Journal of Multidisciplinary Healthcare (Feb 2019)
Health care professionals’ experiences and enactment of person-centered care at a multidisciplinary outpatient specialty clinic
Abstract
Gudrun Evén,1 Jonas Spaak,1 Magnus von Arbin,1 Åsa Franzén-Dahlin,1 Terese Stenfors2 1Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden; 2Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Introduction: Person-centered care (PCC) appears particularly suitable for patients with complex diseases and in multidisciplinary care. However, previous research tends to focus on each profession and condition separately.Purpose: We studied how health care professionals (HCPs) understand PCC, and whether their clinical practice is aligned with their theoretical understanding, when starting clinical practice at a novel multidisciplinary clinic. Methods: In total, 16 semi-structured interviews with HCPs and 31 non-participatory observations of outpatient meetings and other activities at the clinic such as team meetings were conducted at a multidisciplinary, integrated outpatient clinic in Sweden. All patients had simultaneous diabetes mellitus, chronic kidney disease and established cardiovascular disease. The clinic employed a PCC approach. Data were analyzed using an inductive thematic approach. Results: Two key findings emerged. First, PCC requires a holistic view of the patient at all times during care, with everything focused on the patient. This requires that the HCPs know the patient well enough as an individual to be able to tailor the care together with them. Second, working with a PCC philosophy leads to transformed roles for HCPs in patient meetings, with more active involvement by the patient and often also their next of kin. The observations, in comparison with the interviews, showed that not all HCPs applied their views on PCC in patient meetings. Observations showed that some patient meetings were less person-centered than others, potentially due to stress or lack of time. Conclusion: PCC require HCPs to have a holistic view of the patients and a deeper understanding of their situation, as individuals. Working with PCC also leads to a more coaching, supportive role of the HCPs. Keywords: person-centered care, multidisciplinary, qualitative research, interviews, observations, thematic analysis, health care professionals, cardiology, nephrology, endocrinology
