The Fundamentals Of Person Centred Care In Practice

According to the National Health Service, (NHS), person-centred care is the process, in which the patient is involved in their own treatment process in close coordination with the healthcare professional and staffs. Person-centred care is the process in which health professionals and health and social care staffs work synergistically with patent and their family members in order to serve them with proper dignity and respect. This essay is going to discuss the person-centred care in a comprehensive manner by using relevant evidence. This study will represent the critical discussion on important components of person centred care, that are required in the health and social care to conduct proper partnership working with patients and their family order to provide high-quality care and treatment process. Moreover, this essay is going to represent the critical discussion on the obstacles on the person-centred care which can pose potential barriers to the healthcare system in order to achieve the expected target.

As stated by Brummel‐Smith et al. (2016), person-centred care is important for improving healthcare, quality of patents health, safety and coordination among the patient, health care professionals, family members and staffs. Person-centred care assists the health professionals and nurses to world synergistically with the patient and family members and understands the needs, preference and the problems of the patients. There are some critical components of person-centred care, which are obligatory to maintaining by the healthcare professional and the staffs by well-organised manner, in order to maintain the quality of the overall treatment process.

Shared decision making is one of the most important and critical components of person-centred care. As stated by Kogan et al. (2016), person-centred care assists health professionals and nurses to work in partnership with patients and their families, in order to make proper interaction with them. Through conducting clear communication with patient and family members, doctors and nurses are able to get proper information about patient previous medical history, their behaviour, previous health issues, patient psychology and their preference. According to shared decision making in health care is a collaborative process, in which doctors discuss their decision of choosing best as well as relevant treatment process with the nurses, patients and their family members. Through making the discussion and interaction retarding what kind of treatment is appropriate for a patent health condition and what would be the possible outcomes of this treatment, sectors can ensure the transparency of the overall treatment process. On the contrary, Wildevuur and Simone (201) argued that, in many times, doctors are unable to involve patient to share their decision regarding the treatment process that is going to be applied for his or her health condition. For example, in case id dementia patients, they are unable to understand the effeteness and outcomes of the treatment process. Moreover, Kogan et al. (2016) also argued that, through self-management process, it is not possible for every time to get proper approval from the family members and patient about choosing the innovative treatment process. Therefore, in such critical condition, doctors take the decision of choosing appropriate treatment process without making any discussion about the type of treatment process applied to patients, with the patient and family member as the process shared decision making would be ineffective and time-consuming.

Personalised care and support planning is another important component of person-centred care (Herlitz et al. 2016). Personalised care process is important aspects in the person-centred care, in which patients are involved in decisions, planning and delivery of the care process. Personalised care and support planning is a holistic approach, in which doctors and nurses work in partnership with patients and their families. In this process, doctors involved the family members and patients about getting proper information about eth types of treatment, its outcomes, methods, medicines, overall cost and expectancy of the treatment process. According to Lines et al. (2015), through conducting personalised acre, doctors are able to take proper decisions and preference of the patient regarding the treatment process. Therefore, this process, assist the health professionals, to conduct transparent and high-quality care and support process. On the contrary Mezzich et al. (2017) argued that in case of disabled patient, it is difficult for the health professionals to take the decision regarding choosing the relevant treatment process. in addition to this, report from World Health Organisation stated that, NHS staffs in UK based hospitals have been reported to face the ethical dilemmas in maintaining personalised care and support planning, in which patients have rejected to have any surgeries on their body leading to occurrence if health risk of the patient [WHO, 2019]. By supporting the statement Wolff and Boyd (2015) mentioned that, in case of personalised care process for older patients suffering from chronic illness, family members and the patients are not agreed to provide their consent to innovative treatment process and surgeries, as it cannot be tolerated and adapted by the patients due to poor immune system. In spite of all these controversies regarding the implementation of personalised care and support planning, recent evidence suggests that this element if person-centred care assist health professionals and healthcare staffs to make effect collaborative treatment framework by getting proper coordination with patent and their family members.

Dignity, autonomy and respect are considered as critical elements for conducting person-centred care. As opined by Sahlen et al. (2016), person-centred care assist health professionals to serve patients with proper dignity and respect which make them feel valued and respected. Through involving patient in their treatment and recovery process, health professionals assist them to share their viewpoints and decisions regarding the overall care process. Based on the National Health Service (NHS), in order to conduct proper person-centred care, health professionals need to prioritise patient values, physical, psychological and emotional comfort, their values and expressed needs. On the contrary Corazzini et al. (2016) argued that sometimes health professionals and healthcare staff’s are unable to maintain patient autonomy which can lead to health risk for them. For example, a recent survey conducted by the World Health Organisation stated that, in case id dementia patient, patient autonomy and freedom sometimes enhance the risk of injuries, sudden accidents and even death. On supporting this aspect Chenoweth et al. ( 2019) mentioned that, in cases of patient with mental and physical disabilities, autonomy can mislead them towards the wrong direction which not only enhances the chances of health risk but also pose doubts on the integrity of health professional and care process. National Health Service stated that NHS professionals would ensure that, during the person-centred care, nurses and other healthcare staffs would listen to the decisions, views and preferences of the patients. Through discussion and decision-making process, nurses would be able to understand whether the patient would be treated with autonomy and freedom or the patient needs to be provided with proper protection due to their vulnerability towards health risks. According to Røen et al. (2018), in the case of the vulnerable people, dignity and respect are important in person-centred care for developing their, emotional and physical stability, but health professionals cannot provide the freedom of taking decisions and view regarding their own treatment process as it can enhance the chances of health risk.

