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The Importance of Person-Centered Primary Care
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The Importance of Person-Centered Primary Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 24485

Special Issue Editors

Prof. Dr. Jane Murray Cramm

E-Mail Website
Guest Editor
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
Interests: person-centered care; integration of care; wellbeing
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Anna Petra Nieboer

E-Mail Website
Guest Editor
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, the Netherlands
Interests: well-being; ageing in place; quality of care; innovations in health and social care
Dr. Arianne Elissen

E-Mail Website
Guest Editor
Department of Health Services, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, the Netherlands
Interests: population health management; person centered care; integrated care

Special Issue Information

Dear Colleagues,

The number of (older) people with chronic diseases is rising at an astonishing rate, forcing millions to rely on primary care services. To meet their needs, a person-centered primary care approach, which truly supports older patients with (multiple) chronic diseases to achieve well-being, is needed. Putting (older) patients with (multiple) chronic diseases at the center of their own healthcare may seem intuitive, but it is an approach that is not widely practiced in the primary care setting. It is still unclear what effective person-centered primary care looks like in practice, and sound theoretical as well as empirical investigations of the contributions of person-centered primary care to more favorable outcomes are lacking. This Special Issue will describe innovative person-centered primary care approaches and the importance of such approaches to improve outcomes.

Assoc. Prof. Jane Murray Cramm
Prof. Dr. Anna Petra Nieboer
Dr. Arianne Elissen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • person-centered care
  • primary care
  • aging
  • chronic diseases
  • multimorbidity
  • quality of care

Published Papers (5 papers)

