Person-centred care is the holistic treatment of patients based on their assessed clinical condition, considering their individual preferences, priorities and sociocultural contexts.
Studies show that people with diabetes are more likely to engage in self-management and achieve optimal health outcomes if their care plans are person-centred.2,3
A person-centred consultation involves assessing someone’s clinical signs and symptoms, as well as their thoughts, fears, preferences, expectations and social context. This ensures a complete understanding of the individual who is living with type 2 diabetes.
From a position of mutual understanding, using a shared decision-making process (Box 1), management plans can be developed with the patient and tailored to specifically meet their needs, values and choices.
The following are important characteristics of person-centred care:
- care is personalised
- care is coordinated
- care is enabling
- the person is treated with dignity, compassion and respect.
Supporting principles include the following:
- Partnership: people are engaged as true partners in their healthcare
- Compassion and empathy: healthcare is always delivered with compassion and empathy
- Trust: two-way trust is established and maintained
- Carers and family: the support and expertise of carers, families and communities is recognised, encouraged and valued
- Diversity: diversity is valued, and the different needs of people are understood and provided for
- Continuous learning: the person and clinicians strive to continuously improve their knowledge, skills, health literacy and self-management strategies, and foster environments that support ongoing learning
The following key components of person-centred care are discussed in this chapter:
- patient education
- health literacy
- structured multidisciplinary care.
Note that although many of the assessments discussed in this handbook are performed informally during a routine consultation, systems should be developed within the practice to allow appropriate assessment, review and management of individual patients. Some patient-related outcome measures and expectation measures are discussed in an article by Borg et al (2019) and on the International Consortium for Health Outcomes Measurement (ICHOM) website.
For a full recommended structured assessment of the patient with diabetes, refer to the section ‘Assessment of the patient with type 2 diabetes’.
Box 1. Shared decision-making
Shared decision-making is a collaborative process between a patient, their doctor and other members of their care team (practice nurses, credentialled diabetes educators, etc) for making treatment decisions. It involves consideration of the evidence, including benefits and harms of treatment, and takes into account the patient’s values, preferences and circumstances.4
Shared decision-making does not necessarily require the use of decision tools; however, these can be useful.5 For example, the ICAN discussion aid is designed for use with chronic conditions. It helps clinicians work with patients to understand their capacity to follow a treatment plan, taking into account factors such as workload and treatment burden.6
Other shared decision-making resources can be found at the NSW Health Agency for Clinical Innovation.