Self-management support is one of the important as well as critical elements of person-centred care (Roberts et al. 2015). According to National Health Service (NHS), self-management support is an important part of shared decision making, in which patients with long terms condition is involved in the management of their own emotional, physical and psychological health and wellbeing [NHS, 2019]. This process assists the patients to involved in their own treatment process and recovery, by understanding the types of treatment, medication, day-to-day care process and clinical condition. According to Chenoweth et al. (2019), self-management support is one of the important technique in the holistic and personalised care process, in which doctors, nurse and patient share their decision, values, emotions and preference in order to promote the betterment and quality if the overall healthcare process. a recent study conducted by World Health Organisation on NHS hospitals shows that majority of the health professional in NHS hospitals prefers to use self-management process which assists them to maintain transparent interaction within the care process in order to understand the actual health demand, values and expressed needs of the patients. On the contrary, Pate (2017) argued that in chronic health condition self-management process can create a high level of conflict among patients, doctors and nurses. Recent evidence on shared decision making suggests that, in some cases of patients with long term condition, the healthcare authority have to face severe conflict and misunderstand within doctors and patients in order to establishment own viewpoints. On supporting this viewpoint Roberts et al. (2015) argued that, sometimes, the involvement of the patient in order to manage their own health enhance the unethical and unauthentic interference of patients and their family members into the treatment proves which affect adversely the overall quality and outcomes of the treatment process. National Institute of Care and Excellence (NICE) suggest that self-management proves needs to be implemented in such a manner by a health professional in which patient as wells as doctors would have some obligations and limitations regarding their activities and performance. If the patient and doctor maintain their obligation and behave their limits in order to involve in the overall care process, then it would be easier for the healthcare authority to provide high-quality person-centred care.

Along with the above-mentioned benefits of person centred care, there are some barriers that are associated with this process, such as financial barriers, social barriers, high turnover, poor support of patients and family members, traditional methods of healthcare, professional mobility and increased documentation demand, lack of education and inconsistent leadership.

Financial barrier is a major obstacle in the person-centred care system. A recent report from the World Health Organisation suggests that majority of the NHS nurses mentioned that there is lack of timely and appropriate salary in most of the NHS hospitals which spoil the job satisfaction in staffs. As stated by Herlitz et al. (2016), lack of financial support tin majority of public healthcare units in UK males the nurses, doctors and other health and social staffs unable to implement the high-quality personalised care process for promoting patient health and wellbeing. The inconsistent flow of fund makes it difficult for the healthcare authority to buy the modern instrument and machines which are required to take the modem holistic person-centred approach. On the contrary Mezzich et al. (2017), the issues generated by lack of financial find affect the majority of public sectors hospital, but in case of private hospitals, there are increases of investment from the NGOs and trustees. This is why the personalised and holistic care process is mainly performed by private care hospitals and nursing homes but not in the public sector hospitals.

Another barrier to implementing person-centred care is lack of social support, such as traditional social outlook, the old concept of society regarding treatment process, majority of the population in society is aged and lack of education (Wolff and Boyd, 2015). Recent evidence suggests that, in most of the cases, health professionals and nurses do not get proper support from their society in order to implement holistic and innovative person-centred care. Society sometimes pressurises the doctors and nurse to maintain the traditional health care process rather than using high-quality person-centred care, which interferes with expected outcomes f eth overall care process. On the contrary Mezzich et al. (2017) argued that, not only the traditional viewpoint of society bit also sometimes the modern approach of society makes dominate overall the decision and presence of doctors, which demotivate and discourage the health professional to put their best effort into the treatment process. for example, high standard and classy society sometimes interfere with the treatment process, medication process, regular activities and the day to day care process of the patients, which can sometimes hurt the dignity, respect and integrity of health professional and nurse, thereby affecting the overall outcomes of the person-centred care process.

