Understanding and support as a component of person-centered medicine – an evidence-based view

Main Article Content

Janet Wallcraft

Abstract

Despite the fact that the principles of person-centered care are increasingly articulated within health policies and guidance, patients and service users do not routinely experience the quality of care associated with interventions of this type. In a study of 26,555 mental health users, less than half of patients reported that they were sufficiently involved in decisions about their care and treatment. In efforts to improve the patient experience, a range of key factors need urgently to be considered. Among these, the clinician-patient interaction, the establishment of a good inter-personal relationship, the exchange of information and a full involvement of the patient with the clinician in decision-making are vital. As part of these efforts, clinicians need to rediscover the value of positive interaction and empathy within the consultation as well as comprehend what exactly prevents understanding and the giving of proper levels of support to patients and the difference that these make when skillfully employed as part of routine practice. Here, the factors of patient/service user satisfaction, adherence to treatment, power sharing and negotiation of treatment plans and an evaluation and attempt to improve physical and emotional health outcomes are all of key relevance. The present paper discusses all of these factors in depth and concludes with reflections on what is required to achieve them within modern health services.

Article Details

Section
Clinical and Electronic Communication
Author Biography

Janet Wallcraft, Centre for Mental Health Recovery, University of Hertfordshire; and Centre for Excellence in Interdisciplinary Mental Health, University of Birmingham

Janet Wallcraft has a BSc Hons (1st Class) in Science Technology & Society (1987)  and a Postgrad Diploma Social Sciences Research (1989) from Middlesex University, London, and PhD from South Bank University, London (2002) on mental health service users first experiences of breakdown and treatment. She is a Visiting Fellow at the Centre for Mental Health Recovery, University of Hertfordshire, and an Honorary Fellow at the Centre for Excellence in Interdisciplinary Mental Health, University of Birmingham. She has been a long-term consultant and researcher on the experiences of people who use or receive mental health services, working for leading NGOs and Government organisations in England and Wales. 

References

Ong, L. M. L., De Haes, J. C. J. M., Hoos, A. M. & Lammes, F. B. (1995). Doctor-patient communication: a review of the literature. Social Science & Medicine 40, 903-918.

Department of Health. (2010). Equity and Excellence - Liberating the NHS. In: Health. London: The Stationery Office.

Healthcare Commission. (2005). Mental Health Survey 2005. Healthcare Commission.

Beck, R. S., Daughtridge, R. & Sloane, P. D. (2002). Physician-patient communication in the primary care office: a systematic review. The Journal of the American Board of Family Medicine 15 (1) 25-38.

Clarke, A., Hanson, E.J. & Ross, H. (2003). Seeing the person behind the patient: enhancing the care of older people using a biographical approach. Journal of Clinical Nursing 12, 697-706.

Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: a review. Canadian Medical Association Journal, 152, 1423-1433.

Mercer, S. W. & Reynolds, W. J. (2002). Empathy and quality of care. The British Journal of General Practice 52, S9.

Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C. & Gonnella, J. S. (2011). Physicians' Empathy and Clinical Outcomes for Diabetic Patients. Academic Medicine 86 (3) 359-364.

Zolnierek, K. B. H. & DiMatteo, M. R. (2009). Physician communication and patient adherence to treatment: a meta-analysis. Medical Care 47 (8) 826-834.

Uchino, B. N., Cacioppo, J. T. & Kiecolt-Glaser, J. K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin 119 (3) 488-531.