Is patient-centred care a tautology?: View from the Netherlands

Verheij, Theo

doi:10.3399/bjgp11x583489

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…Biomedical approaches will fail to detect nonphysical violence and might not help women exposed to IPV in the long run (Colombini et al, 2013;Humphreys & Thiara, 2003). Approaches to health care that consider the biological, psychological, and social aspects exist and are examples of patient-centered care (Kreindler, 2013;Stewart, 2001;Verheij, 2011). Such an approach has shown promising results for treating multifactorial health problems and mental health problems (Jani et al, 2012;Larivaara, Kiuttu, & Taanila, 2001;Lewin, Skea, Entwistle, Zwarenstein, & Dick, 2001;Magnil, Gunnarsson, & Björkelund, 2011) and might facilitate the integration of health care response to IPV when implemented.…”

Section: Discussionmentioning

confidence: 99%

Health-Sector Responses to Intimate Partner Violence: Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

Briones-Vozmediano

Maquibar

Vives‐Cases

et al. 2015

J Interpers Violence

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This study aims to analyze how middle-level health systems' managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: "IPV is a complex issue that generates activism and/or resistance," "The mandate to integrate a health sector response to IPV: a priority not always prioritized," and "The Spanish health system: respectful with professionals' autonomy and firmly biomedical." The core category, "Developing diverse responses to IPV integration," crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

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Section: Discussionmentioning

confidence: 99%

Health-Sector Responses to Intimate Partner Violence: Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

Briones-Vozmediano

Maquibar

Vives‐Cases

et al. 2015

J Interpers Violence

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“…[5][6][7][8][9] The notable exception is a study set in secondary care which found that cardiologists always prioritised evidencebased medicine over patient choice. 10 In contrast, this study identified that many GPs prioritised maintaining the doctor-patient relationship over following guidelines.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…[5][6][7][8][9] In addition, one empirical study that was set in secondary care, looked at the priorities given to evidence-based medicine and patient choice in the treatment of heart failure; it found that cardiologists always gave evidence-based medicine priority over patient choice. 10 To date, however, relatively little empirical work has been done to explore the compatibility of patient partnership and prescribing approaches, particularly in primary care.…”

Section: Introductionmentioning

confidence: 99%

The compatibility of prescribing guidelines and the doctor-patient partnership: a primary care mixed-methods study

Solomon

Raynor²,

Knapp³

et al. 2012

Br J Gen Pract

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Background UK policy expects health professionals to involve patients in decisions about their care (including medicines use) and, at the same time, to follow prescribing guidelines. The compatibility of these approaches is unclear. AimTo explore the relationship between prescribing guidelines and patient-partnership by exploring the attitudes of patients, GPs and primary care trust (PCT) prescribing advisors. Design and settingA mixed-methods study using qualitative, semistructured interviews followed by a quantitative, questionnaire survey in primary care in Northern England. MethodInterviews were conducted with 14 patients taking a statin or a proton pump inhibitor, eight GPs and two prescribing advisors. A multi-variate sampling strategy was used. Qualitative findings were analysed using framework analysis. Questionnaires based on themes derived from the interviews were distributed to 533 patients and 305 GPs of whom 286 (54%) and 142 (43%) responded. ResultsAreas of tension between guidelines and patient partnership were identified, including potential damage to trust in the doctor and reduced patient choice, through the introduction of the policy maker as a third stakeholder in prescribing decisions. Other areas of tension related to applying single condition guidelines to patients with multiple illnesses, competition for doctors' time and the perception of cost containment. Many GPs coped with these tensions by adopting a flexible approach or prioritising the doctor-patient relationship over guidelines. ConclusionRigidly applied guidelines can limit patient choice and may damage the doctor-patient relationship. GPs need flexibility in order to optimise the implementation of prescribing guidelines, while responding to individuals' needs and preferences.

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Is patient-centred care a tautology?: View from the Netherlands

Cited by 2 publications

References 8 publications

Health-Sector Responses to Intimate Partner Violence: Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

Health-Sector Responses to Intimate Partner Violence: Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

The compatibility of prescribing guidelines and the doctor-patient partnership: a primary care mixed-methods study

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