Poster Presentation ANZOS-ASLM-ICCR 2019

A qualitative study of embedding person-centred care in chronic and complex out patients services (#170)

Jane Elizabeth Bradshaw 1 , Nazlee Siddiqui 2 , Anita Sharma 3 , David Greenfield 2
  1. Chronic Pain Service, Nepean Hospital, Penrith, NSW, Australia
  2. University Of Tasmania, Sydney, NSW, Australia
  3. Nepean Hospital, Penrith, NSW, Australia

Introduction

There is a gap in the literature about how person- centred care (PCC) is reflected in the patient experience within multidisciplinary team (MDT) care.The aim was to capture the views of the patients and clinicians thus to create enhance patient  engagement and produce workable solutions to support healthy relationships between patients and clinicians so improving  health outcomes in chronic and complex disease management

Methods

Exploratory qualitative design with semi-structured  question with focus group discussions and interviews in 3 clinical areas which included Geriatric, Rehabilitation and Chronic Pain Services  Participant numbers were patients (13 )  and clinicians (7 ).Thematic analysis of the data  with reference to domains of person centred care was completed

Major Findings

          Continuous Planning and Treatment   Clinicians partnered with patients during their journey to give treatment choices and enhance autonomy 

         Emotional Support including social aspect of care. Patients valued the ongoing warm and compassionate relationship with the team which was vital for their successful treatment 

         Experiential Learning and Empowerment (for patients). Group learning using socialisation facilitated self management of chronic health issues 

Summary

A variety of enhancements to the services were recommended including - Reflective ‘Schwartz’  or narrative groups to support  clinicians  to continue to provide emotional  engagement with patients addressing issues of burnout and self-care

Review of service gaps in services in chronic and complex care to provide more social orientated group treatments

Research projects to explore the patient experience with the presence of the patient and family in MDT case conference 

  1. Jalil, R., Ahmed, M., Green, J. S. & Sevdalis, N. 2013. Factors that can make an impact on decision-making and decision implementation in cancer multidisciplinary teams: an interview study of the provider perspective. International journal of surgery, 11, 389-394.
  2. Hamilton, D. W., Heaven, B., Thomson, R. G., Wilson, J. A. & Exley, C. 2016. Multidisciplinary team decision-making in cancer and the absent patient: a qualitative study. BMJ open, 6, e012559.
  3. Olander, E. K., Berg, M., Mccourt, C., Carlström, E. & Dencker, A. 2015. Person-centred care in interventions to limit weight gain in pregnant women with obesity-a systematic review. BMC pregnancy and childbirth, 15, 50.
  4. Pelzang, R. 2010. Time to learn: understanding patient-centred care. British journal of nursing, 19, 912-917.