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Research

19 pages, 1046 KiB  
Article
The Patient Centered Assessment Method (PCAM) for Action-Based Biopsychosocial Evaluation of Patient Needs: Validation and Perceived Value of the Dutch Translation
by Rowan G. M. Smeets, Dorijn F. L. Hertroijs, Mariëlle E. A. L. Kroese, Niels Hameleers, Dirk Ruwaard and Arianne M. J. Elissen
Int. J. Environ. Res. Public Health 2021, 18(22), 11785; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211785 - 10 Nov 2021
Cited by 3 | Viewed by 2497
Abstract
The Patient Centered Assessment Method (PCAM) is an action-based tool that supports professionals to engage in a biopsychosocial assessment with patients and measure their needs. It is a promising tool for person-centered care. As the Netherlands lacks such a tool, a Dutch version [...] Read more.
The Patient Centered Assessment Method (PCAM) is an action-based tool that supports professionals to engage in a biopsychosocial assessment with patients and measure their needs. It is a promising tool for person-centered care. As the Netherlands lacks such a tool, a Dutch version was developed. Furthermore, we aimed to contribute to the relatively limited insights into the psychometric properties and value of the tool when used as part of a needs assessment in primary care. Confirmatory factor analysis was used to study construct validity and Cronbach’s alpha was computed to assess reliability. Furthermore, we interviewed 15 primary care professionals who used the PCAM. It was confirmed that each PCAM domain measures a separate construct, informed by the biopsychosocial model. The tool showed adequate reliability (Cronbach’s alpha = 0.83). Despite face validity concerns, the tool was mainly valued for measurement of patient needs and to facilitate action planning. Criticism of the PCAM pertained to a limited focus on the patient perspective, which is one of the crucial aspects of person-centered care. These rich, mixed-method insights can help to improve the value of the PCAM, as one of the few multifunctional tools to support professionals in holistic assessments. Full article
(This article belongs to the Special Issue The Importance of Person-Centered Primary Care)
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18 pages, 702 KiB  
Article
Easier Said Than Done: Healthcare Professionals’ Barriers to the Provision of Patient-Centered Primary Care to Patients with Multimorbidity
by Sanne J. Kuipers, Anna P. Nieboer and Jane M. Cramm
Int. J. Environ. Res. Public Health 2021, 18(11), 6057; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116057 - 04 Jun 2021
Cited by 15 | Viewed by 9396
Abstract
Patient-centered care (PCC) has the potential to entail tailored primary care delivery according to the needs of patients with multimorbidity (two or more co-existing chronic conditions). To make primary care for these patients more patient centered, insight on healthcare professionals’ perceived PCC implementation [...] Read more.
Patient-centered care (PCC) has the potential to entail tailored primary care delivery according to the needs of patients with multimorbidity (two or more co-existing chronic conditions). To make primary care for these patients more patient centered, insight on healthcare professionals’ perceived PCC implementation barriers is needed. In this study, healthcare professionals’ perceived barriers to primary PCC delivery to patients with multimorbidity were investigated using a constructivist qualitative design based on semi-structured interviews with nine general and nurse practitioners from seven general practices in the Netherlands. Purposive sampling was used, and the interview content was analyzed to generate themes representing experienced barriers. Barriers were identified in all eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, emotional support, family and friends, continuity and transition, and coordination of care). They include difficulties achieving mutual understanding between patients and healthcare professionals, professionals’ lack of training and education in new skills, data protection laws that impede adequate documentation and information sharing, time pressure, and conflicting financial incentives. These barriers pose true challenges to effective, sustainable PCC implementation at the patient, organizational, and national levels. Further improvement of primary care delivery to patients with multimorbidity is needed to overcome these barriers. Full article
(This article belongs to the Special Issue The Importance of Person-Centered Primary Care)
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13 pages, 332 KiB  
Article
Factors Affecting Health-Promoting Behaviors among Nursing Students
by Younghui Hwang and Jihyun Oh
Int. J. Environ. Res. Public Health 2020, 17(17), 6291; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176291 - 28 Aug 2020
Cited by 17 | Viewed by 6416
Abstract
Health-promoting behaviors help prevent chronic illness. Health-promoting behaviors of nursing students can affect not only their own health, but also the health of their future patients, for whom they can act as role models. Nursing students should participate in health-promoting behaviors; however, nursing [...] Read more.
Health-promoting behaviors help prevent chronic illness. Health-promoting behaviors of nursing students can affect not only their own health, but also the health of their future patients, for whom they can act as role models. Nursing students should participate in health-promoting behaviors; however, nursing students often have unhealthy behaviors. This study aimed to investigate the factors affecting health-promoting behaviors in nursing students. A descriptive, self-report survey of 304 nursing students from three universities in South Korea was conducted. Subjects’ general characteristics, health perceptions, health concerns, and health-promoting behaviors were collected. Of the total participants, 90.1% were female and the mean age was 20.4 years. The mean score for health-promoting behaviors was 2.47, higher than the midpoint. The mean for the subscale of physical activity among health-promoting behaviors was the lowest. The main factors affecting health-promoting behaviors were gender, health perceptions, health concern, and time per week spent searching online for health-related information. The main factors affecting physical activity were gender, health concern, and time per week spent searching online for health-related information. Based on the study findings, it is recommended that a program to empower nursing students to perform health-promoting behaviors be incorporated into the nursing education curriculum with regard to unique needs based on gender. Specifically, it would be effective to develop programs that are easily accessible via the Internet. Full article
(This article belongs to the Special Issue The Importance of Person-Centered Primary Care)
15 pages, 1129 KiB  
Article
Preferences of Patients with Non-Communicable Diseases for Primary Healthcare Facilities: A Discrete Choice Experiment in Wuhan, China
by Erping Jia, Yuanyuan Gu, Yingying Peng, Xianglin Li, Xiao Shen, Mingzhu Jiang and Juyang Xiong
Int. J. Environ. Res. Public Health 2020, 17(11), 3987; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17113987 - 04 Jun 2020
Cited by 13 | Viewed by 2879
Abstract
Objectives: To elicit stated preferences of patients with non-communicable diseases (NCDs) for primary healthcare (PHC) facilities and to explore the willingness-to-pay (WTP) for facility attributes. Methods: A discrete choice experiment (DCE) was conducted through face to face interviews. The DCE survey was constructed [...] Read more.
Objectives: To elicit stated preferences of patients with non-communicable diseases (NCDs) for primary healthcare (PHC) facilities and to explore the willingness-to-pay (WTP) for facility attributes. Methods: A discrete choice experiment (DCE) was conducted through face to face interviews. The DCE survey was constructed by five attributes: type of service, treatment measures, cost, travel time, and care provider. Patients’ preferences and willingness to pay for facility attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among patients with different sociodemographic characteristics. Results: Patients placed different weights on attributes, depending on whether they perceived their health condition as minor or severe. For conditions perceived as minor, patients valued treatment measures (56.60%), travel time (32.34%) and care provider (8.51%) most. For conditions perceived as severe, they valued treatment measures (52.19%), care provider (38.69%), and type of service (7.30%) most. The WTP related to the change from Traditional Chinese Medicine (TCM) service to Modern Medicine (MM) service was the largest for both severity scenarios. For conditions perceived as minor, patients would be willing to pay 102.84 CNY (15.43 USD) for a reduction in travel time to below 30 min. For conditions perceived as severe, WTP related to the change from general service to specialized service and from junior medical practitioner to senior medical practitioner, were highly valued by respondents, worth 107.3 CNY (16.10 USD) and 565.8 CNY (84.87 USD), respectively. Conclusions: Factors related to the provision of PHC, such as treatment measures, care provider and type of service were highly valued. The findings could contribute to the design of better PHC delivery, improve the participation of patients in PHC, and provide some evidence to promote shared decision-making. Full article
(This article belongs to the Special Issue The Importance of Person-Centered Primary Care)
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11 pages, 296 KiB  
Article
The Need for Co-Creation of Care with Multi-Morbidity Patients—A Longitudinal Perspective
by Sanne J. Kuipers, Anna P. Nieboer and Jane M. Cramm
Int. J. Environ. Res. Public Health 2020, 17(9), 3201; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093201 - 05 May 2020
Cited by 5 | Viewed by 2513
Abstract
Background: Primary care delivery for multimorbid patients is complex, due to single disease–oriented guidelines, complex care needs, time constraints and the involvement of multiple healthcare professionals. Co-creation of care, based on the quality of communication and relationships between healthcare professionals and patients, may [...] Read more.
Background: Primary care delivery for multimorbid patients is complex, due to single disease–oriented guidelines, complex care needs, time constraints and the involvement of multiple healthcare professionals. Co-creation of care, based on the quality of communication and relationships between healthcare professionals and patients, may therefore be valuable. This longitudinal study investigates the relationships of co-creation of care to physical and social well-being and satisfaction with care among multimorbid patients in primary care. Methods: In 2017 and 2018, longitudinal surveys were conducted among multimorbid patients from seven primary care practices in Noord-Brabant, the Netherlands (n = 138, age = 73.50 ± 9.99). Paired sample t-tests and multivariate regression analyses were performed. (3) Results: Co-creation of care improved significantly over time (t = 2.25, p = 0.026), as did social well-being (t = 2.31, p = 0.022) and physical well-being (t = 2.72, p = 0.007) but not satisfaction with care (t = 0.18, p = 0.858). Improvements in co-creation of care from T0 to T1 were associated with social well-being (B = 0.157, p = 0.002), physical well-being (B = 0.216, p = 0.000) and satisfaction with care (B = 0.240, p = 0.000). (4) Conclusions: Thus, investment in co-creation of care by primary care practices may lead to better outcomes for multimorbid patients. Full article
(This article belongs to the Special Issue The Importance of Person-Centered Primary Care)
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