Person-centered care#Related concepts

The concept of person-centered care can be distinguished from a traditional treatment model which views the patient as a passive receiver of a medical intervention.Tinetti ME, Fried T. The end of the disease era. American Journal of Medicine. 2004;116(3):179-85. Many health professionals are traditionally focused on the needs of the patients instead of their resources. Rather than the conventional way of making medical recommendations from health professionals to a patient, the person-centered care model allows for the inclusion of the patient and their relatives in making a joint design and mutual agreement on the medical plans and treatments. The overall perspective of the life situation of the patient is considered to create objectives and strategies for both short- and long-term monitoring.{{Cite web |title=Översikt personcentrerad vård| language = Swedish | trans-title = Overview of person-centered care | last=Hörnsten|first=Åsa| work = Värdhandboken | publisher= Umeå University |year=2013| url=http://www.vardhandboken.se/Texter/Personcentrerad-vard/Oversikt/ | url-status = dead | archive-url = https://web.archive.org/web/20150628003813/http://www.vardhandboken.se/Texter/Personcentrerad-vard/Oversikt/| archive-date = 28 June 2015}}

The concept of person-centered care has grown to be internationally associated with successful outcomes in health care.{{Cite book|url=https://books.google.com/books?id=taE7KjcgyysC|title=Person-centered Nursing: Theory and Practice |last1=McCormack |first1=Brendan |last2=McCance |first2=Tanya |date=15 June 2010 |publisher=Wiley |isbn=9781444390490 |language=en}} Initially, the method was developed for senior patients and patients with intellectual disabilities, albeit it has been held under scrutiny later on.{{Cite journal |last1=Wilberforce |first1=Mark |last2=Challis |first2=David |last3=Davies |first3=Linda |last4=Kelly |first4=Michael P. |last5=Roberts |first5=Chris |last6=Loynes |first6=Nik |date=2016-03-07 |title=Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties |journal=BMC Geriatrics |volume=16 |issue=1 |pages=63 |doi=10.1186/s12877-016-0229-y |issn=1471-2318 |pmc=4782329 |pmid=26951641 |doi-access=free }}

Within person-centered care, the patient is considered an independent and capable individual with their own abilities to make informed decisions. Autonomy and participation are emphasized and respected. For the patient, the person-centered approach allows for involvement and extended possibilities to take responsibility for their own health and treatment.{{Cite journal|title=Person-centred care after acute coronary syndrome, from hospital to primary care — A randomised controlled trial |last=Fors |first=Andreas |date= 6 May 2015 |doi=10.1016/j.ijcard.2015.03.336 |pmid=25919754 |volume=187 |journal=International Journal of Cardiology |pages=693–699}}{{Citation |url=http://www.adlibris.com/se/bok/personcentrerad-omvardnad-i-teori-och-praktik-9789144054391 |title=Personcentrerad omvårdnad: i teori och praktik | language = Swedish | trans-title = Person-centered nursing: in theory and practice | first1 = David | last1 = Edvardsson | first2 = Anna | last2 = Ekwall | first3 = Ulla | last3 = Hällgren Graneheim | first4 = Liv | last4 = Meidell | first5 = Astrid | last5 = Norberg | first6 = Regina | last6 = Santamäki Fischer | first7 = Maria | last7 = Svanström | first8 = Agneta | last8 = Törnquist | first9 = Helle | last9 = Wijk | editor-first = Ania | editor-last = Willman | publisher = Studentlitteratur AB | year = 2009 |access-date=31 May 2016}}{{Cite journal |last1=Ekman |first1=Inger |last2=Swedberg |first2=Karl |last3=Taft |first3=Charles |last4=Lindseth |first4=Anders |last5=Norberg |first5=Astrid |last6=Brink |first6=Eva |last7=Carlsson |first7=Jane |last8=Dahlin-Ivanoff |first8=Synneve |last9=Johansson |first9=Inga-Lill |date=1 December 2011 |title=Person-Centered Care – Ready for Prime Time|journal=European Journal of Cardiovascular Nursing |volume=10 |issue=4 |pages=248–251 |doi=10.1016/j.ejcnurse.2011.06.008 |issn=1873-1953 |pmid=21764386|s2cid=24930300 |doi-access=free }}{{Cite web |url=http://www.dagensmedicin.se/artiklar/2015/04/10/personcentrerad-vard-starkte-hjartpatienter/ |title=Personcentrerad vård stärkte hjärtpatienter | language=Swedish | trans-title = Person-centered care strengthened cardiac patients | first = Carl-Magnus | last = Hake | work = Dagens Medicin | date = 4 October 2015 |access-date=31 May 2016}}

There are four vantage points that constitute the foundation of person-centered care:

• The health care should be based on the unique person's needs and his or her right to health
• The health institution should focus on the abilities of the person and encourage activity
• The health care should be coherent
• Health professionals should always approach patients with dignity, compassion and respect. They should work with an ethical perspective.

