  What
we mean by 'person-centred health care'
Proposed definitions vary and there
is no universally accepted definition.1
For the purpose of this discussion paper,
person-centred health care is most simply understood
as a system that is designed to respect the
patient’s preferences, values and/or needs.1
This approach involves partnership
between health professional and patient, with shared
aspirations for treatment and acknowledgement of
people’s life goals. For those with long-term
conditions, it means giving them the understanding
and skills to optimise their investment of time in
their condition to keep themselves well. This idea
is not new, but is increasingly supported by
clinical evidence, particularly in the areas of
diabetes, asthma and arthritis. Health professionals
working in primary care, particularly GPs, are
already recognised for their person-centred
approach, compared with some specialist disciplines
or hospital settings.
Central principles
Although the priorities of patients,
their families and carers will differ according to
culture and medical condition, all these elements
are fundamental to person-centred health care:2,5,9
-
Respect for the individual’s
values, expressed needs and preferences.
-
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Patient-based
evidence
Patient
organisations are urging people
to take responsibility to ensure
that their health care is based
on evidence by asking the
following questions at every
management decision point.10
1. What are my
treatment options?
2. What are the possible
outcomes of those options?
3. How likely is each of the
outcomes to occur? |
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Choice – patients have the right
and responsibility to participate in health care
decisions including treatment and management. To
do this responsibly they need the options and
probable outcomes carefully explained.
Patient-centred care doesn’t mean the
subjugation of science to patients’ uninformed
demands. Clearly, it is counterproductive to
provide health care that simply reflects patient
demands without first offering choices that are
well informed by available evidence.
-
Access to services required by
the person’s medical condition, including
preventive care.
-
Support – acknowledging and
addressing the person’s emotional and social
needs. This means involving the person’s family
and friends (as the patient desires) and
considering educational, cultural and personal
factors affecting the person’s ability to manage
their condition.
-
Education and information that
is accurate, relevant and answers the person’s
concerns. Information must be given in a mode
appropriate to the person’s level of
understanding of their condition, educational
status, language, age and culture.
Related and enabling principles
Putting these principles into
practice requires a focus on health promotion and
healthy lifestyles, rather than just on specific
medical conditions, and effective communication
between provider and patient. Health professionals’
ability to deliver person-centred health care
depends on factors that link these approaches at the
level of health policy and government (Figure 1).
These enabling principles include:3,5,9
-
coordination and integration of
care across boundaries of the health care system
-
supportive community-based
services and programs
-
planned and systematic
involvement of patients in health policy – both
individually and through patient organisations.
Figure 1
The foundations of person-centred health care in
primary care
Person-centred primary health care
involves practices being organised around the
principles of informed choice, respect, partnership,
a holistic approach and good communication. Primary
care providers’ capacity to offer this type of care
is supported by a health system designed to ensure
access, patient involvement in policy making, and
coordination between levels and types of health
services.
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