共查询到20条相似文献,搜索用时 15 毫秒
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Evidence‐based medicine meets person‐centred care: a collaborative perspective on the relationship 下载免费PDF全文
Amy I. Price PhD Ben Djulbegovic MD PhD Rakesh Biswas MBBS MD Pranab Chatterjee MBBS MD 《Journal of evaluation in clinical practice》2015,21(6):1047-1051
In a recent list‐serve, the way forward for evidence‐based medicine was discussed. The purpose of this paper was to share the reflections and multiple perspectives discussed in this peer‐to‐peer encounter and to invite the reader to think with a mind for positive change in the practice of health care. Let us begin with a simple question. What if we dared to look at evidence‐based medicine (EBM) and informed shared decision making like two wheels on a bike? They both need to be full of substance, well connected, lubricated and working in balance, propelled and guided by a competent driver, with good vision to get the bike where we want it to go. We need all the tools in the toolkit for the bike to stay operational and to meet the needs of the driver. By the same rationale, evidence alone is necessary but not sufficient for decision making; values are necessary and if neglected, may default to feelings based on social pressures and peer influence. Medical decisions, even shared ones, lack focus without evidence and application. Just as a bike may need a tune up from time to time to maintain optimal performance, EBM may benefit from a tune up where we challenge ourselves to move away from general assumptions and traditions and instead think clearly about the issues we face and how to ask well‐formed, specific questions to get the answers to meet the needs we face in health care. 相似文献
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How to make a particular case for person‐centred patient care: A commentary on Alexandra Parvan 下载免费PDF全文
George Graham PhD 《Journal of evaluation in clinical practice》2018,24(5):1084-1086
In recent years, a person‐centred approach to patient care in cases of mental illness has been promoted as an alternative to a disease orientated approach. Alexandra Parvan's contribution to the person‐centred approach serves to motivate an exploration of the approach's most apt metaphysical assumptions. I argue that a metaphysical thesis or assumption about both persons and their uniqueness is an essential element of being person‐centred. I apply the assumption to issues such as the disorder/disease distinction and to the continuity of mental health and illness. 相似文献
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Mike R. Nolan Sue Davies Jayne Brown John Keady Janet Nolan 《Journal of clinical nursing》2004,13(Z1):45-53
Currently considerable emphasis is placed on the promotion of person‐centred care, which has become a watchword for good practice. This paper takes a constructively critical look at some of the assumptions underpinning person‐centredness, and suggests that a relationship‐centred approach to care might be more appropriate. A framework describing the potential dimensions of relationship‐centred care is provided, and implications for further development are considered. 相似文献
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Using holistic interpretive synthesis to create practice‐relevant guidance for person‐centred fundamental care delivered by nurses 下载免费PDF全文
Rebecca Feo Tiffany Conroy Rhianon J. Marshall Philippa Rasmussen Richard Wiechula Alison L Kitson 《Nursing inquiry》2017,24(2)
Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. 相似文献
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Benjamin Djulbegovic MD PhD Robert M. Hamm PhD Thomas Mayrhofer PhD Iztok Hozo PhD Jef Van den Ende MD 《Journal of evaluation in clinical practice》2015,21(6):1121-1124
Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' ‘reflective equilibrium/considered judgment’. In turn, this can help define a threshold model that is empirically testable. 相似文献
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The impact of the Dementia ABC educational programme on competence in person‐centred dementia care and job satisfaction of care staff 下载免费PDF全文
Anne Marie Mork Rokstad PhD Betty Sandvik Døble Msc Knut Engedal Øyvind Kirkevold Jūratė Šaltytė Benth PhD Geir Selbæk 《International journal of older people nursing》2017,12(2)
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Wan Nishfa Dewi RN BN MNg David Evans RN DipN BN MNS PhD Helen Bradley PhD MEdSt GrCertIntHlth BEd RN RM 《International journal of nursing practice》2014,20(6):616-622
Person‐centred care (PCC) is defined as the health‐care providers selecting and delivering interventions or treatments that are respectful of and responsive to the characteristics, needs, preferences and values of the individual person. This model of care puts the person at the centre of care delivery. The World Health Organization suggests that PCC is one of the essential dimensions of health care and as such is an important indicator of health‐care quality. However, how PCC is implemented differs between countries in response to local cultures, resources and consumer expectations of health care. This article discusses person‐centred care in the Indonesian health‐care system. 相似文献