Lack of respect from the institution as well as from patients and their family members sometimes pose potential constraints on the overall person-centred care delivery process. as stated by Chenoweth et al. (2019), NHS nurses have been reported to do not get proper ancillary support from their institution, which damages their interest for contribution best effort for promoting patient health and safety. Moreover, health professionals and nurses are also abused and humiliated by the patient’s family members by posing doubt on their integrity and ability. due to these aspects, a majority if the health professionals and nurses lose their patience, interest and hardworking mentality in order o provide the best support and care during the patient centred care process. on the contrary Corazzini et al. (2016) argued that not only health professionals, but also patients are sometimes, humiliated and abused but h doctors and nurses which pose potential barrier on achieving the expected outcomes of the person-centred care.

Other important obstacles to the person-centred care are lack of education, high turnover of the health professionals and nurses, presence of patient towards the traditional healthcare system and poor consent from the patient and their family. Due to these obstacles, it becomes difficult for the health professionals and nurses to execute the health needs and meet them accordingly by applying the personalised care process.

From the above-mentioned discussion, it can be concluded that person-centred care is the process, in which the patient is involved in their own treatment and recovery process in close coordination with health care professionals and nurses. This care process is associated with a holistic and personalised approach which assist the patient to get proper respect, dignity and autonomy in terms of promoting their health and wellbeing. There are some critical components of person-centred care process such as self-management process, integrated care, personalised care, marinating dignity, respect and autonomy of patient and shared decision-making process. Along with these elements promote high-quality person-centred care, there are some obstacles that are associated with this care daily process. The constraints are poor social support, lack of support to health professionals and nurses, poor consent from patients and family members, lack of education and poor financial support. In order to promote proper person-centred care, health professional and healthcare authority needs to improve h overall healthcare framework which can assist them to implement the proper element of person-centred care.

References

• American Geriatrics Society Expert Panel on Person‐Centered Care, Brummel‐Smith, K., Butler, D., Frieder, M., Gibbs, N., Henry, M., Koons, E., Loggers, E., Porock, D., Reuben, D.B. and Saliba, D., 2016. Person‐centered care: A definition and essential elements. Journal of the American Geriatrics Society, 64(1), pp.15-18.]
• Kogan, A.C., Wilber, K. and Mosqueda, L., 2016. Person‐centered care for older adults with chronic conditions and functional impairment: A systematic literature review. Journal of the American Geriatrics Society, 64(1), pp.e1-e7.
• Wildevuur, S.E. and Simonse, L.W., 2015. Information and communication technology–enabled person-centered care for the “big five” chronic conditions: scoping review. Journal of medical Internet research, 17(3), p.e77.
• Herlitz, A., Munthe, C., Törner, M. and Forsander, G., 2016. The counseling, self-care, adherence approach to person-centered care and shared decision making: moral psychology, executive autonomy, and ethics in multi-dimensional care decisions. Health communication, 31(8), pp.964-973.
• Lines, L.M., Lepore, M. and Wiener, J.M., 2015. Patient-centered, person-centered, and person-directed care: they are not the same. Medical care, 53(7), pp.561-563.
• Mezzich, J.E., Kirisci, L., Salloum, I., Trivedi, J., Kar, S.K., Adams, N. and Wallcraft, J., 2017. Systematic conceptualization of person centered medicine and development and validation of a person-centered care index. International Journal of Person Centered Medicine, 6(4).
• Wolff, J.L. and Boyd, C.M., 2015. A look at person-centered and family-centered care among older adults: results from a national survey. Journal of general internal medicine, 30(10), pp.1497-1504.
• Sahlen, K.G., Boman, K. and Brännström, M., 2016. A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial. Palliative medicine, 30(3), pp.296-302.
• Corazzini, K.N., Meyer, J., McGilton, K.S., Scales, K., McConnell, E.S., Anderson, R.A., Lepore, M. and Ekman, I., 2016. Person-centered nursing home care in the United States, United Kingdom, and Sweden: Why building cross-comparative capacity may help us radically rethink nursing home care and the role of the RN.
• Chenoweth, L., Stein-Parbury, J., Lapkin, S., Wang, A., Liu, Z. and Williams, A., 2019. Effects of person-centered care at the organisational-level for people with dementia. A systematic review. PloS one, 14(2), p.e0212686.
• Røen, I., Kirkevold, Ø., Testad, I., Selbæk, G., Engedal, K. and Bergh, S., 2018. Person-centered care in Norwegian nursing homes and its relation to organizational factors and staff characteristics: a cross-sectional survey. International psychogeriatrics, 30(9), pp.1279-1290.
• Roberts, G., Morley, C., Walters, W., Malta, S. and Doyle, C., 2015. Caring for people with dementia in residential aged care: Successes with a composite person-centered care model featuring Montessori-based activities. Geriatric Nursing, 36(2), pp.106-110.
• Pate, R., 2017. Assessing and Implementing Person-Centered Care Training for Direct Care Workers: Long-Term Care Facilities (LTCs). Northeastern Illinois University.