Fundamentals of Person-Centred Healthcare Practice. Группа авторов

3 The Person‐centred Practice Framework

       Tanya McCance1 and Brendan McCormack2

       1 Ulster University, Northern Ireland, UK

       2 Queen Margaret University, Edinburgh, Scotland, UK

      Contents

Learning outcomes

Introduction

      This chapter will explore the development of models and frameworks to support the delivery of person‐centred practice across the professions, taking account of the current evidence base. The Person‐centred Practice Framework, the framework of choice for this book, will be introduced and examined to provide a critical understanding of its component parts and how it relates to practice. This will be placed in the context of theory development and will link to key underpinning theoretical concepts described in Chapters 1 and 2. The Person‐centred Practice Framework will be used to explore some of the challenges currently faced by healthcare professionals in operationalising person‐centredness. The activities provided will illustrate how application of the framework can support learning to enhance professional practice.

What is person‐centred practice?

      Person‐centredness reflects the ideals of humanistic caring in which there is a moral component, and practice has at its basis a therapeutic intent, which is translated through relationships that are built on effective interpersonal processes. Buetow (2016) discusses caring from the perspective of a physician as ‘a moral value and an ethical practice defining a connectedness with, and respectful and concerned attention to, concrete needs of others and oneself’ (p. 104). This philosophical position has resonance across the caring professions and reflects models for developing person‐centred healthcare that fundamentally take account of the humanness of people.

      Despite this shared philosophical position, professional groups use a variety of different models and theories to underpin their practice. Within nursing, the use of models has evolved over time, ranging from those based on activities of daily living (Roper et al. 2000) to those that are more relationships centred (Peplau 1997) and many more besides (Fitzpatrick and Whall 2016). The allied health professions have also drawn on a variety of models and theories ranging from the traditional medical model, to biopsychosocial models such as the International Classification of Functioning, Disability and Health (ICF) (WHO 2001) and moving towards the integration of social models for health and well‐being.

Social models of health recognise that our health is influenced by a wide range of individual, interpersonal, organisational, social, environmental, political and economic factors. They encourage us to have a deeper understanding of health: ‘Health, and what makes people healthy, can only be fully understood by exploring the myriad of interactions and influences that emerge out of the complexities of human experience and the various inter‐relationships of the mind, body and society’ (Yuill et al. 2010, p. 14). Irrespective of the models or theories that guide practice (and as reflected in Chapter 2), we advocate the importance of the underpinning values of person‐centredness, where the core value of ‘respect for the person’ is paramount.

      Person‐centredness in practice requires the formation of therapeutic relationships among professionals, patients and others significant to them in their lives. It is generally accepted that the principles underpinning person‐centredness as an approach focus on treating people as individuals; respecting their rights as a person; building mutual trust and understanding; and developing positive relationships. Furthermore, these principles reflect a standard of care that practitioners aspire to in their professional practice. The challenge, however, continues to be how these principles are translated into everyday practice to enable multiprofessional teams to deliver this standard of care consistently over time (Mitchell et al. 2015; Wolf et al. 2017; Sharp et al. 2018).

      The Person‐centred Practice Framework described in this chapter was originally born out of a desire to operationalise person‐centredness in a way that would illuminate practice, and provide practitioners with a language that would enable them to name components of person‐centredness, and the barriers and enablers that influence its development in the workplace.

Introducing the Person‐centred Practice Framework

      This book is based around the Person‐centred Practice Framework of McCormack and McCance (2017) and is built upon similar values underpinning separate research by both authors.

      When