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The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review.
Giusti, Alessandra; Nkhoma, Kennedy; Petrus, Ruwayda; Petersen, Inge; Gwyther, Liz; Farrant, Lindsay; Venkatapuram, Sridhar; Harding, Richard.
Afiliación
  • Giusti A; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK alessandra.giusti@kcl.ac.uk.
  • Nkhoma K; King's Global Health Institute, King's College London, London, UK.
  • Petrus R; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
  • Petersen I; School of Applied Human Sciences, University of KwaZulu-Natal College of Humanities, Durban, South Africa.
  • Gwyther L; School of Applied Human Sciences, University of KwaZulu-Natal College of Humanities, Durban, South Africa.
  • Farrant L; School of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa.
  • Venkatapuram S; School of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa.
  • Harding R; King's Global Health Institute, King's College London, London, UK.
BMJ Glob Health ; 5(12)2020 12.
Article en En | MEDLINE | ID: mdl-33303515
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Atención Dirigida al Paciente / Toma de Decisiones Clínicas Tipo de estudio: Prognostic_studies / Systematic_reviews Aspecto: Ethics / Patient_preference Límite: Humans Idioma: En Revista: BMJ Glob Health Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Atención Dirigida al Paciente / Toma de Decisiones Clínicas Tipo de estudio: Prognostic_studies / Systematic_reviews Aspecto: Ethics / Patient_preference Límite: Humans Idioma: En Revista: BMJ Glob Health Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido