International Journal of Person Centered Medicine

Towards Coproduction in Person Centered Medicine and Health

Inés Bustamante — Sat, 10 Feb 2024 00:00:00 +0000

Participatory Research for Person-Centered Care: Involving Undocumented and Recent Migrants

Carol Rivas — Sat, 10 Feb 2024 00:00:00 +0000

Background: Participatory research is increasingly used to inform person-centered care bottom-up. Nonetheless, researchers often declare it too challenging to include the most underserved groups, a misconception the CICADA study sought to address.

Objectives: The objectives of this study were to examine a combination of several participatory approaches and research methods that were used to explore COVID-19 pandemic experiences of health and social care among disabled people from minoritized ethnic groups.

Methods: An intersectional mixed-methods study included secondary data analyses, a three-wave survey and semi-structured qualitative interviews with follow-up workshops. Inclusive assets-based participatory methods were deployed. These incorporated focal community members as co-researchers and participants as co-designers of pragmatic outputs.

Results: This approach enabled rich data collection from groups often excluded from health research, such as disabled recent and undocumented migrants. Data exemplify the extent, diversity and intersecting nature of various determinants of health and inequities and also successful coping strategies. The community of focus was chosen bottom-up with stakeholders, across the UK, with emphasis on locally relevant contexts and local capacity building, with local embedding of co-researchers. Focusing on community and individual strengths, assets and contexts has transformative potential. Shared power with and engagement of underserved groups was ensured throughout.

Conclusions: Participatory research methods can effectively inform person-centered care, especially for underserved groups. Different participatory procedures are designed for different ends and should be used strategically. A carefully considered approach with community members as co-researchers and partner collaborators is practical, effective and efficient. Co-creation and co-design enhance mutual understandings, with outputs likely to be
used in practice for and by underserved groups.

Planning in the Consultation and Clinical Notes Using a Person-Centered Structure

Werdie van Staden — Sat, 10 Feb 2024 00:00:00 +0000

Background: The concluding part of a clinical consultation and its recording in clinical notes typically comprises the ‘plan’ or ‘further management’, which guides further actions regarding tests and investigations, treatments, counselling, referrals and follow-up.

Objective: The objective of this article is to consider how this part of the consultation and clinical notes may be structured in an explicitly person-centered way, more so than merely in a patient-centered way.

Methods: The tenets of Person centered Medicine are applied to the standard objectives of the planning section of the clinical consultation. Using an informal case study, this application is contrasted with applying too narrow an understanding of Person centered Medicine as if the same as patient-centered medicine.

Results: The planning section is conventionally structured in biopsychosocial domains, but it is typically formulated as the clinician’s plan and is rather unilateral in presenting the clinician’s perspective. Although at times implicitly incorporating the patient’s contributions, the patient’s voice does not routinely feature explicitly in the plan or the patient is merely required to understand, commit and adhere to the plan. In contrast, the planning section may be structured explicitly in a person-centered way and reflect co-production and shared decision-making. This may be achieved by deliberately adding the headings ‘co-produced’ and ‘co-decided’ and by requiring that the entire plan be informed by not only medical/health expertise but crucially by that which matters to the patient in that individual’s context (including concerns, expectations, values, preferences, aspirations and strengths).

Conclusion: Clinicians and medical educators should optimize ‘the plan’ section of the consultation and the clinical notes by which to foster a routine that is more person-centered and that lives up to the requirements of shared decision-making and co-production.

British Models of Person Centered Medicine

Mohammed T Abou-Saleh — Sat, 10 Feb 2024 00:00:00 +0000

Background: The National Health Service (NHS) was established in 1948 as a publicly funded healthcare system in the UK providing universal health coverage that is comprehensive, equitable and free at the point of delivery. The British experience of person centered medicine (PCM) is enshrined in the NHS constitution.

Objectives: The objective of this study was to highlight important developments in and evolution of PCM within the NHS in person-centered care (PCC), research and innovations in undergraduate and graduate health education.

Methods: This is a narrative overview of the British experience of PCM.

Results: It is evident that the British experience and practice of PCM have evolved naturistically over seven decades since the establishment of the NHS. Academic research groups in collaboration with the NHS have introduced person-centered models of care supported by pivotal research in practice. Importantly, person-centered nursing has been widely adopted following the early development of a framework for person-centered nursing and its extensive evaluation. There emerged many initiatives on PCM by National Voices, the Health Foundation, British medical schools and the Royal Medical Colleges. The landmark development was the production by the Royal College of Psychiatrists in the UK of the first blueprint for a postgraduate psychiatric curriculum that is in tune with person-centered psychiatry.

Conclusions: It is envisaged that the NHS will evolve and increasingly promote, adopt, codesign and implement PCC approaches adapted to the local, regional and national contexts including services redesign, health education and applied health research. These innovations contribute to the universal development of person-centered healthcare and health education.

Innovative Curriculum Model for Person Centered Medical Education

Juan Perez-Miranda, Fernando Caballero Martinez — Sat, 10 Feb 2024 00:00:00 +0000

The academic medical education model of Francisco de Vitoria University (UFV) was presented at the Jim Appleyard Memorial 14th Geneva Conference on person cenetred medicine in April 2022. The objective of creating a new medical education model aimed at training person-centered physicians and how it was articulated in the curriculum is the main purpose of this short manuscript. The main characteristics and foundational ideas inspiring this model are presented.

Lima Declaration 2022: Mutual and Integral Care for Persons Centered Total Health

Juan Mezzich — Sat, 10 Feb 2024 00:00:00 +0000