Are we ready for a person-centered care model for patient-physician consultation? A survey from family physicians of East Mediterranean Region
Abstract
Background: Person-centered care has long been identified as a key component of health systems and one of the six domains of quality. This study aimed to identify the perceptions of patients and physicians regarding person-centered care in the Eastern Mediterranean Region (EMR).
Methods: A multicountry, cross-sectional study was conducted in 6 countries of EMR during July 2012 to September 2012. From each country, an expert Family Physician (FP) was identified and invited for the study. During the first phase, 190 FPs practicing for at least 6 months were recruited. In the second phase, the recruited FPs approached 300 patients aged > 18 years with 1 or more recurring problems. Data analysis was conducted using SPSS version 19.
Results: Of a total of 360 patients, 53% were between 25-40 years of age and the majority 55.7% were females. Among physicians, 66.8% were females and 72.1% had undergone specialization in Family Medicine from EMR. About 36% of the patients, while 62.6% of the physicians, preferred a person-centered care model of care. Among physicians, field of specialization (AOR= 0.7; 95% C.I: 0.3-0.9) and regularity in continuing medical education sessions (AOR= 0.3; 95% C.I: 0.1-0.5) were significant factors for preferring a person-centered care model. Educational status (AOR= 3.0; 95% C.I: 1.1-7.9) was associated with a preference for person-centered care among patients.
Conclusion: The results of the study highlight that a majority of physicians prefer person-centered care, while patients prefer a mix of both patient- and physician-centered care. Strategies should be developed that will help physicians and patients to embrace person-centered care practices.Keywords
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Institute of Medicine. Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington: National Academies Press.
Miles, A. & Mezzich, J.E. (2011). The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice. International Journal of Person Centered Medicine 1 (2) 207-222.
World Health Organization. (1978). Alma Ata Declaration. Geneva: World Health Organization.
Mezzich, J.E. (2011). The Geneva Conferences and the emergence of the International Network for Person-centered Medicine. Journal of Evaluation in Clinical Practice 17 (2) 333-336.
Mezzich, J.E., Snaedal, J., van Weel, C. & Heath, I. (2010). Conceptual Explorations on Person-centered Medicine 2010: Introduction to conceptual explorations on person-centered medicine. International Journal of Integrated Care 10 e002.
Berwick, D.M. (2003). Escape fire: designs for the future of health care. San Francisco: Jossey-Bass.
Davis, K., Schoenbaum, S.C. & Audet, A.M. (2005). A 2020 Vision of Patient Centered Primary Care. Journal of General Internal Medicine 20 (10) 953-957.
Meterko, M., Wright, S. Lin, H., Lowy, E. & Cleary, P.D. (2010). Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine. Health Services Research 45 (5 part 1) 1188-1204.
Rao, J.K., Anderson, L.A., Inui, T.S. & Frankel, R.M. (2007). Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Medical Care 45 (4) 340-349.
Griffin, S.J., Kinmonth, A.L., Veltman, M.W., Gillard, S., Grant, J. & Stewart, M. (2004). Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Annals of Family Medicine 2 (6) 595-608.
Stewart, M., Brown, J.B., Donner, A., McWhinney, I.R., Oates, J., Weston, W.W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice 49 (9) 796-804.
Al-Daghri, N.M., Al-Attas, O.S., Alokail, M.S., Alkharfy, K.M., Yousef, M., Sabico, S.L. & Chrousos, G.P. (2011). Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC Medicine 9 (1) 76.
Qidwai, W., Beasley, J.W. & Gomez-Clavelina, F.J. (2008). The present status and future role of family doctors: a perspective from the International Federation of Primary Care Research Networks. Primary Health Care Research & Development 9 (3) 172-182.
Mezzich, J.E., Snaedal, J., et al. (2009). The International Network for Person-centered Medicine: Background and First Steps. World Medical Journal 55, 104-107.
