Comparing patients’ perspectives of “good care” in Dutch outpatient psychiatric services with academic perspectives of patient-centred care

Figures & data

Figure 1. Flowchart of study selection.

Table 1. Overview of the included papers.

Author(s)TitleJournal	Year	Type of review	Core dimensions of PCC described
HobbsA dimensional analysis of patient-centered careNurs Res	2009	Dimensional analysis (n = 69)	Describes 5 dimensions of PCC.Perspective: alleviating vulnerabilitiesContext: fragmentation of service provision; patient acuity; staffing; centralised and decentralised decision making; efficiency; effectivenessCondition: heterogeneous response to illness; needs exceed capacity; suffering; disease condition; approach of health professional to patient; caring presence of health professional; characteristics of health professional; rule orientation of health professionalProcess: therapeutic engagementConsequences: lessen suffering; needs of patient met; effective care; minimise erosion of individual identity; address complexity by health professional; broadening explanatory perspective of illness by health professional
Kitson et al.What are core elements of patient-centered care? A narrative review and synthesis of the literature form health policy, medicine and nursingJ Adv Nurs	2012	Narrative review (n = 60)	Describes three themes.Patient participation and involvement: patient participating as a respected and autonomous individual; the care plan is based on the patient’s individual needs and the care addresses the patient’s physical and emotional needsRelationship between the patient and health professional: a genuine health professional-patient relationship; open communication of knowledge, personal expertise and clinical expertise between the patient and the professional; health professional having appropriate skills and knowledge; having a cohesive and co-operative team of professionalsThe context where care is delivered: access to care; policy practice continuum/language used; barriers to PCC; supportive organisational system; therapeutic environment
Leplege et al.Person-centeredness: conceptual and historical perspectivesDisabil Rehabil	2007	Conceptual and historical analysis (n = 10)	Describes four concepts. PCC means:Person as expert: participation and empowerment;Respect the person behind impairment or disease;Addressing the person’s difficulties in life;Addressing the person’s specific and holistic properties
Lusk &FaterA concept analysis of patient-centered careNurs Forum	2013	Concept analysis (n = 24)	Describes attributes, antecedents and consequences of PCC.Attributes: encouraging patient autonomy; caring attitude of health professional; individualising patient care by the health professionalAntecedents: the need for healthcare intervention, the ability of the patient or significant other to participate in his/her own careConsequences: experience of power; shared decision-making; caring; self-care ability; patient satisfaction
McCormack et al.Exploring person-centeredness: a qualitative meta-synthesis of four studiesScand J Caring Sci	2010	Qualitative meta-synthesis (n = 4)	Describes PCC on the basis of pre-requisites, care environment, care processes and outcome.Prerequisites: professionally competent; developed interpersonal skills; commitment to the job; clarity of beliefs and values; knowing “self”The care environment: appropriate skills mix; shared decision making systems; effective relationships; supportive organisational systems; power sharing; potential for innovation and risk takingCare processes: working with patient’s beliefs and values; engagement; sharing decision making; having sympathetic presence; providing for physical needsOutcome: satisfaction with care; involvement with care; feeling of well-being; creating a therapeutic culture
Mead & BowerPatient-centeredness: a conceptual framework and review of the empirical literatureSoc Sci Med	2000	Narrative review (n = 41)	Describes five dimensions.Biopsychosocial perspective; patient-as-person; sharing power and responsibility; therapeutic alliance; doctor-as-person
MorganA concept analysis of person-centered careJ Holistic Nurs	2011	Concept analysis (n = 50)	Describes PCC on the basis of attributes, antecedents and consequences.Attributes: holistic; individualised; respectful; empoweringAntecedents: vision and commitment; organisational attitudes and behavior; shared governanceConsequences: improves quality of care; increased satisfaction with healthcare; improved health outcomes
Pelletier & StichlerPatient-centered care and engagement. Nurse Leaders’ Imperative for Health ReformJ Nurs Admin	2014	Narrative review (n = 40)	Describes PCC on the basis of attributes.Attributes: considerate and respectful of patients’ beliefs, values and personal meanings associated with their state of wellness or illness; inclusive of patients’ personal and social support system; delivered in the context of caring, therapeutic partnership between patient and provider; integrated and coordinated across a continuum of services, providers and settings; enables with the education, information and evidence necessary to engage patients in their own healthcare; activating and facilitating use of internal and external resources to manage their own care.
PelzangTime to learn: understanding patient-centered careBr J Nurs	2010	Narrative review (n = 17)	Describes two models; a systems model introduced by Flarey (1995) and a process model, consisting of 7 dimensions introduced by Gerteis et al. (1993).Process model:respect of patients’ values, preferences and expressed needs; coordination and integration of care; information, communication and education; physical comfort; emotional support and alleviation of fear and anxiety; involvement of family and friends; transition and continuity of care.Systems model:Organisational self-care: development; retention/recruitment; imageMasters of change: planning; research; adaptationPartners in care: collaboration; coordination; communicationPatient-centered environment: values; empowerment; advocacy
Scholl et al.An integrative model of patient-centeredness- A systematic review and concept analysisPLoS One	2014	Systematic review (n = 417)	Describes 15 dimensions.Essential characteristics of health professional; health professional-patient relationship; patient as unique person; biopsychosocial perspective; health professional-patient communication; integration of medical and non-medical care; teamwork and teambuilding; access to care; coordination and continuity of care; patient information; patient involvement in care; involvement of family and friends; patient empowerment; physical support; emotional support
Sidani & FoxPatient-centered care: clarification of its specific elements to facilitate interprofessional careJ Interprof Care	2014	Integrative literature review (n = 178)	Describes three components and one non-specific element of PCC.Components:Holistic care: attend to all patient’s needs at the time of particular healthcare encounter or experienced over time; target the totality of patients’ condition; all patients’ needs i.e. physical care, comfort, emotional care; education; development and enactment of a care plan that incorporates health promotion, illness prevention and behavioral change strategiesCollaborative care: patients’ involvement in decision making; encouraging independence and self-directed care; developing an effective partnership; offering and respecting patients’ choices; finding common ground on what the problem is; collaborating on problem solving by understanding patients’ problem; negotiating treatment goals; sharing information in complete, accurate and timely way; educating patient; sharing power and responsibilityResponsive care: maintaining consistency between intervention and patients’ needs, values and preferences; individualising care; acknowledging the patient as an individual by concentrating on patient’s circumstances rather than the disease; understanding and respecting patients’ perspectives, feeling and needs; right for autonomy; providing flexible, personalised careNon-specific element:The therapeutic relationship: patients respect professionals’ expertise; healthcare professionals are personable, open to and respectful of patients’ knowledge and experiences; health professionals have competent communications skills; health professionals listen; health professionals share information; health professionals communicate effectively; health professional provides technical and emotional support
SlaterPerson-centredness: a concept analysisContemp Nurse	2006	Concept analysis (n = 19)	Describes seven attributes:Recognition of personhood; evidence of a therapeutic relationship between person and health provider; respect for the individuality of the person; provision of care that reflects professional ethical standards; identification and reinforcement of the person’s strengths and positive aspects rather than the weaknesses and problems; acknowledgement of the person’s lived world; empowerment for the person to make their own decisions about their own health

Figure 2. The integrative model of PCC.