Person‐centred health care: a critical assessment of current and emerging research approaches

Martin, Carmel M.; Félix‐Bortolotti, Margot

doi:10.1111/jep.12283

Cited by 25 publications

(15 citation statements)

References 60 publications

(44 reference statements)

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“…This is incongruent with person-centred care, which entails involving the individual as an active participant in their healthcare (i.e., patient engagement) and tailoring treatment to individual wants and needs [3–5]. This model of care can help to achieve optimal outcomes for patients [6, 7] and is also recognised as an important indicator of quality of service provision [8–13]. The specialty of nephrology has been late to recognise the importance of person-centred care and patient engagement [14]; however the potential of person-centred care to complement evidence-based practice in providing healthcare for people with CKD is beginning to receive greater attention [15–17].…”

Section: Introductionmentioning

confidence: 99%

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Douglas

Bonner

2017

BMC Nephrol

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BackgroundPeople with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS).MethodsA cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015. Participants were ≥18 years old and had a self-reported doctor’s diagnosis of CKD (any stage; N = 97). The survey was based upon existent literature which identified 10 areas that those with CKD believe require additional support. Descriptive data were generated and Mann-Whitney U tests were performed to compare the desires of different groups of participants.ResultsOf the 97 participants, 36 completed a hardcopy survey in clinic, and 61 completed the online version. Just over half (60.8%) were female, age ranged from 16–89 (M = 56.44), and time since diagnosis ranged from just diagnosed to 60 years (Mdn = 8.08 years). Strong interest in receiving additional support across all 10 areas was reported (Mdns = 8.00–10.00), with “keeping a positive attitude and taking care of mental and physical health” receiving the highest rating. Those who were: younger (p < .001); more highly educated (p < .001); working (p < .001); diagnosed longer ago (p = .015); and women (p = .050) expressed stronger overall desire for additional support.ConclusionsIn addition to information about CKD and medications, everyday strategies ought to be prioritised in patient education. Varying levels of engagement and eagerness to learn more about self-management highlight the need for a person-centred approach to SMS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0416-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Douglas

Bonner

2017

BMC Nephrol

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“…Complexity theory provides numerous concepts which can be applied alongside diverse extant theoretical frameworks to view complex phenomena in different ways (Eppel, 2017;Tenbensel, 2015). This facilitates a transdisciplinary approach to research, allowing different bodies of knowledge to be blended to provide a wider understanding of complex problems (Gear et al, 2017;C. M. Martin & Felix-Bortolotti, 2014).…”

Section: Complexity Theorymentioning

confidence: 99%

“…M. Martin & Felix-Bortolotti, 2010). In health care research, assumptions about knowledge often go unacknowledged, triggering calls for improved theory application to support generalizable and robust findings (C. M. Martin & Felix-Bortolotti, 2014; Thompson et al, 2016). Complexity theory is particularly useful in calling attention to influences on knowledge and is increasingly being used to explain and understand complex health care system behavior.…”

Section: Introductionmentioning

confidence: 99%

Advancing Complexity Theory as a Qualitative Research Methodology

Gear

Eppel

Koziol‐McLain

2018

International Journal of Qualitative Methods

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Although complexity theory is increasingly used to explain and understand complex health-system behavior, little is known about utilizing complexity theory to augment qualitative research methods. We advance this field by describing our use of complexity theory as a qualitative research methodology to explore sustainable health-care responses to intimate partner violence. We outline how complexity theory shaped our theoretical perspective, conceptualization of the research problem, and selection of methodology and methods. We show how a research methodology informed by complexity theory can capture new insights into complex problems, advancing the application of complexity theory and qualitative research design.Keywords complexity theory, complex adaptive system, intimate partner violence, health care, methods in qualitative inquiry, discourse analysis What Is Already Known?Complexity theory is increasingly used to explain and understand complex health-system behavior, yet application within health-care research varies widely. Most often, a selection of complexity concepts is applied to guide a research approach or data interpretation. What This Paper Adds?We advance this field by considering the implications of utilizing complexity theory as a qualitative research methodology and present a possible framework for exploring and describing complex system behavior.

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“…Martin and Felix‐Bortolotti define PCC as, ‘a strong moral prerogative in health care delivery that entails a deep respect for unique living persons, and the obligation of health professionals and decision makers to care for them on their terms’ [12]. Here, the emphasis is on the moral aspect of the charge and on the uniqueness of each individual, which suggests that making use of values derived from population level studies would not fulfill the requirements of PCC.…”

Section: Comparing Ebm and Vbp On Patient Valuesmentioning

confidence: 99%

‘What the patient wants’: an investigation of the methods of ascertaining patient values in evidence‐based medicine and values‐based practice

Wieten

2015

Evaluation Clinical Practice

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Evidence-Based Medicine (EBM), Values-Based Practice (VBP) and Person-Centered Healthcare (PCH) are all concerned with the values in play in the clinical encounter. However, these recent movements are not in agreement about how to discover these relevant values. In some parts of EBM textbooks, the prescribed method for discovering values is through social science research on the average values in a particular population. VBP by contrast always investigates the individually held values of the different stakeholders in the particular clinical encounter, although the account has some other difficulties. I argue that although average values for populations might be very useful in informing questions of resource distribution and policy making, their use cannot replace the individual solicitation of patient (and other stakeholder) values in the clinical encounter. Because of the inconsistency of the EBM stance on values, the incompatibility of some versions of the EBM treatment of values with PCH, and EBM's attempt to transplant research methods from science into the realm of values, I must recommend the use of the VBP account of values discovery.

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Person‐centred health care: a critical assessment of current and emerging research approaches

Cited by 25 publications

References 60 publications

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Advancing Complexity Theory as a Qualitative Research Methodology

‘What the patient wants’: an investigation of the methods of ascertaining patient values in evidence‐based medicine and values‐based practice

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