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The realities of partnership in person-centred care: A qualitative interview study with patients and professionals

Artikel i vetenskaplig tidskrift
Författare Axel Wolf
Lucy Moore
Doris Lydahl
Öncel Naldemirci
Mark Elam
Nicky Britten
Publicerad i BMJ Open
Volym 7
Nummer/häfte 7
Publiceringsår 2017
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för sociologi och arbetsvetenskap
Institutionen för vårdvetenskap och hälsa
Språk en
Länkar dx.doi.org/10.1136/bmjopen-2017-016...
Ämnesord Healthcare service, Patient Participation, Patient-Centred Care, Person-Centred Care, Qualitative
Ämneskategorier Sociologi, Sociologi (exklusive socialt arbete, socialpsykologi och socialantropologi), Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi, Hälsovetenskaper

Sammanfattning

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Objective Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients' sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice. Design Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients. Setting Four internal medicine wards and two primary care centres in western Sweden. Participants 16 health professionals based at hospital wards or primary care centres delivering person-centred care, and 20 patients admitted to one of the hospital wards. Results Our findings identified both informal and formal aspects of partnership. Informal aspects, emerging during the interaction between healthcare professionals and patients, without any prior guidelines or regulations, incorporated proximity and receptiveness of professionals and building a close connection and confidence. This epitomised a caring, respectful relationship congruent across accounts. Formal aspects, including structured ways of sustaining partnership were experienced differently. Professionals described collaborating with patients to encourage participation, capture personal goals, plan and document care. However, although patients felt listened to and informed, they were content to ask questions and felt less involved in care planning, documentation or exploring lifeworld goals. They commonly perceived participation as informed discussion and agreement, deferring to professional knowledge and expertise in the presence of an empathetic and trusting relationship. Conclusions In our study, patients appear to value a process of human connectedness above and beyond formalised aspects of documenting agreed goals and care planning. PCC increases patients' confidence in professionals who are competent and able to make them feel safe and secure. Informal elements of partnership provide the conditions for communication and cooperation on which formal relations of partnership can be constructed.

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