Applied Concepts of Health and Wellbeing
“Healthcare reform is being driven by the rhetoric around patient-centered care yet no common definition exists” (Kitson et al. 2013, P.4)
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This text discusses the statement, “Healthcare reform is driven by the rhetoric around patient-centred care yet no common definition exists” (Kitson et al. 2013, p.4). It is well documented that patient-centred care (PCC) is quickly becoming a more ubiquitous concept, across governments and international organisations (Fix et al. 2017). However, it is also recognised that barriers are preventing PCC from becoming a culturally congruent ideology, in both theory and clinical practice (Office of Patient-Centred Care and Cultural Transformation, 2016). This text, broadly considers some of the fundamental issues, preventing physiotherapists from using a patient-centred approach. As well as, considering the rationale behind the overwhelming support for PCC. An overarching issue identified in much of the literature, is the absence of a universal definition for PCC. There is confusion between patients, practitioners, and policy-makers, surrounding the constructs that govern PCC (Grenness et al. 2014). Subsequently, complicating the task of healthcare reform. Professional attitudes, are identified as another central challenge to the implementation of PCC. The challenge, stems from an unwillingness to deviate from a biomechanistic approach. The biopsychosocial model is offered as a more complete foundation to base clinical practice. Despite existing challenges, this text argues patient-centred models are needed, to support the growing number of patients with multifaceted conditions and complex psychosocial problems (DiMatteo et al. 2007). The inclusive nature of a patient-centred approach, is associated with superior health-related outcomes and quality improvement (Grenness et al. 2014). Adhering to the holistic needs of patients, is also identified as good ethical practices as part of a broader analysis on ethical viewpoints within physiotherapy. To underpin theory and clinical practice, this text undertakes a reflection from a practice placement to discuss the value of PCC, when treating chronic respiratory conditions. In summary, there are clear advantages to using a patient-centred approach, but challenges are limiting its capacity to negotiate true healthcare reform.
Definitions for PCC stem from the field of humanistic psychology (Rogers, 1965). Conceptually, these definitions focused on patients becoming active participants of their healthcare, through the development of power-balanced clinical relationships (Grenness et al. 2014). More recently, providers, policy-makers, and researchers, loosely agree the term PCC represents a shift in the values that dictate healthcare approach; transcending from traditional, disease-focused, problem-solving methods, towards patient-centred approaches, that place more...