Physiotherapists need to engage in a person-centred ethics for better health

Introduction

Person-centred care is emerging within the modern health care system. As well as the WHO and national authorities, in different countries highlight the importance of person-centredness [1,2]. There are many different terms for person-centredness, such as, for example, person-centred care, person-centred approach and person-centred working methods, which can be confusing and constitute an obstacle to understanding what it really means. Person-centredness is a multidimensional concept and cannot be reduced to an explanation [3], but with this text I would like to develop the importance of person-centredness in physiotherapy and thereby encourage physiotherapists to participate in research and development of person-centredness.

A person-centred ethics for better health

Although person-centredness can be expressed in different ways, I am addressed by Ekman et al., who believe that person-centredness is basically a conscious ethics as the basis for actions and relationships that one as a professional is included in Ref. [4]. This ethics is mainly based on a personal philosophy developed by Paul Ricoeur, where one aims for the good life (health), with and for staff, patients and relatives in fair organisations [5]. It may sound abstract and far from a clinical reality, but it has been found that by applying this ethics, good results have been seen, for example, in reduced days in hospitals, reduced concern for the disease and lower health care costs [6–8]. It has also been possible to show in most studies that, the person-centredness had good results in strengthening the patient’s self-efficacy. So far, few studies, however, have been initiated by physiotherapists.

How can a person-centred ethics be applied in physiotherapy?

Mudge et al. claim that physiotherapists have been quick to absorb person-centredness [9], but I believe that physiotherapists have not been particularly visible in the development of person-centredness. When searching in scientific databases, it is difficult to distinguish physiotherapeutic articles that have a distinct person-centred focus. In one of the articles found, Feldthusen et al. [10] showed that a physiotherapy programme based on principles of person-centredness had significant effects on fatigue in patients with rheumatoid arthritis. In a recent article, Lotzke et al. showed that a person-centred prehabilitation programme before lumbar spine surgery had effect on the early outcomes of surgery [11]. However, although no health profession can claim to maintain or restore health as its own work, I would like to highlight the value of physiotherapy in relation to a person-centred ethic, as physiotherapy aims to promote health with and through movement [12,13].

Evidence based gaps

In a WHO report, about person-centred care, they conclude that research studies have so far focussed mainly on treatment and diagnosis, and adult and elderly care, meaning that the evidence base for other services (health promotion, prevention, long term care, rehabilitation and palliative care) is less strong than is evidence on other life stages (such as childhood) [14]. Since physiotherapists are active in promotion, prevention and rehabilitation throughout the life span, I believe that we should come forward and take a clear role in developing person-centred care. Not to take over the patient’s role but to add the knowledge we have about health and abilities. However, this does not mean that we should abdicate from our professional roles and that person-centredness is separate from evidence-based care. On the contrary, we must develop evidence-based methods by integrating person centredness.

Disclosure statement

No potential conflict of interest was reported by the author.