Table 2 Summary of person-centred care content in included guidelines
Guidelines (n, %) [references] | Examples [reference, page number] | ||
|---|---|---|---|
Limited content | Expanded content | ||
Foster a healing relationship Establishing a friendly, courteous, and comfortable relationship | (0, 0) | -- | -- |
Exchange information Learning about the patient; words or language used to discuss health care | (9, 25.0) | The treatments and procedures for each patient relies on mutual communication between the patient, physician, and other healthcare professionals [54 p4] | Invite patients disclosing the impact of pain on their daily functioning, to assess their ideas and concerns regarding the cause of their pain and the perceived control over pain episodes, and to take account of their expectations and preferences for treatment. It is deemed important to establish the patient’s functional and valued life goals, that is, what it is that they cannot currently do as well as they would wish to. Assess sleep problems: the quantity and quality of sleep, including whether the patient feels refreshed on waking and sleep hygiene habits such as regular exercise during the day, stress management, noise, sleep timing and avoidance of caffeine, nicotine, alcohol and daytime napping. Assess social factors related to pain and its consequences: the way family members and other significant others react to patient’s pain or pain-related disability; work; family and friends; economic problems; housing. Assess other factors that might influence pain or pain management, such as dependence on tobacco, alcohol or drugs [44 p802] |
Respond to emotions Responding to or managing emotional reactions | (3, 8.3) | Preoperative education could be considered if there is much anxiety for the operation [57 p274] | Assess beliefs and emotions about pain and pain-related disability: the psychological response to pain and psychological vulnerability factors, psychological distress, psychiatric comorbidity and cognitions such as catastrophizing (rumination, magnification and helplessness), fear of movement-related pain, catastrophizing and pain self-efficacy. If there are indications that social variables or psychological factors interfere with effective pain management and functional status, then consider (depending on the severity) providing basic social and psychological management support or referral to a psychologist, social worker, self-management support programme, CBT or multidisciplinary treatment. If psychopathology (e.g., depression and anxiety) is present, discuss treatment options with the patient and the patient ’s primary care physician. If psychosocial factors such as fear of movement or catastrophising cognitions underlie a disabled, sedentary lifestyle, then consider a multidisciplinary intervention including cognitive-behavioural therapy [44 p802-803] |
Manage uncertainty Addressing uncertainties about prognosis or outcomes | (1, 2.7) [41] | Clinicians are encouraged to continually provide their patients with necessary information about OA disease progression and self-care techniques and to promote hope, optimism, and a positive expectation of benefit from treatment [41 p1583] | -- |
Share decisions Engaging patient in discussion and decision-making. Including planning care with patients and tailoring plan to diverse characteristics, including patient characteristics, preferences, circumstances (e.g., finances) | (22, 61.1) [9, 10, 36, 37, 39,40,41,42,43,44,45, 47, 49,50,51,52,53,54,55, 65,66,67,68,69] | Treatment decisions should be made in light of all circumstances presented by the patient [54 p4] | Each health professional must decide with each patient the most appropriate management plan at a particular time and for that location. Many patient-centred factors are important in determining the selection of treatments for individual patients with knee OA—for example, psychosocial factors and OA status; comorbid disease and drugs; patient beliefs about their knee OA; patient beliefs and preferences for its management; and previous patient experiences of treatments and health professionals. The management plan for patients with knee OA has to be individualised, reviewed, and adjusted in the light of the patient’s response and adherence and will vary between patients and between locations [69 p1154] |
Enable self-management Setting expectations for follow-up care; preparing for self-managing health and well-being | (27, 75.0) [9, 10, 36, 38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59, 64,65,66,67,68,69] | Self-management programs are recommended to improve pain and function for patients with knee osteoarthritis [9 p8] | Teach and encourage behavioural change strategies through goal setting of physical activity and weight changes, action plans to maintain changes and regular follow-up over at least 1 year to re-evaluate and discuss goals and action plans…the addition of advice from a dietician for overweight or obese patients to the combination of patient education or self-management intervention plus exercise was found to improve both pain and function in patients with hip or knee OA [55 p1128] |