Developing a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals

Alessandra Giusti, Panate Pukrittayakamee, Ghadeer Alarja, Lindsay Farrant, Joy Hunter, Olona Mzimkulu, Liz Gwyther, Nokuzola Williams, Kamonporn Wannarit, Lana Abusalem, Sawsan Alajarmeh, Waleed Alrjoub, Lakkana Thongchot, Satit Janwanishstaporn, Adib Edilbi, Ruba Al-Ani, Omar Shamieh, Ping Guo, Kennedy Bashan Nkhoma, Sridhar VenkatapuramRichard Harding

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Person-centred care (PCC) is internationally recognised as a critical component of high-quality healthcare. However, PCC evolved in a few high-income countries and there are limited data exploring this concept across the vast majority of countries which are low- and middle-income. This study aimed to appraise and adapt a PCC model across three serious physical conditions in three middle-income countries and generate an evidence-based framework and recommendations for globally relevant PCC.

Methods Cross-national, cross-sectional qualitative study. In depth, semistructured interviews conducted with: advanced cancer patients in Jordan (n=50), their caregivers (n=20) and healthcare professionals (HCPs) (n=20); chronic obstructive pulmonary disease patients in South Africa (n=22), their caregivers (n=19) and HCPs (n=22); heart failure patients in Thailand (n=14), their caregivers (n=10) and HCPs (n=12). Data were analysed using framework analysis. Santana et al’s PCC model (2018) and Giusti et al’s systematic review (2020) were used to construct an a priori coding frame for deductive analysis, with additional inductive coding for coding that did not fit the frame.

Results The findings both reveal specific practical actions that contribute towards delivering PCC and highlight new cross-national domains of person-centredness: interdependency and collectivism; bringing care into the home and community; equity and non-discrimination; addressing health and illness within the context of limited resources; and workforce well-being.

Conclusion The data suggest that PCC requires particular structural features of the healthcare system to be in place, such as professional education in PCC values and partnerships with community-based workers. These structures may better enable PCC processes, including tailored information sharing and providing genuine opportunities for patients to do the things that matter to them, such as making informed care decisions and sustaining social relationships. PCC must also accommodate a collectivist perspective and support the well-being of the workforce.
Original languageEnglish
Article numbere008843
Number of pages18
JournalBMJ Global Health
Volume7
Issue number7
DOIs
Publication statusPublished - 13 Jul 2022

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