTRACTThis single-class activity expands current literature on person-centered messages by providing attention to message quality in mediated contexts. Students begin the activity by reviewing a hypothetical scenario in which a friend has posted about a family death loss on social media. After reviewing this scenario, students then create sample supportive messages that they could share with a grieving friend. Students are also asked to apply their knowledge about person-centered messages to evaluate other fictional support messages. Students who participate in this activity will be provided with additional skills for comforting grieving friends effectively.Courses: This single-class activity can be implemented in several courses, including interpersonal communication, the dark side of interpersonal communication, and family communication.Objectives: Students who complete this activity should be able to: (1) outline what qualities comprise a person-centered support message; (2) discuss why highly person-centered messages are effective in providing support to others; and (3) evaluate death loss support messages across levels of person centeredness.

Patient participation from the perspective of staff members working in spinal cord injury rehabilitation

Study designQualitative method, semi-structured interviews.ObjectivesThe aims of this study were to explore the meaning of patient participation from the perspective of staff members working with spinal cord injury (SCI) rehabilitation, and what they saw as requisites for and constraints to patient participation.SettingSwedish spinal injury unit.MethodsInterviews with 13 staff members at a spinal unit were conducted individually and analyzed by means of content analysis.ResultsOne category describing patient participation emerged from the interviews: Patient – a team member. Four categories were extracted as requisites: Communication; information and knowledge;routines; respecting the patient as a unique person; and an open climate. Three categories of constraints were identified: Understaffing and new staff members; patients’ inability to grasp information; and structures and fragmented responsibilities.ConclusionsThe informants were unanimous in stating that the patient is an integral and natural member of the rehabilitation team. Recognizing the person with SCI as a team member acknowledges and endorses the patient as a person with capabilities to participate in his or her rehabilitation. The patient as a person also means that he or she has unique needs and preferences, which the staff members must accommodate. This is also fundamental in a person-centered approach. Therefore, the viewpoints of the informants may be useful for other settings to enhance person centeredness and patient participation.

“Anyone free to chat?” Using technological features to elicit quality support online

ABSTRACTThis study examines how support seekers can integrate verbal and nonverbal cues in social network sites (SNSs) to elicit quality support from others. Building from sensitive interaction systems theory and verbal person centeredness (VPC), participants (N = 579) evaluated a SNS profile that contained manipulated levels of directness in status updates used to seek support and nonverbal emotional expression in profile pictures. To capture the transaction of support, participants provided supportive messages in public and private conditions that were coded for their level of VPC. Negative emotional cues in profile pictures increased VPC in private messages, whereas directness in status updates negatively predicted VPC in private messages. Participants produced messages with higher levels of VPC after they viewed profiles that incorporated more features to disclose distress effectively. Broadly, this study addresses whether the content people post on SNS profiles shapes the quality of the supportive messages they receive.

Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study

BackgroundHand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room.MethodsThe study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach.ResultsDoubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in “safe spaces” worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene.ConclusionEnabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136). Date of registration 2016/11/28, retrospectively registered.

Testing Reliability and Validity of the Person-centered Climate Questionnaire-staff version in Korean for Long-term Care Facilities

Purpose: To test the reliability and validity of the Korean version of the Person-centered Climate Questionnaire - staff version (KPCQ-S) in long-term care institutions. Methods: A total of 297 staff in long-term care institutions including nine nursing homes (NHs) and 4 long-term care hospitals (LTCHs) were included. The KPCQ-S was developed following the WHO guidelines of the process of translation and adaptation of instruments. An internal consistency using Cronbach’s α was tested for reliability. Exploratory factor analysis (EFA) was used to examine the construct validity. Convergent and discriminant validity were examined using Pearson correlation. Results: EFA demonstrated the construct validity of the 14-item KPCQ-S with three-factor solutions, specifically three factors (safety, everydayness, and community) in NHs and four factors (safety, everydayness, community, and comprehensibility) in LTCHs. Convergent validity was found in the correlation with the work satisfaction (r=.55). The KPCQ-S showed satisfactory internal consistency reliability (Cronbach’s a=.91). Conclusion: The KPCQ-S is found to be a reliable and valid tool for measuring staff perceptions of the person centeredness of long-term care environments.