Siriwardena, A.N., Edwards, A.G.K., Campion, P., Freeman, A. & Elwyn, G. (2006). Involve the patient and pass the MRCGP: investigating shared decision making in a consulting skills examination using a validated instrument. British Journal of General Practice 56 (532) 857-862.
Campion, P., Foulkes, J., Neighbour, R. & Tate, P. (2002). Patient centredness in the MRCGP video examination: analysis of large cohort. British Medical Journal 325 (7366) 691-692.
Hutchinson, L., Aitken, P. & Hayes, T. (2002). Are medical postgraduate certification processes valid? A systematic review of the published evidence. Medical Education 36 (1) 73-91.
Qidwai, W., Ashfaq, T., Khoja, T.A.M. & Rawaf, S. (2012). Access to Person-Centered Care: A Perspective on Status, Barriers, Opportunities and Challenges from the Eastern Mediterranean Region. South Asia Journal of Family Medicine 4 (6) 4-13.
Starfield, B. (2011). Is patient-centered care the same as person-focused care? The Permanente Journal 15 (2): 63-69.
O'Connor, L.A., Morgenstern, J., Gibson, F. & Nakashian, M. (2005). Nothing about me without me: Leading the way to collaborative relationships with families. Child Welfare 84 (2) 153-170.
Cloninger, C.R. &. Cloninger, K.M. (2011). Person-centered therapeutics. International Journal of Person Centered Medicine 1 (1) 43-52.
Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C., Ferrier, K. & Payne, S. (2001). Preferences of patients for patient centred approach to consultation in primary care: observational study. British Medical Journal 322 (7284) 468-472.
Mezzich, J.E. (2011). Building person-centered medicine through dialogue and partnerships: perspective from the international network for person-centered medicine. International Journal of Person Centered Medicine 1 (1) 10-13.
Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., Carlsson, J., Dahlin-Ivanoff, S., Johansson, I.L., Kjellgren, K., Lidén, E., Öhlén, J., Olsson, L.E., Rosén, H., Rydmark, M. & Sunnerhagen, K.S. (2011). Person-centered care - ready for prime time. European Journal of Cardiovascular Nursing 10 (4) 248-251.
Miles, A. (2012). Person-centered medicine-at the intersection of science, ethics and humanism. International Journal of Person Centered Medicine 2 (3) 329-333.
Ali, N.S., Khuwaja, A.K., Kausar, S. & Nanji, K. (2012). Patients' evaluations of family practice care and attributes of a good family physician. Quality in Primary Care 20 (5) 375-383.
Greene, S.M., Tuzzio, L. & Cherkin, D. (2012). A framework for making patient-centered care front and center. The Permanente Journal 16 (3) 49-53.
Koren, M.J. (2010). Person-centered care for nursing home residents: The culture-change movement. Health Affairs 29 (2) 312-317.
Boise, L. & White, D. (2004). The family's role in person-centered care: practice considerations. Journal of Psychosocial Nursing and Mental Health Services 42 (5) 12-20.
Frankl, V.E. (2005). Person-Centered Care. In: Treatment Planning for Person-centered Care: The Road to Mental Health and Addiction Recovery: Mapping the Journey for Individuals, Families and Providers p. 17, Adams, N. & Grieder, D.M., (eds.). London: Elsevier.
Edvardsson, D., Fetherstonhaugh, D., Nay, R. & Gibson, S. (2010). Development and initial testing of the Person-centered Care Assessment Tool (P-CAT). International Psychogeriatrics 22 (1) 101-108.
Mezzich, J.E., Snaedal, J., et al. (2009). The Second Geneva Conference on Person-centered Medicine. World Medical Journal 55, 100-101.
Schall, M., Sevin, C. Wasson, J.H. (2009). Making high-quality, patient-centered care a reality. Journal of Ambulatory Care Management 32 (1) 3-7.
DOI: http://dx.doi.org/10.5750/ejpch.v1i2.679
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