Person-centered care is based on a holistic approach to health care that takes the whole person into account instead of a narrow perspective where the focus lies on the illness or the symptoms. The person-centered approach also includes the person's abilities, or resources, wishes, health and well-being as well as social and cultural factors.{{Cite book |url=http://www.adlibris.com/se/bok/personcentrering-i-halso--och-sjukvard-fran-filosofi-till-praktik-9789147114054 |title=Personcentrering i hälso-och sjukvård: från filosofi till praktik | language=Swedish | trans-title = Person centering in health-care: from philosophy to practice | first1 = Inger | last1 = Ekman | first2 = Astrid | last2 = Norberg | first3 = Bengt | last3 = Kristensson Uggla | first4 = Karl | last4 = Swedberg | first5 = Irma | last5 = Lindström Kjellberg | first6 = Jesper | last6 = Hök | first7 = Axel | last7 = Wolf | first8 = Eric | last8 = Carlström | first9 = Eva | last9 = Lidén | first10 = Staffan | last10 = Svensson | first11 = David | last11 = Edvardsson | first12 = Kerstin | last12 = Dudas | first13 = Jerzy | last13 = Kaczynski | first14 = Lars-Eric | last14 = Olsson | first15 = Charlotta | last15 = Saldert | first16 = Andreas | last16 = Fors | first17 = Ingela | last17 = Skärsäter | first18 = Mathias | last18 = Klang | first19 = Håkan | last19 = Hedman | first20 = Anne-Marie | last20 = Boström | first21 = Per-Olof | last21 = Sandman | first22 = Ewa | last22 = Stenwall | first23 = Kristina | last23 = Kindblom | year = 2014 | publisher = Liber | isbn = 9789147114054 |access-date=31 May 2016}}

According to the Gothenburg model of person centered care there are three central themes to person-centered care work: the patient's narrative, the partnership and the documentation.{{Cite journal|last1=Britten|first1=Nicky|last2=Ekman|first2=Inger|last3=Naldemirci|first3=Öncel|last4=Javinger|first4=Mikaela|last5=Hedman|first5=Håkan|last6=Wolf|first6=Axel|date=2020-09-01|title=Learning from Gothenburg model of person centred healthcare|url=http://dx.doi.org/10.1136/bmj.m2738|journal=BMJ|volume=370 |pages=m2738|doi=10.1136/bmj.m2738|pmid=32873594 |s2cid=221389006 |issn=1756-1833|url-access=subscription}}

The health care team may consist of several different professionals with varying expertise from different health care units. The patient is a natural part of the team. Within the team, the patient and relatives have discussions with health professionals aiming to reach a mutual understanding on how to achieve safe and accurate care for the unique patient.

The personal health or care plan is designed to capture the patient's narrative. A common understanding of strategies, goals and evaluation of the outcomes should be established. The documentation should clearly state the responsibilities of each member of the team, including the patient's own role and obligations. To fully live up to the person-centered care concept, patients should have full and easy access to all information and documentation about them. For reasons of security, accessibility and cost effectiveness, all documentation should be digital and include all medical records. The person's own notes, reports of health status and the overall health plan should also be carefully documented. The collected documentation is the foundation of the health care.

