Keeping the person in focus - instead of the disease
Right now, there is a large focus on something called person-centered care, amongst health care. There are indications that this may, for example, lead to better control in RA, but what does this mean in practice?
In healthcare, there is a change in the direction of person-centered care. An example of this change is that many are starting to use the word person instead of patient. The reason is that the word patient to a greater extent emphasizes the disease, the sick body, or the connection to a care institution, while the word person highlights the individual with their unique resources and experiences.
As an example, during a care visit where person-centered care is used, a person with RA could experience that the care is established to create an equal relationship between patient and nurse in one scenario. The nurse listens responsively to the patients and lets their stories form the basis for the care. It can lead to both participation and independence for patients. (1)
There is also ongoing research about person-centered care. In a Swedish study where 70 people with RA participated, there was a tendency for those who received person-centered care to have a lower disease activity with less swollen joints, compared with people who received traditional care. (2)
There is no established definition of the term person-centered care. This is mainly because it is still a new area that is constantly evolving. However, some starting points are common to person-centered care:
Care is based on the unique person and their right to health
Care demands the person's abilities and is activating
Care is cohesive
Care always meets every human being with dignity, compassion and respect and is based on a basic ethical approach (3)
Person-centered care simply means focusing on the whole person and not just on the disease. When healthcare is introducing person-centered care, fundamental changes are required both in how the work is organized and around the traditional roles. New relationship patterns are required between patients, healthcare professionals, managers and healthcare teams. It also requires new ways of looking at healthcare management. (3)
Focus on the individual's own experiences
A prerequisite for a person to have a real influence on their care is their own story, i.e. the person's own experiences of their everyday life and situation. A person-centred care also means that the health care staff puts the person in need of care at the center before illness, symptoms, or signs of illness and that the person is seen as a decision-making, valuable and equal partner in planning, execution and follow-up of care and welfare. (4)
If the care is not person-centered there is a risk that the healthcare staff will let their professional knowledge and experience take over. The patient's capacity and ability to prioritize and make relevant decisions based on their situation, their conditions, goals and wishes will then not be given space to influence and set up objectives for their care. There may then be a risk that the patient will be reduced to a disease, symptom, or organ that does not function properly.
Why person-centered care?
The reason why care should become even more person-centered is based on the discussions that take place both internationally and in Sweden. It is based, amongst other things, on surveys in the USA with the purpose to find causes of recurring problems that may have involved risks or injuries to patients. The studies show that several core competencies are necessary for good and safe care and that these are competencies that all healthcare professionals must-have. Person-centered care is one of these competencies. Others are: evidence-based care, collaboration in teams, improved knowledge for quality development, safe care and informatics. (4)
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References and read more:
Bergsten, U., Almehed, K,. Baigi, A., T.H Jacobsson, L. A randomized study comparing regular care with a nurse‐led clinic based on tight disease activity control and person‐centred care in patients with rheumatoid arthritis with moderate/high disease activity: A 6‐month evaluation. Centrum for Person‐Centered Care; University of Gothenburg