Person centered care can be defined as the approach to care that keeps patients in the center of decision making allowing them the dignity and autonomy to take healthcare decisions about their own lives. Nurses need to provide coordinated and personalized care, support and treatment that respect their autonomy and dignity and empower them to become an active member in their own care planning (Oldham, 2016).
Person centered care enables support patients in recognizing and developing their own strengths and abilities and thereby help them to live an independent and fulfilling life. Bio-psycho-social model of health is the best approach that professionals adopt nowadays. The assignment would show how nursing professionals can ensure seven dimensions of patient centered care in treating john and thereby follow bio-psycho-social model of care to develop health conditions of the patient.
The patient named John has been suffering from long time from diabetes and the symptoms are not managed effectively for all through the years. The condition had become so worse that he had to undergo amputation surgery for his limbs. Huge outflow of money and unemployment for long fifteen years due to his poor health outcomes make him feel to be a burden on his son-in-law. The economic crisis faced by him and his family had made him depressed. Moreover, he had not been able to manage and control his blood glucose level due to improper taking of medication that resulted from poor health literacy. Therefore, it is important for the healthcare professional to ensure that she provides patient centered care to john in ways, which follow the seven dimensions of care (Johnson et al., 2018).
The first dimension of care is respecting the values, preferences and expressed needs of the patient and the second dimension is the effective coordination and integration of care. The professional who would be caring for John should ensure that she understands specific preferences and values of John. He is from Italian backgrounds and therefore his needs and values might be different from others. Gathering knowledge and working as per his wish is important for respecting his dignity and providing culturally competent care. The professionals need to coordinate with other members of the team to ensure effective integration of care.
The team might comprise of dietician for managing diet of john, podologist for further consultation with his conditions of feet (Ross et al., 2015). The team may also comprise of nursing professionals who develop his exercise regimen, references to monetary aiding services in the community and many others. This would help in planning a comprehensive and holistic care for patient. The third dimension would be effective conveying of information, communication as well as education and the fourth dimension of care would be ensuring physical comfort. It is seen that John does not have health literacy and therefore he does not understand the importance of medication. As he does not take medication in a scheduled manner, he often forgets and therefore the course of medication is not achieved properly.
Hence, these issues result in poor outcome on the health of the individual and do not make him live better quality life (Richards et al., 2015). Hence, the professional needs to communicate educate and provide information to John in ways by which he develop health literacy, take medications at the right time and be punctual with his medications. This would help him to manage his diabetes symptoms successfully. Ensuring his physical comfort is another important aspect of caring for john.
The fifth dimension for person-centered care is the emotional support and alleviation of fear as well as anxiety and the sixth dimension is involving family and friends in the care. John is emotionally broken as he is quite upset about the impact of diabetes on his health and social life. His eyesight had become poor and he remained unemployed for many years that had resulted in financial instability for him. Moreover, he cannot drive and he had also socially excluded himself. He feels himself to be a burden on his son-in-law as well. He needs to be counseled properly and his negative thoughts need to be overcome by replacing term with positive thoughts. This can be achieved by different psychological therapies.
Moreover, he enjoys time with his family and therefore his family members need to be made effective members of healthcare planning. The support of his family would make him feel more encouraged and thereby he would comply with the treatment. His motivation towards- self-care would increase (Fors et al., 2015). The seventh dimension of care is continuity and transition as well as effective access to care. John lives in the suburban region and he might face issues in accessing care. In that case, the nurse might set up follow-up sessions by telehealth technologies. Moreover, he might require financial aid and hence the nurse might refer him to services where he can get help to afford his medications and live quality lives.
The biomedical model of care mainly considers biological determinants of health that affects the psychological system of human beings. The social model of care mainly considers the social determinants of health and evaluates the impact of the determinants like socioeconomic status, employment, income, education, food, addiction, access to care and others on health on the patient (Tomlinson, 2018). Therefore, in the former model of care, healthcare professionals only apply interventions that help in managing the biological determinants of health.
On the other hand, professionals undertaking the latter approach apply interventions so that the social determinants are handled and managed effectively. The previous model is highly criticized but the later model helps in providing a comprehensive holistic care that results in overall development of quality of life of the people and not only the psychological health of individuals (Sjogren et al., 2015).
In case of John it was seen that he had undamaged diabetes. His biological determinants of health were that his cells of the body had become resistant to insulin and so the insulin cannot make the cells take up glucose from blood. Hence, blood glucose level was increasing in his blood.
The biomedical model of care would consider interventions that would help in overcome the issues like medication, insulin therapies, lifestyle management and others (Cairns et al., 2015). However, only providing these interventions will never help in providing holistic care. Some of the determinants that the healthcare professionals should also take into consideration are his lack of employment and no source of income, poor health literacy and lack of heath education that are the social determinants of health governing his health conditions (Wade et a., 2017).
He is highly demotivated and depressed about his health and financial condition and so these social determinants need to be cared to ensure that he is psycho-socially sable. Interventions for overcoming all the social determinants of health should be the main goal of the nurse and she can achieve success by developing his health education knowledge, arrange for funds for him by referring him to specific fund aiding schemes and others.
Conclusion:
One of the most important aspects of the person-centered care is to respect the values of patients and put them at the centre of the care planning. The nursing professionals need to take preferences and expressed needs of the person in the account before designing the care plan. The nurses should also coordinate and integrate the care and work together with the patients and team members for making sure that there is good communication, information sharing and education among the embers.
The nurses need to provide emotional support and thereby involve family and friends. The nurses need to make sure that there is continuity of support between and within the services. They also need to make sure that patients have access to appropriate care when they need it. Professionals should follow the social model of health while developing interventions and this would ensure best quality life for the patient.
References:
Cairns, V. A., Reid, G. S., Murray, C. D., & Weatherhead, S. J. (2015). Experience of psychosocial formulation within a biopsychosocial model of care for first-episode psychosis. International Journal of Psychosocial Rehabilitation. Vol 19 (2) 47, 62.
Eaton, S., Roberts, S., & Turner, B. (2015). Delivering person centred care in long term conditions. Bmj, 350, h181.
Fors, A., Ekman, I., Taft, C., Björkelund, C., Frid, K., Larsson, M. E., … & Swedberg, K. (2015). Person-centred care after acute coronary syndrome, from hospital to primary care—a randomised controlled trial. International Journal of Cardiology, 187, 693-699.
Johnson, C. D., Haldeman, S., Chou, R., Nordin, M., Green, B. N., Côté, P., … & Ameis, A. (2018). The Global Spine Care Initiative: model of care and implementation. European Spine Journal, 27(6), 925-945.
Oldham, J. (2016). Person-centred care. Future Hospital Journal, 3(2), 85-86.
Richards, T., Coulter, A., & Wicks, P. (2015). Time to deliver patient centred care.
Ross, H., Tod, A. M., & Clarke, A. (2015). Understanding and achieving person?centred care: the nurse perspective. Journal of Clinical Nursing, 24(9-10), 1223-1233.
Sjögren, K., Lindkvist, M., Sandman, P. O., Zingmark, K., & Edvardsson, D. (2015). To what extent is the work environment of staff related to person?centred care? A cross?sectional study of residential aged care. Journal of clinical nursing, 24(9-10), 1310-1319.
Tomlinson, J. (2018). Books: Person-Centred Primary Care: Searching for the Self: Critical Reflection.
Wade, D. T., & Halligan, P. W. (2017). The biopsychosocial model of illness: a model whose time has come.
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