Person-centred care is a concept used in the United Kingdom by Skills for Health, in their 2017 framework; by the Health Foundation, set out in their 2016 "quick guide"; by the Social Care Institute for Excellence; by the Royal College of General Practitioners and NHS England, who have developed a Person-Centred Care toolkit; by the Health Innovation Network South London; and by the Care Quality Commission, in their regulations for service providers.{{cite web |last1=Fagan |first1=Petrea |last2=de Iongh |first2=Anya |last3=Harden |first3=Beverley |last4=Wright |first4=Colin |title=Person-Centred Approaches: Empowering people in their lives and communities to enable an upgrade in prevention, wellbeing, health, care and support |url=https://www.skillsforhealth.org.uk/wp-content/uploads/2021/01/Person-Centred-Approaches-Framework.pdf |publisher=Skills for Health |access-date=16 August 2022 |date=2017}}{{cite web |title=Person-centred care made simple: What everyone should know about person-centred care |url=https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple_0.pdf |publisher=The Health Foundation |access-date=16 August 2022 |date=2016}}{{cite web |title=Prevention and Wellbeing: Person-centred care |url=https://www.scie.org.uk/prevention/choice/person-centred-care |publisher=Social Care Institute for Excellence |access-date=16 August 2022}}{{cite web |title=Person-Centred Care toolkit |url=https://elearning.rcgp.org.uk/mod/book/view.php?id=12953 |website=RCGP Learning |publisher=Royal College of General Practitioners |access-date=16 August 2022}}{{cite web |title=What is person-centred care and why is it important? |url=https://healthinnovationnetwork.com/system/ckeditor_assets/attachments/41/what_is_person-centred_care_and_why_is_it_important.pdf |publisher=Health Innovation Network South London |access-date=16 August 2022}}{{cite web |title=Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9 |url=https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-9-person-centred-care |publisher=Care Quality Commission |access-date=16 August 2022 |date=2022}}

The Health Innovation Network defines Person-centred care as:

{{Blockquote

|text=a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs. This means putting people and their families at the centre of decisions and seeing them as experts, working alongside professionals to get the best outcome|source=What is person-centred care and why is it important?}}

The concept is defined as including decision-making that is shared between services users and professionals, ensuring service users have access to advocacy, providing personal budgets for people to access services, treating people with dignity, ensuring service users have all the information they need, supporting individual choices and ensuring treatment and support are personalised and take into account people's preferences. The Royal College of GPs notes that the key question is not '"what's the matter with you" but "what matters to you".

The Health Foundation states that "a commonly cited barrier is that many [service providers] believe the care they provide is already person-centred. However, the evidence shows that this is often not the case".

Research on person-centered care is carried out in many different universities. The University of Gothenburg Centre for Personcentred Care (GPCC), in Sweden, has been established since 2010. The center conducts interdisciplinary research funded partly by the Swedish government's investments targeted towards care sciences.

A conceptual framework for person-centered care has been presented by McCormack and McCance.{{Cite journal|last=Riddett|first=Jackie|date=2017-03-09|title=Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) McCormack Brendan and McCance Tanya (Eds) Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) 288pp £29.99 Wiley Blackwell 9781118990568 1118990560|url=http://dx.doi.org/10.7748/mhp.20.6.13.s14|journal=Mental Health Practice|volume=20|issue=6|pages=13|doi=10.7748/mhp.20.6.13.s14|issn=1465-8720|url-access=subscription}} The holistic framework by McCormack and McCance consists of four constructs; prerequisites, the care environment, person-centred processes, and expected outcomes.

Patient-centered care is a concept that also emphasises the involvement of the patient and their families in the decision making of medical treatments. A main difference is that person-centered care describes the whole person in a wider context rather than the patient-centered approach which is based on the person's role as a patient. There is a difference between the word “patient” and “person”, still there is a widespread use of the concept of patient-centered care and person-centered care as equals. The word “patient” can be defined as a person who receives treatment for a disorder or illness. Characteristic of a patient is vulnerability and dependence.{{Cite journal|last1=Håkansson Eklund|first1=Jakob|last2=Holmström|first2=Inger K.|last3=Kumlin|first3=Tomas|last4=Kaminsky|first4=Elenor|last5=Skoglund|first5=Karin|last6=Höglander|first6=Jessica|last7=Sundler|first7=Annelie J.|last8=Condén|first8=Emelie|last9=Summer Meranius|first9=Martina|date=January 2019|title="Same same or different?" A review of reviews of person-centered and patient-centered care|url=http://dx.doi.org/10.1016/j.pec.2018.08.029|journal=Patient Education and Counseling|volume=102|issue=1|pages=3–11|doi=10.1016/j.pec.2018.08.029|pmid=30201221 |s2cid=52180607 |issn=0738-3991|url-access=subscription}} To get a deeper understanding of the word “person” we need to define the philosophical concept of personhood. Personhood is linked with responsibilities and human rights, and characteristics such as rationality and consciousness.{{Cite book |title=Concise medical dictionary |date=2020 |editor=Jonathan Law |editor2=E. A. Martin |isbn=978-0-19-187376-8 |edition=Tenth |location=Oxford |oclc=1142355883}} The goal of person-centered care is for the person to live a meaningful life. The concept has a more holistic focus on the person’s uniqueness in disregard to the sickness. Patient-centered care has sprung out of resistance against the paternalistic and biomedical approach to medicine.

