Meanings and perceptions of patient-centeredness in social work, nursing and medicine: A comparative study

Abstract

Answering patients' evolving, more complex needs has been recognized as a main incentive for the development of interprofessional care. Thus, it is not surprising that patient-centered practice (PCP) has been adopted as a major outcome for interprofessional education. Nevertheless, little research has focused on how PCP is perceived across the professions. This study aimed to address this issue by adopting a phenomenological approach and interviewing three groups of professionals: social workers (n = 10), nurses (n = 10) and physicians (n = 8). All the participants worked in the same department (the General Internal Medicine department of a university affiliated hospital). Although the participants agreed on a core meaning of PCP as identifying, understanding and answering patients' needs, they used many dimensions to define PCP. Overall, the participants expressed value for PCP as a philosophy of care, but there was the sense of a hierarchy of patient-centeredness across the professions, in which both social work and nursing regarded themselves as more patient-centered than others. On their side, physicians seemed inclined to accept their lower position in this hierarchy. Gieryn's concept of boundary work is employed to help illuminate the nature of PCP within an interprofessional context.

Keywords::

• Patient-centeredness
• client-centeredness
• perception
• interprofessional care
• internal medicine
• social work
• nursing

Acknowledgements

David Gachoud took part in this study within an educational research fellowship at the Wilson Centre for Research in Education, University of Toronto, Canada. David Gachoud would like to thank Mathieu Albert and Scott Reeves for their genuine supervision throughout his fellowship. He also thanks Gerard Waeber at the Department of Internal Medicine, University Hospital of Lausanne, Switzerland, and the SICPA Foundation, Switzerland, for the support that allowed him to complete his research fellowship. Finally, he thanks Diana Reynolds for her support in the research process.

Declaration of interest

David Gachoud took part in this research project within a fellowship that was funded by the University Hospital of Lausanne, Switzerland and the SICPA foundation, Switzerland. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

¹“Patient” will be used interchangeably with “client” since some professions are more used to one term than to the other. “Centered” will be used interchangeably with “focused” since the databases do not make any difference between these terms, thereby assuming a conceptual similarity.