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Patient-centred healthcare

from Psychology, health and illness

Published online by Cambridge University Press:  18 December 2014

By
Peter Bower  and
Nicki Mead
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Peter Bower
Affiliation:
University of Manchester
Nicki Mead
Affiliation:
University of Manchester
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Introduction

The delivery of healthcare is increasingly influenced by two fundamental philosophies. The first is evidence-based healthcare, which is defined as the ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients’ (Kleijnen et al., 1997; Sackett et al., 1996). However, in the past 30 years, an extensive body of literature has emerged advocating another key philosophy, which is described as patient-centred healthcare. This notion is commonly discussed in both the professional and health policy literature. This chapter will consider the nature of patient-centred healthcare, and review current research of relevance to this complex concept.

The definition of patient-centred healthcare

Despite the increasing popularity of the concept of patient-centred healthcare in the literature, there is little consensus as to its exact meaning. In fact, patient-centred healthcare has been most commonly understood in terms of its opposition to the philosophy of evidence-based healthcare (Bensing, 2000; Stewart, 2001). Evidence-based healthcare is generally based on rigorous outcomes research, characterized by the randomized controlled trial, which is itself concerned with the response of the ‘average’ patient receiving defined, conventional treatment for distinct, biomedical disorders. Evidence-based healthcare has a focus on treatments and technologies, often provided in specialist hospital settings. The style of healthcare practice engendered by this philosophy has been described as ‘doctor-centred’. This means that evidence derived from controlled outcomes research on populations is to be interpreted and applied by the professional to the care of individual patients.

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Cambridge Handbook of Psychology, Health and Medicine , pp. 468 - 472
Publisher: Cambridge University Press
Print publication year: 2007

