Development of the concept of patient-centredness – A systematic review

TY - JOUR

T1 - Development of the concept of patient-centredness – A systematic review

AU - Langberg, Emil Mørup

AU - Dyhr, Lise

AU - Davidsen, Annette Sofie

PY - 2019/7

Y1 - 2019/7

N2 - Objective: Patient-centredness is often linked to high-quality patient care, but the concept is not well-defined. This study aims to provide an overview of how patient-centredness has been defined in the literature since Mead and Bower's review in 2000, and to provide an updated definition of the concept. Method & design: We performed a systematic literature search in PubMed to identify original articles with a sufficient definition of patient-centredness. We analysed extracted data defining patient-centredness. Results: Eighty articles were included. The dimensions “biopsychosocial” “patient-as-person” “sharing power and responsibility” and “therapeutic alliance” corresponded to four of five dimensions described by Mead and Bower. “Coordinated care” was a new dimension. Conclusion: The identified dimensions are encompassed by three elements: the patient, the doctor-patient relationship and the framework of care i.e. the health care system. The additional focus on coordinated care could reflect increasing complexity of the health care system. Practice implications: Narrowing down the understanding of patient-centredness to these three focus areas, viz. 1) understanding of the patients’ experience of the illness in their life situation, 2) the professional's relationship with the patient, and 3) coordination of care in the system, could make the operationalisation and implementation of a patient-centred approach more manageable.

AB - Objective: Patient-centredness is often linked to high-quality patient care, but the concept is not well-defined. This study aims to provide an overview of how patient-centredness has been defined in the literature since Mead and Bower's review in 2000, and to provide an updated definition of the concept. Method & design: We performed a systematic literature search in PubMed to identify original articles with a sufficient definition of patient-centredness. We analysed extracted data defining patient-centredness. Results: Eighty articles were included. The dimensions “biopsychosocial” “patient-as-person” “sharing power and responsibility” and “therapeutic alliance” corresponded to four of five dimensions described by Mead and Bower. “Coordinated care” was a new dimension. Conclusion: The identified dimensions are encompassed by three elements: the patient, the doctor-patient relationship and the framework of care i.e. the health care system. The additional focus on coordinated care could reflect increasing complexity of the health care system. Practice implications: Narrowing down the understanding of patient-centredness to these three focus areas, viz. 1) understanding of the patients’ experience of the illness in their life situation, 2) the professional's relationship with the patient, and 3) coordination of care in the system, could make the operationalisation and implementation of a patient-centred approach more manageable.

KW - Biopsychosocial

KW - Coordinated care

KW - Patient-centredness

KW - Shared decision-making

KW - Systematic review

KW - Therapeutic alliance

U2 - 10.1016/j.pec.2019.02.023

DO - 10.1016/j.pec.2019.02.023

M3 - Review

C2 - 30846206

AN - SCOPUS:85062270981

SN - 0738-3991

VL - 102

SP - 1228

EP - 1236

JO - Patient Education and Counseling

JF - Patient Education and Counseling

IS - 7

ER -