According to the American College of Rheumatology (ACR), person-centered care (PCC) is at the heart of quality-based health care.1
Rheumatoid arthritis affects between 0.5% and 1% of the global population and has a major impact on the patient's quality of life (physical, social and psychological).2,3
What is PCC?
PCC promotes the recognition of the patient as an expert on the disease in all aspects of life.2 It promotes patient education about their disease which allows them to have the tools to achieve better self-care and autonomy during the course of the disease.2
PCC considers the preferences, needs and values of patients, their families and caregivers in making decisions about their health and treatment plan, and encourages respectful and supportive collaboration with healthcare professionals.1
Patients have a leading role in disease management and collaborate as partners with the healthcare professional to accurately make the diagnosis and jointly create an optimal treatment plan through shared decision-making.1,2
All rheumatic diseases have a chronic course, so visits to health professionals, especially the rheumatologist, are frequent throughout life and a relationship based on trust will facilitate quality health care.2
What does it mean to apply PCC in health care?
It involves putting the patient at the center of everything that is done in the delivery of health care.2 Working in collaboration with the patient's values and beliefs, inviting the patient to participate in decision-making, providing empathetic care, and providing holistic care, including all of the patient's biopsychosocial spheres (physical, mental, spiritual, social, educational and spiritual).2
The outcomes of effective PCC involve achieving a good patient experience with the care provided, engaging patients in care, achieving wellness, and receiving care in facilities with a healthy organizational culture.2
What do patients expect from PCC?
According to a study of rheumatoid arthritis patients' perceptions of PCC, patients expect:2
Prerequisites: to be treated with respect and access to dedicated, competent and committed health care professionals.
Care environment: accessibility to health care, access to multidisciplinary teams and supportive organizations.
PCC processes: being listened to, supported and involved in decision-making.
PCC outcomes: being satisfied with care and achieving optimal health status.
On the other hand, one study identified six areas of non-healthcare needs of inflammatory arthritis and osteoarthritis patients:3
Assistance with daily activities to achieve greater independence.
Need for social connectedness and participation.
Concern about financial security, the need for family support due to unemployment, and rising health care costs.
Desire to continue working and to receive work flexibility.
Exercise and leisure.
Limitations in driving and using public transportation due to mobility problems.
PCC provides comprehensive care for rheumatic patients and should be the standard of quality to which we should aspire in health care in order to achieve better health outcomes and quality of life.
The basis of PCC is good communication between all those involved in health care, which is why the ACR provides the following recommendations so that as patients we can achieve good communication with the health care professional and participate in shared decision-making1
- Prepare questions for the medical consultation.
- Ask for clarification when you do not understand any aspect of the disease and treatment.
- Keep a record of your medical history and follow up on symptoms to detect changes and share them with the physician in a timely manner.
- To strive for effective and empathic communication with health professionals involved in the care.
- Be knowledgeable about the disease and self-care to achieve better disease management and outcomes.
- Understand the benefits and risks associated with treatments.
- If desired, actively participate in decisions about their care.
Also, we can have a role in advocacy by:1
- Asking questions about your health care and treatment plan.
- Knowing your options, rights and responsibilities as a patient.
- Inviting a family member or someone close to you to be part of the treatment experience so they can understand your needs and support you in times of crisis.
References
1. American College of Rheumatology. Patient role [internet]. USA: ACR; 2023 [citado 29 de octubre de 2023). Disponible en: https://rheumatology.org/patient-role
2. Landgren E, Bremander A, Lindqvist E, Nylander M, Larsson I. Patients' perceptions of person-centered care in early rheumatoid arthritis: A qualitative atudy. ACR Open Rheumatol. 2021;3(11):788-795. doi: 10.1002/acr2.11326.
3. Fairley JL, Seneviwickrama M, Yeh S, Anthony S, Chou L, Cicuttini FM, Sullivan K, Briggs AM, Wluka AE. Person-centred care in osteoarthritis and inflammatory arthritis: A scoping review of people's needs outside of healthcare. BMC Musculoskelet Disord. 2021;22(1):341. doi: 10.1186/s12891-021-04190-z.
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