Person Centred Care May - July 2019

This bulletin covers person centred health care, and should be of interest to staff working in this area, within acute, community and social care sectors.

Many of the following articles are available online via the NHS Scotland Knowledge Network. If prompted, please use your NHS Scotland Athens username and password, if you do not have one you can register here:   https://www.athensregistration.scot.nhs.uk/

Critical appraisal is an essential part of evidence-based practice and involves systematically evaluating evidence to establish whether it is valid, accurate and relevant.  For introductory resources, visit the Critical Appraisal Tools pathway.

This bulletin contains a selection of material gathered from a search of the evidence base, and is not intended to be comprehensive. Professional judgment should be exercised when appraising the material. The Library takes no responsibility for the wording, content and accuracy of the information supplied, which has been extracted in good faith from reputable sources. NHSGGC is not responsible for the content of external internet sites.

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Books

Martz, E (ed) Promoting self-management of chronic health conditions: theories and practice.  Oxford; Oxford University Press, 2018.  Available from NHS Scotland Libraries : view availability and request online.

Articles

Ankolekar, A., Vanneste, BGL, Gurpe, EB, et al (2019) Development and validation of a patient decision aid for prostate Cancer therapy: from paternalistic towards participative shared decision making.  BMC Medical Informatics and Decision Making 19: 130.   Patient decision aids (PDAs) can support decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision making (SDM) approach making participatory medicine possible.  The aim of this study was to develop a PDA for prostate cancer that is accurate and user friendly.

Bastemeijer, C., Boosman, H., van Ewijk, H., et al (2019) Patient experiences: a systematic review of quality improvement interventions in a hospital setting.  Patient Related Outcome Measures 10: 157-159 In the era of value-based healthcare, one strives for the most optimal outcomes and experiences from the perspective of the patient.  So, patient experineces have become a key quality indicator for healthcare.  While these are supposed to drive quality improvement (QI), their use and effectiveness for this purpose has been questioned.  The aim of this systematic review was to provide insight into QI interventions used in a hospital setting and their effects on improviingpatient experiences, and possible barriers and promoters of QI work.

Brand, G., Osborne, A., Wise, S. et al (2019) Using MRI art, poetry, photography and patient narratives to bridge clinical and human experiences of stroke recovery.  Medical Humanities Published Online First 06 June 2019.  The findings of this study enhance understanding of how art can be used to wide thelens of stroke recovery and provides a valuable template to co-produce peer- to- peer and health professions education reflective learning resources to promote more human-centred approaches to care.

Bucknall, T., Digby, R., Fossum, M., et al (2019) Exploring patient preferences for involvement in medication management in hospitals.  Journal of Advanced Nursing Published 04 June 2019.  "Little is known about patient preferences for participation in medication administration and hospital discharge planning.  Individual patient understanding of and interest in participation in medication administration varies.  In accordance with individual patient preferences, patients need to be included more effectively and consistently in their own medication management when in hospital.

Close, J., Fosh, B., Wheat, H., et al. (2019) Longitudinal evaluation of a countywide alternative to the Quality and Outcomes Framework in UK General Practice aimed at improving person centred coordinatated care.  BMJ Open 9; 029721 The Somerset Practice Quality Scheme (SPQS) leveraged time savings and reduced administrattive burden via discretionary removal of QOF incentives, enabling practices to engage actively in a number of schemes aimed at improving care for people with LTCs.  The authors found no differences in the experiences of healthcare professionals between SPQS and control practices.

Crowe, C., Manley, K. (2019) Person-centred, safe and effectivecare in maternity services: the need for greater change towards best practice.  International Practice Development Journall London 9(1). Implementating best practice and learning from quality of care inquiries are identified as key challenges when providing person-centred, safe, and efffective care mediatd through contextual factors such as learning, leadership and teamwork.  

Cramm, JM., Neiboer, AP. (2019) Validation of an instrument to assess informal caregivers' perceptions about the delivey of patient- centred care to people with intellectual disabilities in residential settings.  BMC Health Services Research 19:518.  The psychometric properties of the 24-item PCC instrument for informal caregivers (PCC-IC) were satsifactory, indicatiing that PCC-IC is valid and reliable for the assessment of the eight dimensions of PCC among informal caregivers of PWIDs in residential settings.