People-centered care is an umbrella term, articulated by WHO among others,{{cite web | url = http://www.wpro.who.int/health_services/people_at_the_centre_of_care/definition/en/ | url-status = dead | archive-url = https://web.archive.org/web/20180119121053/http://www.wpro.who.int/health_services/people_at_the_centre_of_care/definition/en/ | archive-date = 19 January 2018 | title = What is people-centred health care? | publisher = World Health Organization, Western Pacific Region | date =}} which entails the right and duty for people to actively participate in decisions at all levels of the health care systems. People-centered care focuses both on the individual's right to health, access to health care and information, but also health literacy on a collective level.

Relational care with older people, which has evolved from person-centred care, considers the wellbeing and quality of life of everyone involved in a person's care, encompassing the older person, professionals, and communities within and beyond care settings.The Open University, [https://wels.open.ac.uk/news/new-research-and-toolkit-provide-transformative-approach-care-launched-ou-academics New research and toolkit to provide transformative approach to care launched by OU academics], accessed 17 May 2024

Health activation is a condition where a health care consumer is equipped, educated, and motivated to be an effective manager of their own health and use of health care services.{{cite web | first = Eric | last = Bricker | title = What is Health Activation? | date = 5 May 2016 | publisher = Compass Professional Health Services | url = http://www.compassphs.com/blog/health-activation/what-is-health-activation/ | url-status = dead | archive-url = https://web.archive.org/web/20161230072510/http://www.compassphs.com/blog/health-activation/what-is-health-activation/ | archive-date = 30 December 2016}}{{cite web | publisher = Insignia Health | title = Patient Activation Measure® (PAM®) | access-date = 28 December 2016 | url = http://www.insigniahealth.com/products/pam-survey | url-status = dead | archive-url = https://web.archive.org/web/20161204163000/http://www.insigniahealth.com/products/pam-survey | archive-date = 4 December 2016}}{{cite web | first = Ginger | last = Lerner-Wren | title = The Need for Health Activism in the Criminal Justice System | date = 30 May 2015 | work = HuffPost | publisher = Verizon Media | url = http://www.huffingtonpost.com/ginger-lernerwren/the-need-for-health-activ_b_6965274.html}} The concepts are very similar, although person-centered care places the emphasis on the healthcare provider, whereas the term health activation is used in reference to the attitude and behavior of the patient.

Good care focus on empowerment, respect, humanization, and absence of infantilization. Good care implies, on the one hand, prevention of abuse or mistreatment, and on the other, patient-centered care.{{Cite book |url=https://www.worldcat.org/oclc/1317702293 |title=Promoting good care of older people in institutions |date=2022 |publisher=Dykinson |others=Gema Pérez-Rojo, Javier López |isbn=978-84-1122-180-1 |location=Madrid |oclc=1317702293}}

Good care is measured via a self-reported questionnaire. The Good Care Scale in Nursing Homes (GCS-NH)a) has been used, which is a 62-item questionnaire that assesses empowerment, respect, humanization, and non-infantilization, by measuring how strong nursing home staff agree with each statement on a scale of 0- 4.{{Cite journal |last1=López |first1=Javier |last2=Pérez-Rojo |first2=Gema |last3=Noriega |first3=Cristina |last4=Velasco |first4=Cristina |date=January 2021 |title=Personal and Work-Related Factors Associated with Good Care for Institutionalized Older Adults |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=2 |pages=820 |doi=10.3390/ijerph18020820 |pmid=33477928 |pmc=7833360 |issn=1660-4601|doi-access=free }}

{{reflist}}

• {{cite journal | title = "Same same or different?" A review of reviews of person-centered and patient-centered care | first1 = Jakob | last1 = Håkansson Eklund | first2 = Inger K. | last2 = Holmström | first3 = Tomas | last3 = Kumlin | first4 = Elenor | last4 = Kaminsky | first5 = Karin | last5 = Skoglund | first6 = Jessica | last6 = Höglander | first7 = Annelie J. | last7 = Sundler | first8 = Emelie | last8 = Condén | first9 = Martina Summer | last9 = Meranius | journal = Patient Education and Counseling | volume = 102 | number = 1 | date = January 2019 | pages = 3–11 | doi = 10.1016/j.pec.2018.08.029 | pmid = 30201221 | s2cid = 52180607 }}
• [https://onlinelibrary.wiley.com/doi/epdf/10.1002/nop2.520 Paradoxes of person-centred care: A discussion paper]

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