The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review
Introduction Person-centred care has become internationally recognised as a critical attribute of high-quality healthcare. However, the concept has been criticised for being poorly theorised and operationalised. Serious illness is especially aligned with the need for person-centredness, usually nece...
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| Format: | Article |
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BMJ Publishing Group
2020-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/12/e003330.full |
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| author | Richard Harding Sridhar Venkatapuram Alessandra Giusti Kennedy Nkhoma Ruwayda Petrus Inge Petersen Liz Gwyther Lindsay Farrant |
| author_facet | Richard Harding Sridhar Venkatapuram Alessandra Giusti Kennedy Nkhoma Ruwayda Petrus Inge Petersen Liz Gwyther Lindsay Farrant |
| author_sort | Richard Harding |
| collection | DOAJ |
| description | Introduction Person-centred care has become internationally recognised as a critical attribute of high-quality healthcare. However, the concept has been criticised for being poorly theorised and operationalised. Serious illness is especially aligned with the need for person-centredness, usually necessitating involvement of significant others, management of clinical uncertainty, high-quality communication and joint decision-making to deliver care concordant with patient preferences. This review aimed to identify and appraise the empirical evidence underpinning conceptualisations of ‘person-centredness’ for serious illness.Methods Search strategy conducted in May 2020. Databases: CINAHL, Embase, PubMed, Ovid Global Health, MEDLINE and PsycINFO. Free text search terms related to (1) person-centredness, (2) serious illness and (3) concept/practice. Tabulation, textual description and narrative synthesis were performed, and quality appraisal conducted using QualSyst tools. Santana et al’s person-centred care model (2018) was used to structure analysis.Results PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow data: n=12,446 studies screened by title/abstract, n=144 full articles assessed for eligibility, n=18 studies retained. All studies (n=18) are from high-income countries, and are largely of high quality (median score 0.82). The findings suggest that person-centred care encompasses the patient and family being respected, given complete information, involved in decision-making and supported in their physical, psychological, social and existential needs. The studies highlight the importance of involving and supporting family/friends, promoting continuation of normality and self-identity, and structuring service organisation to enable care continuity.Conclusion Person-centred healthcare must value the social network of patients, promote quality of life and reform structurally to improve patients’ experience interacting with the healthcare system. Staff must be supported to flexibly adapt skills, communication, routines or environments for individual patients. There remains a need for primary data investigating the meaning and practice of PCC in a greater diversity of diagnostic groups and settings, and a need to ground potential components of PCC within broader universal values and ethical theory. |
| format | Article |
| id | doaj-art-b087f9854d934902bc4d8a1be005c9d1 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-b087f9854d934902bc4d8a1be005c9d12025-08-20T01:53:33ZengBMJ Publishing GroupBMJ Global Health2059-79082020-12-0151210.1136/bmjgh-2020-003330The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic reviewRichard Harding0Sridhar Venkatapuram1Alessandra Giusti2Kennedy Nkhoma3Ruwayda Petrus4Inge Petersen5Liz Gwyther6Lindsay Farrant7King’s College LondonGlobal Health Institute, King`s College London, London, UKKing`s Global Health Institute, King`s College London, London, UKKing`s College London, London, UKSchool of Applied Human Sciences, University of KwaZulu-Natal College of Humanities, Durban, South AfricaCentre for Rural Health, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South AfricaDivision of Interdisciplinary Palliative Care and Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South AfricaSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South AfricaIntroduction Person-centred care has become internationally recognised as a critical attribute of high-quality healthcare. However, the concept has been criticised for being poorly theorised and operationalised. Serious illness is especially aligned with the need for person-centredness, usually necessitating involvement of significant others, management of clinical uncertainty, high-quality communication and joint decision-making to deliver care concordant with patient preferences. This review aimed to identify and appraise the empirical evidence underpinning conceptualisations of ‘person-centredness’ for serious illness.Methods Search strategy conducted in May 2020. Databases: CINAHL, Embase, PubMed, Ovid Global Health, MEDLINE and PsycINFO. Free text search terms related to (1) person-centredness, (2) serious illness and (3) concept/practice. Tabulation, textual description and narrative synthesis were performed, and quality appraisal conducted using QualSyst tools. Santana et al’s person-centred care model (2018) was used to structure analysis.Results PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow data: n=12,446 studies screened by title/abstract, n=144 full articles assessed for eligibility, n=18 studies retained. All studies (n=18) are from high-income countries, and are largely of high quality (median score 0.82). The findings suggest that person-centred care encompasses the patient and family being respected, given complete information, involved in decision-making and supported in their physical, psychological, social and existential needs. The studies highlight the importance of involving and supporting family/friends, promoting continuation of normality and self-identity, and structuring service organisation to enable care continuity.Conclusion Person-centred healthcare must value the social network of patients, promote quality of life and reform structurally to improve patients’ experience interacting with the healthcare system. Staff must be supported to flexibly adapt skills, communication, routines or environments for individual patients. There remains a need for primary data investigating the meaning and practice of PCC in a greater diversity of diagnostic groups and settings, and a need to ground potential components of PCC within broader universal values and ethical theory.https://gh.bmj.com/content/5/12/e003330.full |
| spellingShingle | Richard Harding Sridhar Venkatapuram Alessandra Giusti Kennedy Nkhoma Ruwayda Petrus Inge Petersen Liz Gwyther Lindsay Farrant The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review BMJ Global Health |
| title | The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review |
| title_full | The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review |
| title_fullStr | The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review |
| title_full_unstemmed | The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review |
| title_short | The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review |
| title_sort | empirical evidence underpinning the concept and practice of person centred care for serious illness a systematic review |
| url | https://gh.bmj.com/content/5/12/e003330.full |
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