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Charles Bardes 'Defining Patient-Centered Medicine'

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The article “Defining ‘Patient-Centered Medicine’” by Charles Bardes in The New England Journal of Medicine explains the differences between the normal care and patient-centered medicine. To understand what patient-centered medicine is, you must know one of the main differences is that “…it seeks to focus medical attention on the individual patient’s needs and concerns, rather than the doctor’s” (782) which as a patient, is a high priority. The patient-centered medicine you are given will be personalized specifically for you and will work around your way of life. In the article, another author explains patient-centered medicine in more depth by saying that it will “ 'take into account the patient, the social context in which he lives, and the
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These are respect regarding the patient's values, preferences, and needs; information and education, access to care, emotional support, involvement of family and/or friends, continuity and secure transition between health care settings, physical comfort, and coordination of care. They all work together to transform healthcare into a model that is patient centered. Value-based approach impact on health

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Responsibilities. Some people run away from it while others miss the chance to take them. Such as in the book, Of Mice and Men. There is a part in the book where an old Swamper, Candy, has given in to killing his old dog, because his friend Carlson explains how the dog is so old that he hurts whenever he gets up and how he’s basically suffering. Although Carlson kills the dog for him, Candy later feels bad about not killing the dog himself.

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Patient centered care efforts will improve health care and will assist with eliminating disparities. Patient centered care will promote patient

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This supports personalisation as it means that an individual has the right to choose which care provider they would like to receive care from. If a care provider doesn’t take into account what an individual wants, personalisation allows for an individual to easily move between care providers without having to go through their social worker. Person-centred approaches and thinking encourages individuals to have choice and control over their needs and wishes. This also allows for an individual’s rights to be respected and means that the individual will only receive care and support based around their needs which will encourage individuals to continue to do what they can and not feel loss of control because carers have taken over control. 3.2 – Personalisation affects the balance of power between individuals and those providing support as the individual has chosen the care provider to provide care for themselves and if the care provider is not making the individual happy or providing the wrong care, then the individual has the power to get rid of the care provider and find another care provider.

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It will also take a look at some of the alternative methods of nursing to contrast with the patient centred approach. Included is also a description of Mc Cormack and Mc Cance (2010) Person Centred Practice Framework. This will lead into the second part of the essay, as it will demonstrate how nurses can employ a person centred approach in the clinical setting to promote and recognise older people as equal partners in their care. Firstly for the purpose of this essay, patient centred care and person-centeredness will be defined using a definition supplied by the HSE (2010).

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The world is a diverse population, with people coming from various ethnic and cultural backgrounds. A person’s views, values, and traditions determine their daily needs and practices. So, healthcare providers face certain challenges and restrictions because a patient’s belief may inhibit professionals from providing the most effective care. Therefore, cultural competence is an important idea for healthcare providers to consider when understanding and respecting patients. Balcazar, Suarez-Balcazar, and Taylor-Ritzler (2009) noted in “Cultural competence:

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As its evident that person centeredness is valued by the person, encouraging it in practise is important. The aim of the framework of McCormack’s model of person centred care is to raise awareness of the importance of respect for the individual. It does this well by empowering healthcare workers to recognise key components in their practise. It has also been used as a systematic framework to initiate significance from practise- derived data that can advise the expansion of person centred practise. McCormack’s model can be used as a tool to aid practitioners to recognise obstacles that can demote the developments of person centred care in their

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Tom Kitwood (1997) cited in (The Open University, 2017) supports the approach of seeing and treating people as individuals, he calls this ‘person-centred care’. This approach looks at the physical, social and psychological needs of the individual. Person-centred care encourages people to have more involvement in making decisions about their care so they get the support and service they need. There are three main types of long-term care settings such as residential care homes which offer different degrees of personal care, Nursing homes offer care which requires the skills of qualified nursing staff and long-stay hospitals which offer a more specialised medical care. (The Open University, 2017).

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Patient centered care focuses on getting to know the older person as an individual such as their values, Aspirations, health, social needs, preferences and providing care specific to their needs. It enables the older person to make decisions on what kind of options with assistance available, promoting his/her Autonomy and independence. It involves them in such way to be included in shared decisions between healthcare teams and families, so the can be control with a choice of specific care / services. It provides information that is tailored for the individual in order to assist them in decision making based on evidence, helping them to understand their options and consequences of this. Supporting a person on his/her choice and letting them pursue their stated wishes, As a patient centered approach so they are involved as equal partners in their care ( Manley et al,

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(Kitson et al, 2013) Patient care is initial assessment collaborated with commitment for the nurse to care for the patient and build a trusting comfort relationship to meet patients’ fundamental needs (Kitson et al, 2014). Patient-centred care focuses on involving patients’ by allowing choice and decision-making. It takes into consideration patients’ individual physical, psychosocial, cultural and emotional needs (Feo and Kitson,

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In a clinical environment, person centred care is an essential approach in order to achieve the best outcomes for the patients individual needs. Person centred care involves taking a holistic approach to healthcare in which multiple factors such as age, beliefs, spirituality, values and preferences are taken into consideration when assessing, treating and caring for a patient (Epstein & Street 2011). It enables the patient to have a more interactive and collaborative approach in their healthcare, share responsibility and maintain their dignity and values. It involves a bio-psychosocial perspective to healthcare as opposed to a biomedical attitude. In order to provide patient centred care, the clinician needs to consider the individual’s needs

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This model is interesting because it is one of the most commonly used models and was created within the clinical setting. The Chronic Care Model (CCM) is primarily patient-focused and was created to improve the care of patients with chronic medical conditions by allowing the patient to have

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Person-Centred Care aims to ensure that the older adult is an equal partner in their health care. Key components that ensure PCC is provided are the following: respect and holism power and empowerment choice and autonomy empathy and compassion. (Rcn.org.uk, 2015) A person-centred approach to nursing focuses on the individuals needs, wants, goals and desires so that they become central to the care and nursing process (OpenLearn, 2015). According to The Department of Health (State of Victoria, Australia), person-centred care is a philosophical approach to care, ensuring that service systems are developed in partnership with older people and/or their carers (Health.vic.gov.au, 2015).

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At the core of both patient centeredness and cultural competence, however, is the importance of seeing the patient as a unique person (Beach et al., 2006). The instance a nurse meets patients; three cultures meet as well, the nurse’s culture, the patient’s culture and the setting’s. Nurses need to apply their understanding of cultural diversity to foster culturally sensitive nursing care. This facilitates nurses to be more efficient in managing nursing assessments and being a patient’s

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3.3% of patients have a written care plan of whom 71% had helped to put it together. 67% reported they utilise their care plan day to day to manage their own health Unfortunately it is not evident from the findings what percentage of patients who had contributed to their care plan use it day to day compared to those that had not contributed. These findings which have been relatively consistent in recent years suggest the existence of other barriers to person centred care. One of these barriers may be the challenge of changing existing mindsets of clinicians to move from the biomedical models of care to a biopsychosocial model, from expert to partner.

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