Seeing the Elephant: A Systematic Scoping Review and Comparison of Patient-Centeredness Conceptualizations from Three Seminal Perspectives

Figures & data

Figure 1 Blind monks examining an elephant (Hanabusa Itchō, 1652–1724). Notes: Reproduced from Itcho H. [Blind monks examining an elephant]. In: The Floating World of Ukiyo-e: Shadows, Dreams, and Substance. Abrams in association with the Library of Congress; 2001:96. ¹

Table 1 Search Protocol Details and Results Summary

Database	Literature Results #Produced→#Kept (Year Range)	Filter Notes
CINAHL	164→21 (1993–2015)	Limits: research article, peer-reviewed, English, academic journals; exclude MEDLINE
Dissertations & Theses	84→16 (1980–2018)	Limits: English, full text
Health & Psychological Instruments	25→5 (1986–2013)
MEDLINE	454→56 (1952–2019)	Limits: English, full text, Ovid full text
PsychInfo	60→10 (1998–2018)	Limits: English, full text
Sociological Abstracts	121→5 (1979–2019)	Limits: English, peer-reviewed, lit. review
Academic Search Premier	186→13 (2002–2019)	Limits: full text, English, ref. available, scholarly
Cochrane	25→6 (2005–2019)
EMBASE	184→38 (2000–2019)	Limits: English, article; exclude MEDLINE
Alternative Methods	87
Non-duplicate Total	1385→257

Note: The most recent search date was 7/10/2019.

Figure 2 Search protocol details and results. Notes: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 6(7): e1000097. Copyright: © 2009 Moher et al. Creative Commons Attribution License.⁷⁶

Figure 3 Hudon et al’s integrative conceptualization of PC in Medicine.

Notes: Dotted lines reflect Stewart’s non-divisible conceptualization of PC; solid lines reflect Mead and Bower’s divisible conceptualization of patient-centeredness. Adapted with permission from Hudon C, Fortin M, Haggerty JL, Lambert MM, Poitras M-ER. Measuring patients’ perceptions of patient-centered care: a systematic review of tools for family medicine. Ann Fam Med. 2011;9(2):155–164.

Figure 4 McCormack and McCance’s “The Person-centred Practice Framework re-presented.” Notes: Republished with permission of John Wiley & Sons - Books from McCormack B, McCance T, Klopper H. Person-Centred Practice in Nursing and Health Care: Theory and Practice. 2nd ed. Wiley-Blackwell; 2016; permission conveyed through Copyright Clearance Center, Inc.⁵²

Figure 5 Analogous concept map of seminal PC concept alignment across Medicine, Nursing, and Health Policy patient-centeredness conceptualizations.^37,45,46,52

Notes: *McCormack and McCance’s person-centred outcomes; cells with X signify that no concept from respective seminal traditions existed in the specified area.

Table 2 Six Distinguishing Features of Patient-Centeredness Conceptualizations in Medicine, Nursing, and Health Policy

Distinguishing Features	Medicine	Nursing	Health Policy
1. Organizational Structure	Process-Oriented	System-Oriented	Process-Oriented
2. Predominant Level of Care	Micro-level	Meso-level	Macro-level
3. Methodological Approach	Deductive	Deductive	Inductive
4. Care Setting of Origin	Outpatient	Inpatient	Inpatient
5. Outcomes of Interest	Clinical & Patient-reported	Clinical & Patient-reported	Patient-reported only
6. Language	“Patient”-Centered	“Patient”-Centered	“Person”-Centered

Itcho H. [Blind monks examining an elephant]. In: The Floating World of Ukiyo-e: Shadows, Dreams, and Substance. Abrams in association with the Library of Congress; 2001:96. Available from: https://www.loc.gov/pictures/item/2004666374/. Accessed April 9, 2021. Japanese.

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McCormack B, McCance T, Klopper H. Person-Centred Practice in Nursing and Health Care: Theory and Practice. 2nd ed. Wiley-Blackwell; 2016.

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