The "person/patient-centered care" concept |
Concepts facilitate communication between individuals. |
What defines the concept of patient-centered care (PCC) for the Brazilian reality? |
We chose to use the term "person-centered care". It was emphasized, however, that the choice of word can be conditioned to the level of complexity in which care is provided and, in this regard, the need for caution was emphasized to avoid distortions, obscurity and loss of healthcare's primary focus. There was no precise definition of person-centered care, with the proposal to set a specific agenda for this discussion. |
Contextual aspects relevant to the implementation of person/patient-centered care. |
Recognition that contextual factors, at different levels, influence the success (or not) of actions. |
What are the contextual aspects that facilitate or hinder a patient-centered healthcare provision culture? |
The recognition of contextual aspects is essential when you want to promote change. Context variations influence health practices, affecting their effectiveness. Contextual aspects are characterized by organizational practices such as teamwork, as well as anything in the practice environment that may hinder or facilitate the implementation of person / patient-centered care. |
Policy strategies for implementation of person-centered care. |
Although there are policies that consider elements of person-centered care in its composition and definition of its strategies, there is still no health policy focused on person-centered care in the country. |
Should a policy be established in this regard? Which strategies would be appropriate? What are the similarities and differences between NHP and person-centered care? |
We cannot deny the existence of interfaces between person-centered care and the National Humanization Policy (NHP), but we recognize that they are not the same thing. The contribution of person-centered care to safe care was highlighted. We propose that an attempt be made to establish a dialogue between groups that work in the area of healthcare quality and the group that participates in the formulation of the NHP. |
Communication between health professionals and patients. |
All relationships built between professionals, patients and families are permeated by communication and organizational aspects that interfere with the continuity of treatment. |
What are the challenges for developing communication skills? What is the role of technologies in the communication in health services? How do we promote better communication among health professionals and between professionals and patients to foster person-centered care? |
Organizational elements and lack of communication skills are aspects that can interfere with the communication process. Among the outstanding organizational factors: consultation time; the medical consultation environment; the role of technologies in the organization of care; the reduction of hierarchy gradients in the relationships among professionals; information sharing; the creation of means to enable the acquisition of accurate and reliable information; increased health literacy. Effective communication contributes to information sharing. |
Sharing information and decisions as an element of person-centered care |
There are significant challenges for decision-making to be a frequent practice in health services. |
What limits are essential, from the patient's point of view, for the sharing of decisions? |
Communication is an essential element for sharing decisions. Privacy has been cited as a principle that must be respected and preserved. The declaration of patient's rights was pointed out as a document that should be made available in the health services. Trust influences the sharing of decisions. Media-driven news feeds the "culture of fear" and interfere with trust building. |
Contextual aspects that interfere in the continuity of care and adherence to the therapeutic plan |
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The proposed dismemberment of this item follows: "continuity of care" was referred to as a realm of the health system; "adherence" was related to aspects inherent to the subject of care, but that does not neglect the organizational aspects. |
The relationship of the principle of integrality with the patient-centered care model. |
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It was recommended to withdraw this item, since, "integrality" is a multidimensional concept that should not be discussed in isolation. The need for a framework to address integrality was considered. Integrality was highlighted as the essence of person-centered care. |
The incorporation of changes into the curricula and formation processes towards a new theoretical orientation and health practices. |
The education and training of the health professionals are still predominantly dominated by the biomedical perspective (DNV / GL, 2013, p.126), but the social changes resulting from the process of demographic and epidemiological transition modify the demands and needs of the population. |
Considering the aging population and the prevalence of chronic health conditions, what kind of disciplines could be incorporated into the curricula? What new demands and responsibilities are imposed on academia? |
The influence of the market on the training of health professionals. The State as an inducer of changes in the care process. The inclusion of theoretical-practical disciplines focused on the development of empathy and compassion. Interdisciplinarity and teamwork are essential elements to be encouraged during the training process. |
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Are the perceptions about patient-centered care in the Brazilian health context different from those observed in developed countries? How do we encourage the development of empirical studies in Brazil focused on this theme? Are there any particularly relevant issues? |
Emphasis was placed on the lack of empirical work in Brazil on the quality of health services in general, emphasizing, in particular, the need for governmental and financial support to develop research on person-centered care. It was pointed out that there are few studies in Brazil on person/patient-centered care and those that exist have generic denominations and study in isolation the theoretical elements of this practice of care. |
Development of empirical work in Brazil on person-centered care |
The development of empirical work in Brazil on person/patient-centered care that recognizes it as realm of the quality of the health services is still insufficient. |
Are the perceptions about person/patient-centered care in the Brazilian health context different from those observed in developed countries? Considering the different perspectives of person/patient-centered care, how do we encourage the development of empirical work in Brazil focused on this subject? Are there any particularly relevant issues? |
Emphasis was placed on the lack of empirical work in Brazil on the quality of health services in general, emphasizing, in particular, the need for governmental and financial support to develop research on person-centered care. It was pointed out that there are few studies in Brazil on person/patient-centered care and those that exist have generic denominations and study in isolation the theoretical elements of this practice of care. |
Person-centered care for safe care |
The high incidence of adverse events in Brazil. Evidence that the involvement of patients and their relatives in care contributes to safer care. Concern of health systems with the issue of quality of care and patient safety. |
To what extent does the legitimacy of the patient and companions in the care process contribute to safe care? How can patient and companions be involved in the healthcare process to make it safer? |
The legitimation of the patient and companions in the care process contributes to a great extent for safe care. Sharing information is essential for safer care. |
Creation of specific measurement tools aimed at the study of elements of person-centered care. |
Tools for measuring components of person/patient-centered care are used, with greater emphasis on developed countries. It is an area where Brazil needs to move forward, validating existing tools or proposing new ones. |
What realms and aspects should be considered in the measurement of person-centered care. To what extent can the proposition or validation of tools for measuring the person/patient-centered care contribute to the improvement of the quality of care? |
The possibility of adapting international tools used to measure elements of patient-centered care or even the free creation consistent with the culture of healthcare in Brazil was highlighted. |
Development of empirical studies on patient/person-centered care in Brazil. |
The development of empirical work in Brazil on the person/patient- centered care that recognizes it as a realm of the quality of health services is still insufficient. |
Are the perceptions about patient-centered care in the Brazilian health context different from those observed in developed countries? How do we encourage the development of empirical work in Brazil focused on this theme? |
Emphasis was placed on the lack of empirical work in Brazil on the quality of health services in general, emphasizing, in particular, the need for governmental and financial support to develop research on patient/person-centered care. It was pointed out that there are few studies in Brazil on patient/person-centered care and those that exist have generic denominations and study in isolation the theoretical elements of this practice of care. |