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References

Balint, E. (1969). The possibilities of patient-centred medicine. Journal of the Royal College of General Practitioners, 17, 269–76.Google Scholar
Balint, E., Courtenay, M., Elder, A., Hull, S. & Julian, P. (1993). The doctor, the patient and the group: Balint revisited. London: Routledge.
Balint, M. (1964). The doctor, his patient and the illness. London: Pitman Medical.
Bensing, J. (2000). Bridging the gap: the separate worlds of evidence-based medicine and patient-centered medicine. Patient Education and Counseling, 39, 17–25.Google Scholar
Bower, P. (1998). Understanding patients: implicit personality theory and the general practitioner. British Journal of Medical Psychology, 71, 153–63.Google Scholar
Browne, K. & Freeling, P. (1976). The doctor–patient relationship. London: Churchill Livingstone.
Burkitt Wright, E., Holcombe, C. & Salmon, P. (2004). Doctors' communication of trust, care, and respect in breast cancer: qualitative study. British Medical Journal, 328, 864–8.Google Scholar
Butow, P., Dunn, S., Tattersall, M. & Jones, R. (1995). Computer-based interaction analysis of the cancer consultation. British Journal of Cancer, 71, 1115–21.Google Scholar
Byrne, P. & Long, B. (1976). Doctors talking to patients. London: HMSO.
Cape, J. (1996). Psychological treatment of emotional problems by general practitioners. British Journal of Medical Psychology, 69, 85–99.Google Scholar
Engel, G. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196, 129–35.Google Scholar
Engel, G. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137:5, 535–43.Google Scholar
Ford, S., Fallowfield, L. & Lewis, S. (1996). Doctor–patient interactions in oncology. Social Science and Medicine, 42, 1511–19.Google Scholar
Gask, L. & McGrath, G. (1989). Psychotherapy and general practice. British Journal of Psychiatry, 154, 445–53.Google Scholar
Graugaard, P. & Finset, A. (2004). Trait anxiety and reactions to patient-centered and doctor-centered styles of communication: an experimental study. Psychosomatic Medicine, 62, 33–9.Google Scholar
Grol, R., Maeseneer, J., Whitfield, M. & Mokkink, H. (1990). Disease-centred versus patient-centred attitudes: comparison of general practitioners in Belgium, Britain and the Netherlands. Family Practice, 7(2), 100–4.Google Scholar
Guadagnoli, E. & Ward, P. (1998). Patient participation in decision-making. Social Science and Medicine, 47, 329–39.Google Scholar
Henbest, R. & Stewart, M. (1989). Patient-centredness in the consultation. 1: A method for measurement. Family Practice, 6, 249–54.Google Scholar
Horvath, A., Gaston, L. & Luborsky, L. (1993). The therapeutic alliance and its measures. In Miller, N.et al. (Eds.). Psychodymaic treatment research: a handbook for clinical practice (pp. 247–73). New York: Basic Books.
Kinmonth, A., Woodcock, A., Griffin, S., Spiegal, N., Campbell, M.& Diabetes Care from Diagnosis Team (1998). Randomised controlled trial of patient centred care of diabetes in general practice: impact on current wellbeing and future disease risk. British Medical Journal, 317, 1202–8.Google Scholar
Kleijnen, J., Gotzsche, P., Kunz, R., Oxman, A. & Chalmers, I. (1997). So what's so special about randomisation? In Maynard, A. & Chalmers, I. (Eds.). Non-random reflections on health services research (pp. 93–106). London: BMJ Publishing Group.
Laine, C. & Davidoff, F. (1996). Patient-centered medicine: a professional evolution. Journal of the American Medical Association, 275, 152–6.Google Scholar
Langewitz, W., Phillipp, E., Kiss, A. & Wossmer, B. (1998). Improving communication skills: a randomized controlled behaviorally-oriented intervention study for residents in internal medicine. Psychosomatic Medicine, 60, 268–76.Google Scholar
Lewin, S., Skea, Z., Entwistle, V., Zwarenstein, M. & Dick, J. (2001). Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane database of systematic reviews, Issue 4, Art. No. CD003267. DOI: 10.1002/14651858. CD003267.
May, C. & Mead, N. (1999). Patient-centredness: a history. In Dowrick, C. & Frith, L. (Eds.). General practice and ethics: uncertainty and responsibility (pp. 76–90). London: Routledge.
McKinstry, B., Walker, J., Blaney, D., Heaney, D. & Begg, D. (2004). Do patients and expert doctors agree on the assessment of consultation skills? A comparison of two patient consultation scales with the video component of the MRCGP. Family Practice, 21, 75–80.Google Scholar
McWhinney, I. (1985). Patient-centred and doctor-centred models of clinical decision making. In Sheldon, M.et al. (Eds.). Decision making in general practice (pp. 31–46). London: Stockton.
McWhinney, I. (1989). The need for a transformed clinical method. In Stewart, M. & Roter, D. (Eds.). Communicating with medical patients (pp. 25–40). London: Sage.
Mead, N. & Bower, P. (2000a). Measuring patient-centredness: a comparison of three observation-based instruments. Patient Education and Counseling, 39, 71–80.Google Scholar
Mead, N. & Bower, P. (2000b). Patient-centredness: a conceptual framework and review of the empirical literature. Social Science and Medicine, 51, 1087–110.Google Scholar
Mead, N. & Bower, P. (2002). Patient-centred consultations and outcomes in primary care: a review of the literature. Patient Education and Counseling, 48, 51–61.Google Scholar
Mead, N., Bower, P. & Hann, M. (2002). The impact of general practioners' patient-centredness on patients' post-consultation satisfaction and enablement. Social Science and Medicine, 55, 283–99.Google Scholar
Michie, S., Miles, J. & Weinman, J. (2003). Patient-centredness in chronic illness: what is it and does it matter?Patient Education and Counseling, 51, 197–206.Google Scholar
Ockene, J., Quirk, M., Goldberg, R.et al. (1988). A residents' training program for the development of smoking intervention skills. Archives of Internal Medicine, 148, 1039–45.Google Scholar
Rogers, C. (1967). On becoming a person: a therapist's view of psychotherapy. London: Constable.
Roter, D. (1977). Patient participation in patient–provider interactions: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Education Monographs, 5, 281–315.Google Scholar
Roter, D., Hall, J. & Katz, N. (1987). Relations between physicians' behaviors and analogue patients' satisfaction, recall and impressions. Medical Care, 25, 437–51.Google Scholar
Roth, A. & Fonagy, P. (1996). What works for whom? A critical review of psychotherapy research. London: Guildford.
Sackett, D., Rosenberg, W., Gray, J., Haynes, B. & Richardson, W. (1996). Evidence-based medicine: what it is and what it is not. British Medical Journal, 312, 71–2.Google Scholar
Savage, R. & Armstrong, D. (1990). Effect of a general practitioners' consulting style on patients' satisfaction: a controlled study. British Medical Journal, 301, 968–70.Google Scholar
Secretary of State for Health (2000). The NHS Plan. London: HMSO.
Stewart, M. (1984). What is a succesful doctor–patient interview? a study of interactions and outcomes. Social Science and Medicine, 19, 167–75.Google Scholar
Stewart, M. (1995). Effective physician–patient communication and health outcomes: a review. Canadian Medical Association Journal, 152, 1423–33.Google Scholar
Stewart, M. (2001). Towards a global definition of patient centred care. British Medical Journal, 322, 444–5.Google Scholar
Stewart, M., Brown, J., Donner, A.et al. (2000). The impact of patient-centred care on outcomes. Journal of Family Practice, 49, 796–804.Google Scholar
Stewart, M., Brown, J., Weston, W.et al. (1995). Patient-centred medicine: transforming the clinical method. London: Sage.
Stiles, W. & Shapiro, D. (1989). Abuse of the drug metaphor in psychotherapy process–outcome research. Clinical Psychology Review, 9, 521–43.Google Scholar
Stiles, W., Shapiro, D., Harper, H. & Morrison, L. (1995). Therapist contributions to psychotherapeutic assimiliation: an alternative to the drug metaphor. British Journal of Medical Psychology, 68, 1–13.Google Scholar
Street, R. (1992). Analyzing communication in medical consultations: do behavioral measures correspond to patients' perceptions?Medical Care, 30, 976–88.Google Scholar
Szasz, T. & Hollender, M. (1956). A contribution to the philosophy of medicine: the basic models of the doctor–patient relationship. Archives of Internal Medicine, 97, 585–92.Google Scholar
Dam, H., Horst, F., Borne, B., Ryckman, R. & Crebolder, H. (2003). Provider–patient interaction in diabetes care: effects on patient self-care and outcomes. A systematic review. Patient Education and Counseling, 51, 17–28.Google Scholar
Verhaak, P. (1988). Detection of psychologic complaints by general practitioners. Medical Care, 26, 1009–20.Google Scholar
Winefield, H., Murrel, T., Clifford, J. & Farmer, E. (1996). The search for reliable and valid measures of patient-centredness. Psychology and Health, 11, 811–24.Google Scholar
Wissow, L., Roter, D., Bauman, L.et al. (1998). Patient–provider communication during the emergency department care of children with asthma. Medical Care, 36, 1439–50.Google Scholar

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