Translating Person-Centred Care from Theory into Practice: The PCC narrative project
Short description
GPCC kindly provided our team with funding for two projects: the ‘synthesis’ project and the ‘narrative elicitation’ project.
The initial aim of the synthesis project was to bring together the learning about how person-centred care was being implemented in a wide range of different populations with different health conditions. We sought to understand how the same ethical principle of person-centredness was being translated in different contexts, by interviewing health professionals, academics and patients.
We published a series of 5 papers which explored different aspects of person-centredness, which we synthesised in a sixth paper in the British Medical Journal. Our take home message was that fidelity to the Gothenburg framework for person-centred care lies in the ethical approach and not standardised guidelines. We think that this message has enormous relevance for the international spread of the Gothenburg framework. We also proposed that further work in Gothenburg could include patient involvement in the choice of outcome measures so that the research is also person-centred, and that there is a need for reporting guidelines to facilitate the future comparison and synthesis of GPCC trials.
As one of the insights we gained from this work was about the importance of narrative elicitation, we built on the first project to explore how narrative elicitation is carried out in practice. This involved an observational study of 14 admission interviews followed by focus groups and workshops with 53 nurses in the participating hospital. We published two papers about narrative elicitation which highlighted its challenges but also the potential for tackling epistemic injustice in clinical communication. This research was used to develop educational workshops with nurses, and was presented at the Academy of Nursing, Exeter University, in December 2019.
Publications
1. Britten, N., Moore, L., Lydahl, D., Naldemirci, O., Elam, M., & Wolf, A. (2016). Elaboration of the Gothenburg model of person‐centred care. Health Expectations, 20(3), 407-418.
2. Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian Journal of Caring Sciences, 31(4), 662-673.
3. Naldemirci, Ö., Lydahl, D., Britten, N., Elam, M., Moore, L., & Wolf, A. (2018). Tenacious assumptions of person-centred care? Exploring tensions and variations in practice. Health, 22(1), 54-71.
4. Wolf, A., Moore, L., Lydahl, D., Naldemirci, Ö., Elam, M., & Britten, N. (2017). The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. BMJ Open, 7(7), e016491.
5. Naldemirci, Ö., Wolf, A., Elam, M., Lydahl, D., Moore, L., & Britten, N. (2017). Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients. BMC health services research, 17(1), 527.
6. Britten, N., Ekman, I., Naldemirci, Ö., Javinger, M., Hedman, H ,. & Wolf, A. (2020) Learning from the Gothenburg model of person centred healthcare. British Medical Journal, doi:10.1136/bmj.m2738
7. Naldemirci, Ö., Britten, N., Lloyd, H., & Wolf, A. (2019). The potential and pitfalls of narrative elicitation in person-centred care. Health Expectations, doi:10.1111/hex.12998
8. Naldemirci, Ö., Britten, N., Lloyd, H., & Wolf, A. (2020). Epistemic injustices in clinical communication: the example of narrative elicitation in person-centred care. Sociology of Health and Illness, 43(1), 186-200.
9. Lydhal, D. et al. The Changing Nature of Lifeworld Goals in Person-Centred Care Planning: Congruence, continuity and communication. Submitted for publication.
Researchers
Primary Investigators and Research Group leaders
Researchers
Öncel Naldemiric