Feo, R., Conroy, T. Wiechula, R., et al (2019) Instruments measuring behavioural aspects of the nurse-patient relationship: a scoping review.  Journal of Clinical Nursing First Published 04 June 2019.  The volume of tools available demonstrates the imprtance of measuring the nurse-patient relationship.  However, the duplication and variability create challenges in choosing amongst the tools available, and show that, as a concept, the nurse-patient relationship remains poorly understood.

Hinsley, K., Kelly, PJ., Davis, E. (2019) Experiences of patient-centred care in alcohol and other drug treatment settings: a qualititative study to inform design of a patient-reported experience measure.  Drug and Alcohol Review Piblished 08 July 2019.  A growing body of literature supports the use of patient-reported experience measures (PREMs) to monitor the provision of patient-centred care to people accessign health services.  However, there is an absence of research into PREMs in the alcohol and other drugs (AOD) field.  The aim of this study was to explore patient experiences of AOD care and to develop a PREM for AOD treatment settings.

Kuluski, K., Peckham, A., Gill, A., et al (2019) What is important to older people with multimorbidity and their caregivers? Identifying attributes of person centred care from the user persepective.  International Journal of Integrated Care 19(3).  Attritbutes of good care extend beyond disease management.  Whilte the finding of this article inlcude activities that characterise these attributes, further research on implementation barriers and facilitators is required.  

Leamy, M., Reynolds, E., Robert, G., et al (2019) The origins and implementation of an intervention to support healthcare staff to deliver compassionate care: exploring fidelity and adaption in the transfer of Chwartz Center Rounds® from the United States to the United Kingdom.  BMC Health Services Reserach 19:457.  Schwartz Center Rounds® were developed in the United States in 1995 to provide a regular, structured time and sage place for staff to meet to share the emotional, psychological and social challenges of working in healthcare.  Rounds were adopted in the United Kingdom in 2009 and have subsequently implemented in over 180 healthcare organisations  Using Rounds as a case study, we aim to inform to current debates around maintaining fidelity when an intervention developed in one country is transferred and implemented in another.

Moscrop, A., Ziebland, S., Roberts, N., Papanikitas, A (2019) A systematic review of reasons for and against asking patients about their socioeconomic contexts.  International Journal of Equity in Health 18:112.   This first summary of literature on the subject found manuy published reasons for why patients' social and economic circumstances should be enquired about in healthcare settings.  These reasons include potential benefits at the levels of individuals, health service provision, and population,as well as the potential to improve healthcare equity.  Cautions and caveats include concerns about the clinician's role in responding to paitents' social problems; the perceived importance of social health determinants compared with biomedical factors; the use of average population data from geographic areas to infer the socioeconomic experiences of individuals.  Actual evidence of outcomes is lacking; our review suggests hypotheses that can be tested in future research.

Rawlings, D., Devery, K., Poole, N. (2019) Improving the quality in hospital end of life care: honest communication, compassion and empathy.  BMJ Open Quality 8:e000669.  With over hald of expected deaths occuring in acute hospitals and a workforce not trained to care for them, good quality end -of -life care in these settings is hard to achieve.  The National Consensus Statement on Essential Elements for Sage and High Quality End of Life Care has been translated into elearning modules by the End of Life Essentials project, and this study aims to demonstrate how clinicians interpre the Consensus Satement in their day to day practice by answering the question at the of each module: 'Tomorrow, the one thing I can change to more appropriately provide end of life care is ....'

Van Haitsma, K., Abbott, KM>, Arbogast, MA., et al (2019) A preference-based model of care: an integrative theoretical model of the role of preferences in person-centred care.  The Gerontologist, gn075. The Preference-Based Model of Care illustrates how goal-directed behaviours facilitate need fulfillment through the expression of individual preferences and how these behaviours mediate the relationship between person-environment fit and affect balance within a particular social, cultural and political context.  The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.

Vasque, D., Deland, L., Spears, K., et al (2019) Time is precious: person-centred end of life care in an emergency department.  A quality improvement project. Emergency Nurse.  The Time is Precious (TiP) palliative care deicision - framework for use in emergency departments (EDs) is an innovative approac to inter- professional  teamwork to support patients and their families at end of life.