Social Support Strategies in Online Forums Among Adult Offspring of Parents with Harmful Alcohol Use

ABSTRACTThe authors categorized communication strategies employed to exchange social support (type and person centeredness) in three online forums about parents with harmful drinking. Data included discussion postreplies over 2 months; N = 1,644 units of analysis. Support type categories were identification, emotional, informational, network, and esteem. For person centeredness, most messages were moderate (expressed sympathy, provided distraction), followed by high (helped with feelings), and then low (minimized feelings). Adult offspring of parents with harmful drinking predominantly communicate self-interested forms of support in online forums. Based on principles of supportive communication, esteem support and high person centeredness may enhance social support in these settings.

Empowerment: The experience of Recovery Camp for people living with a mental illness

BackgroundMental health recovery is still largely clinically defined and as such can lack person centeredness. To address this, recovery oriented experiences are required which recognise the holistic and diverse needs of individuals. AimThe aim of the study was to examine the experiences of people living with a mental illness who participated in a recovery oriented program called Recovery Camp. The study aimed to examine how the program may have related and contributed to their mental health recovery. MethodsA descriptive phenomenological approach guided the study. Consenting participants (n=5) were interviewed and asked about their subjective experience of Recovery Camp. The interviews were digitally audio recorded and transcribed verbatim. Data were analysed using van Kaam’s Psychophenomenological method. FindingsThis paper presents the perspective of consumers regarding the ways in which Recovery Camp facilitated mental health recovery. Data analysis revealed five themes (Self-determination, Participation, Extending Self, Relationships and Positive change) and a core essence of meaning (Empowerment). ConclusionsPersonal mental health recovery for people living with mental illness can be enhanced through recovery oriented mental health care approaches. Findings contribute to existing literature regarding therapeutic recreation and its link to mental health recovery.

The influence of therapeutic horticulture on social integration

Purpose The purpose of this paper is to qualitatively evaluate the impact of therapeutic horticulture (TH) on social integration for people who have mental health problems. Design/methodology/approach A qualitative grounded theory approach captured the perceptions about TH from people with mental health problems. Data were collected using semi-structured focus group and interviews from a purposive sample (n=7) and were analysed using a constant comparative approach. Findings Four key themes emerged from the analysis: “a space to grow”, “seeing the person”, “learning about each other through nature” and “connecting to nature and others”. The findings suggest that TH enabled participants to integrate socially, engage with nature and develop confidence. Research limitations/implications TH is a potential approach that can help combat social isolation. The findings from this research have implications for people working towards supporting people who are socially excluded. However, this was a pilot study with a small sample size of seven people with mental health problems, whilst four key themes emerged, the saturation of concepts rather than the sample size were saturated to provide an emic perspective of the phenomena. Practical implications TH provides a person centred approach that enables people with mental health problems to re-engage and connect with their fellow human beings. Using TH could help improve the public health and well-being of local communities through re-connecting people to the environment and reduce social isolation. Social implications TH embody the principles of empowerment, person centeredness and can support people with mental health problems to integrate socially. Originality/value There is limited evidence about the influence that TH have on mental health and social integration. The use of TH is an area that is gathering evidence and this small study highlights the perceived potential benefits of this approach.

Individual Listening Values Moderate the Impact of Verbal Person Centeredness on Helper Evaluations: A Test of the Dual-Process Theory of Supportive Message Outcomes

This study is part of a larger program of research concerned with how people evaluate supportive behavior. Past work conducted in our lab found that helper evaluations of supportive listening vary as a function of specific listener behaviors, but the effects of these behaviors were small in magnitude. In this article, we explore one explanation for these small effects, namely, that the impact of listening behaviors on helper evaluations varies as a function of individual communication values. We draw from the dual-process theory of supportive message outcomes to propose that communication values operate to influence individual processing of supportive behavior. Using data from 383 participants asked to watch and evaluate a five-minute recorded comforting conversation, results provide support for the theory. People who place more value on listening as well as theoretically connected communication skills appear more responsive to the presence (or absence) of person-centered behavior.