Patient Centered Care
Delivery
GW4003MV
537735 – Thomas van Waesberge
30th August 2022 – 13th October 2022
,Theme 1
Person centered care instead of patient centered care, because it gives a more holistic perspective for
the needs of the patient. E.g., their family, emotions.
8 dimensions of person centered care:
1. Patient preferences
a. Worthy and respectful
b. Whole person care
c. Shared decision and trust
2. Information and education
a. Complete and understandable information
b. The patient are the expert of their situation and decease
c. Illiteracy receipts and filling in forms
3. Access to care
a. Financial
b. Physical
c. Time waitlists
4. Physical comfort
a. Support of daily life
b. Pain and uncomforting circumstances
5. Emotional support
a. Jobs
b. Continuous pain has effect on emotional status
6. Involvement of family and friends
a. Role and needs of informal caregivers
7. Coordination of care
a. Integral care
8. Continuity and transition
a. Integral care
Conceptual model of PCC
,Moderator
- A moderator is a third variable that affects the direction or strength of the relationship between
an independent and dependent variable.
- Patient condition, expectations.
Mediator
- A mediator explains the mechanisms that underlies an observed relationship between an
independent variable and a dependent variable.
- Patient activation, adherence.
Evidence-based and patient-centered care approaches
-
- Overall there are different perspectives. No consensus
o Either or model
Care is either evidence based or patient-centered
Effective integration is not emphasized
o Integrated model
Overlapping spheres are conceptualized
Evidence Based Patient-Centered Care occurs when evidence, patient
preferences and clinical judgements of healthcare professionals are taken into
account of the care process.
o Continuum model
There is a point on this continuum where both evidence based care and
patient-centeredness are practiced: best practice.
o Cyclical model
Views evidence based patient-centered care as a process in which it moves
from evidence based care to patient-centered care and evidence based
again.
Iterate process between the approaches
More about using both approaches instead of integration of both.
, Workgroup meeting theme 1
1. Explain the two conceptual models (both Rathert and Jayadevappa) and their addition to the
literature.
a. Rathert – based on Donabedian structure-process-outcome model. The 8 process
indicators have an influence on patient satisfaction, patient clinical outcomes and
organizational outcomes. This influence is moderated by patient condition and
expectations, and mediated by patient activation and adherence.
b. Javyadevappa
Patient-centered care encompasses informed decision making and is a particular
process of decision making by patient and physician where the patient: 1)
understands the risk or seriousness of the disease or condition to be prevented; 2)
understands the preventive service, including the risks, benefits, alternatives and
uncertainties; 3) has weighted his or her values regarding the potential benefits and
harms associated with treatment; and 4) has engaged in decision making at a level
that he or she desires and feels comfortable.
Patients differ, across age and ethnicity, in the extent to which they wish to be
involved in decision making for their medical care and treatment. Although some
patients prefer to actively participate in decision making, others opt for a more passive
role and defer decisions to their physicians. Physicians and nurses are thus
encouraged to tailor the medical care per the preferences of patients
Delivery
GW4003MV
537735 – Thomas van Waesberge
30th August 2022 – 13th October 2022
,Theme 1
Person centered care instead of patient centered care, because it gives a more holistic perspective for
the needs of the patient. E.g., their family, emotions.
8 dimensions of person centered care:
1. Patient preferences
a. Worthy and respectful
b. Whole person care
c. Shared decision and trust
2. Information and education
a. Complete and understandable information
b. The patient are the expert of their situation and decease
c. Illiteracy receipts and filling in forms
3. Access to care
a. Financial
b. Physical
c. Time waitlists
4. Physical comfort
a. Support of daily life
b. Pain and uncomforting circumstances
5. Emotional support
a. Jobs
b. Continuous pain has effect on emotional status
6. Involvement of family and friends
a. Role and needs of informal caregivers
7. Coordination of care
a. Integral care
8. Continuity and transition
a. Integral care
Conceptual model of PCC
,Moderator
- A moderator is a third variable that affects the direction or strength of the relationship between
an independent and dependent variable.
- Patient condition, expectations.
Mediator
- A mediator explains the mechanisms that underlies an observed relationship between an
independent variable and a dependent variable.
- Patient activation, adherence.
Evidence-based and patient-centered care approaches
-
- Overall there are different perspectives. No consensus
o Either or model
Care is either evidence based or patient-centered
Effective integration is not emphasized
o Integrated model
Overlapping spheres are conceptualized
Evidence Based Patient-Centered Care occurs when evidence, patient
preferences and clinical judgements of healthcare professionals are taken into
account of the care process.
o Continuum model
There is a point on this continuum where both evidence based care and
patient-centeredness are practiced: best practice.
o Cyclical model
Views evidence based patient-centered care as a process in which it moves
from evidence based care to patient-centered care and evidence based
again.
Iterate process between the approaches
More about using both approaches instead of integration of both.
, Workgroup meeting theme 1
1. Explain the two conceptual models (both Rathert and Jayadevappa) and their addition to the
literature.
a. Rathert – based on Donabedian structure-process-outcome model. The 8 process
indicators have an influence on patient satisfaction, patient clinical outcomes and
organizational outcomes. This influence is moderated by patient condition and
expectations, and mediated by patient activation and adherence.
b. Javyadevappa
Patient-centered care encompasses informed decision making and is a particular
process of decision making by patient and physician where the patient: 1)
understands the risk or seriousness of the disease or condition to be prevented; 2)
understands the preventive service, including the risks, benefits, alternatives and
uncertainties; 3) has weighted his or her values regarding the potential benefits and
harms associated with treatment; and 4) has engaged in decision making at a level
that he or she desires and feels comfortable.
Patients differ, across age and ethnicity, in the extent to which they wish to be
involved in decision making for their medical care and treatment. Although some
patients prefer to actively participate in decision making, others opt for a more passive
role and defer decisions to their physicians. Physicians and nurses are thus
encouraged to tailor the medical care per the preferences of patients
