Basics of person-centred care

JANNE TULLIUS: In this video, we will explore one more approach to help reduce barriers for patients living with limited health literacy, the person-centred care approach. What is person-centred care? There are different definitions for this term, but all agree on some parts. Person-centred care is, as the name suggests, providing care while always having the needs of the patient in mind first. To achieve this, the health providers should listen to, inform, and involve patients in their care. The Health Foundation, a United Kingdom-based organisation, proposes a four-principle framework, rather than a fixed definition for person-centred care.

These principles are affording people dignity, compassion, and respect, offering coordinated care, support, or treatment, offering personalised care, support, or treatment, and supporting people to recognise and develop their own strengths and abilities to enable them to live an independent and fulfilling life. With this framework, no matter the specific care intervention that person receives, it should always follow these principles. The last principle of enabling the patient is somewhat different from the other three. If you think about it, the healthcare providers could follow the first three principles with little to no input from the patient.

They would be able to work in favour of the population they work for and make sure they are treated with respect and dignity while also receiving better coordinated and personalised services, treatment, and support. Think, for example, of a patient with a terminal condition. The healthcare provider could prescribe the best medications and procedures available for the patient and start all the referrals with every specialist specific to its needs and care, because it is in the patient’s best interest. But the patient doesn’t take the medications and is missing appointments with the specialists. Eventually, the patient has to visit the emergency department in a critical condition. Why? Well, this is where the last principle comes into play.

For care to be enabling, it demands a change in the structure of the person-provider relationship, where it usually is the provider set as the expert and the person only has to follow the instructions. It needs to become a partnership, where both person and provider should work hand-in-hand. Two, understand what is important to the person, make decisions about their care and treatment, and to identify and achieve their goals. This way, healthcare providers have a role in supporting patients to gain knowledge, abilities, and confidence they need to fully take part in this new partnership.

This change can also improve the other principles by respecting the patient’s decisions, making a truly personalised care tailored to its goals, understanding what is important to the patient, and allowing for an efficient coordination among the healthcare professionals needed to support the patient’s needs. So back to our terminal patient example, if a healthcare provider makes care enabling, it could be known that this particular patient wants no more invasive treatments or medications that have unpleasant side effects and that the patient just wants to live free of pain, in the company of loved ones, without having to spend lots of time in hospital.

All of these would allow the patient to decide on its own treatment according to his own needs and goals, making that the best possible care the patient can get. And although this seems as an extreme example, the same principles can be used with every patient, regardless of the condition.