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      Elaboration of the Gothenburg model of person‐centred care

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          Abstract

          Background

          Person‐centred care ( PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person‐Centred Care ( GPCC) was set up in 2010 to develop and implement person‐centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals.

          Objective

          In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings.

          Methods

          We conducted a qualitative study and interviewed 18 clinician‐researchers from five health‐care professions who were working in seven diverse GPCC projects.

          Results

          Interviewees’ accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.

          Conclusion

          This study illustrates what is needed for health‐care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice.

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          Most cited references25

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          Patient-centredness: a conceptual framework and review of the empirical literature.

          A 'patient-centred' approach is increasingly regarded as crucial for the delivery of high quality care by doctors. However, there is considerable ambiguity concerning the exact meaning of the term and the optimum method of measuring the process and outcomes of patient-centred care. This paper reviews the conceptual and empirical literature in order to develop a model of the various aspects of the doctor-patient relationship encompassed by the concept of 'patient-centredness' and to assess the advantages and disadvantages of alternative methods of measurement. Five conceptual dimensions are identified: biopsychosocial perspective; 'patient-as-person'; sharing power and responsibility; therapeutic alliance; and 'doctor-as-person'. Two main approaches to measurement are evaluated: self-report instruments and external observation methods. A number of recommendations concerning the measurement of patient-centredness are made.
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            Exploring person-centredness: a qualitative meta-synthesis of four studies.

            Person-centredness as a concept is becoming more prominent and increasingly central within some research literature, approaches to practice and as a guiding principle within some health and social care policy. Despite the increasing body of literature into person-centred nursing (PCN), there continues to be a 'siloed' approach to its study, with few studies integrating perspectives from across nursing specialties. The purpose of this paper is to present the results of a study undertaken to explore if the secondary analysis of findings from four different and unrelated research studies (that did not have the main aim of researching person-centredness) could inform our understanding of person-centred nursing. A qualitative meta-synthesis was undertaken of the data derived from the four unrelated research studies undertaken with different client groups with long-term health conditions. A hermeneutic and interpretative approach was used to guide the analysis of data and framed within a particular person-centred nursing framework. Findings suggest 'professional competence' (where competence is understood more broadly than technical competence) and knowing 'self' are important prerequisites for person-centred nursing. Characteristics of the care environment were also found to be critical. Despite the existence of expressed person-centred values, care processes largely remained routinised, ritualistic and affording few opportunities for the formation of meaningful relationships. Person-centred nursing needs to be understood in a broader context than the immediate nurse-patient/family relationship. The person-centred nursing framework has utility in helping to understand the dynamics of the components of person-centredness and overcoming the siloed nature of many current perspectives. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.
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              • Article: not found

              Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial.

              To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome.
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                Author and article information

                Contributors
                Role: Professor of Applied Health Care Researchn.britten@exeter.ac.uk
                Role: Research Fellow
                Role: PhD student
                Role: Research Fellow
                Role: Professor of Sociology
                Role: University Lecturer
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                18 May 2016
                June 2017
                : 20
                : 3 ( doiID: 10.1111/hex.2017.20.issue-3 )
                : 407-418
                Affiliations
                [ 1 ] Institute of Health ResearchUniversity of Exeter Medical School Exeter
                [ 2 ] Department Sociology and Work ScienceUniversity of Gothenburg Gothenburg
                [ 3 ] Institute of Health and Care Sciences, Sahlgrenska Academy and Centre for Person‐Centred Care University of Gothenburg Gothenburg
                Author notes
                [*] [* ] Correspondence

                Nicky Britten PhD

                University of Exeter Medical School

                South Cloisters

                St Luke's Campus

                Heavitree Road

                Exeter EX1 2LU

                UK

                E‐mail: n.britten@ 123456exeter.ac.uk

                Article
                HEX12468
                10.1111/hex.12468
                5433540
                27193725
                1412a5d7-1ecf-423e-974f-b614cef2e1ca
                © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 April 2016
                Page count
                Figures: 1, Tables: 1, Pages: 12, Words: 6667
                Funding
                Funded by: University of Gothenburg Centre for Person‐Centred Care and the LETStudio at the University of Gothenburg
                Funded by: National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon
                Funded by: Exeter NHS Foundation Trust
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12468
                June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.9 mode:remove_FC converted:16.05.2017

                Health & Social care
                documentation,narrative,partnership,person‐centred care,personhood,qualitative
                Health & Social care
                documentation, narrative, partnership, person‐centred care, personhood, qualitative

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