Person Centered Medicine

Description:

The 21^st is being recognized as the Century of the Person, particularly in Medicine and Health. Person Centered Medicine, as a concept and global programmatic movement developed in collaboration with the World Medical Association, World Health Organization, International Council of Nurses and 30 other institutions over a decade of annual Geneva Conferences, places the whole person as the center of health and as the goal and protagonist of health actions. Seeking the person at the center of medicine, has meant a medicine of the person, for the person, by the person and with the person. Articulating science and humanism, it strives for a medicine informed by evidence, experience and values and aimed at the restoration and promotion of health for all.

The textbook on Person Centered Medicine reviews this perspective as it has evolved to date and its resulting knowledge base. The book structure encompasses an Introduction to the field and four sections on Principles, Methods, Specific Health Fields, and Empowerment Perspectives. Its 42 chapters are authored by 105 clinician-scholars from 25 different countries across world regions (North America, Latin America, Europe, Africa, the Middle East, Asia and Oceania). Its vision and goals involve total health for a total person. Ongoing work and upcoming publications would focus on redesigning health systems fit to purpose, and integrating ancestral knowledge and wisdom, community members’ self- and mutual-care, advances in medical science, and the contributions of health-relevant social sectors.

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Introduction

Person Centered Medicine (PCM), as a basic concept, recognizes the whole person as the center of medicine and health and as the objective and protagonist of health actions. This compact notion will be unpacked and explained through complementary delineations, both informal ones and those resulting from systematic conceptualizations studies presented in the course of this introductory chapter.

To understand further PCM as a concept and as a programmatic movement, a number of angles are to be engaged in this chapter. These include historical unfolding, philosophical bases, maturation processes, inter-institutional collaboration, organizational development, and scholarly activities such as research projects, educational programs, and publications.

Then, the present Person Centered Medicine book will be outlined and analyzed in terms of their objectives, authorship, structure and content. Major substantive topics as well as issues for the implementation of person-centered care will be touched on. The chapter will end with concluding words on the book’s thrust and horizons.

Table of contents :
Contents
Contributors
Chapter 1: Introduction to Person Centered Medicine
1.1 Introduction
1.2 Historical Development of Person Centered Medicine
1.3 Collaborative and Institutional Development of Person Centered Medicine
1.4 Conceptual Development of Person Centered Medicine
1.4.1 Systematic Conceptualization and Measurement of Person-centered Medicine and Care
1.4.2 The Person-Centered Integrative Diagnosis Model
1.5 Scholarly Development of Person Centered Medicine
1.5.1 Research on Person-Centered Diagnosis
1.5.2 Research on Person-Centered Care
1.5.3 Educational Programs on Person-Centered Healthcare
1.5.4 The International Journal of Person Centered Medicine
1.5.5 The Person-Centered Books Program
1.6 Presentation of the Person Centered Medicine Book
1.6.1 Section Highlights
1.7 Colophon
References
Part I: Principles of Person Centered Medicine
Chapter 2: Historical Overview of Person Centered Medicine
2.1 Introduction
2.2 Pre-history (Up to 4000 BC)
2.3 Early History (4000 BC to 476 AC)
2.4 Middle Age (476–1493 AC)
2.4.1 Pre-islamic Period
2.4.2 Islamic Medicine Golden Age
2.4.3 Other Salient and Late Middle Age Events
2.5 Modern Age (1493–1789)
2.5.1 Impact of Travel and Publications
2.5.2 Influence of Religion and Churches
2.5.3 Further Advances in Medicine
2.6 Contemporary Age (1789–Present)
2.7 Articulating Person Centered Medicine Concepts and Historical Eras
2.8 Conclusions
References
Chapter 3: Ontological and Epistemological Bases of Person Centered Medicine
3.1 Introduction
3.2 Objectives
3.3 Approaches to Fulfil the Objectives and Knowledge Base #1: The Ontological Presuppositions of PCM
3.4 Approaches to Fulfil the Objectives and Knowledge Base #2: The Epistemological Presuppositions of PCM
3.5 Other Necessary Conditions for PCM?
3.6 Practical Implications
3.7 Discussion and Conclusions
References
Chapter 4: Human Rights, Ethics and Values in Person Centered Medicine
4.1 Introduction
4.1.1 Mutual Recognition
4.1.2 Identity
4.2 Inclusion and Forgiveness
4.3 Core Values
4.4 The Importance of Dialogue
4.4.1 Consensus
4.5 Human Rights
4.6 Highlighting the Articles of the UN Declaration of Human Rights
4.7 The WHO Constitution
4.8 The UN International Covenant on Economic, Social and Cultural Rights
4.9 Criteria for Right to Health
4.10 Limitations of the Health and Human Rights Perspective
4.10.1 Ethical Principles
4.10.2 Virtue Ethics
4.10.3 Casuistry
4.10.4 Deontological Theory
4.10.5 Utilitarianism
4.11 Principlism
4.12 Practical Application of Ethical Principles
4.13 Instilling Ethics in Medical Education
4.14 The Essence of Medical Professionalism
4.15 The Eight Characteristics of a Profession
4.15.1 Code of Ethics
4.15.2 The Physician’s Pledge
4.15.3 Autonomy
4.15.4 Morality and Integrity
4.15.5 Altruism
4.15.6 Knowledge
4.15.7 Service
4.15.8 Accountability
4.15.9 Professional Associations
4.16 Conclusions
References
Chapter 5: Holistic Framework in Person Centered Medicine
5.1 Introduction: Zooming-In and Zooming-Out in Medicine
5.2 Zooming-Out from Patient-Centered Medicine to Person-Centered Medicine
5.3 The Concept of a Person in a Holistic Framework
5.4 The Concept of Health in a Holistic Framework
5.4.1 What Is a Healthy Personality?
5.4.2 Benefits of Promoting Well-Being
5.5 Conclusion: A Holistic Perspective on Both a Person and Health
References
Chapter 6: Individualized Care in Person Centered Medicine
6.1 Introduction
6.2 Narrative Competence and Individualized Care
6.2.1 Person-Physician Relationship and the Importance of a Person’s Narrative
6.2.2 The Inner Consultation
6.2.3 The Clinical Consultation
6.2.4 Listening
6.2.5 Effective Practice
6.2.6 Ethical Framework
6.2.7 Integrating Knowledge into Clinical Practice
6.2.8 Gothenburg Model of Person-Centred Healthcare
6.3 Multilevel Person-Centered Assessments and Individualized Care
6.3.1 The Person-centered Integrative Diagnosis Model: From Disease Focus to Whole Health Focus
6.3.2 Person-Centered Approach as a Promising Model for Individualized Care
6.3.2.1 Ill Health Status
6.3.2.2 Contributors to Ill Health
6.3.2.3 Experience of Ill Health
6.3.2.4 Positive Health Status
6.3.2.5 Contributors to Positive Health
6.3.2.6 Experience of Positive Health
6.3.3 Shared Decision Making
6.3.4 Life Course and Continuing of Care
6.3.4.1 Risk and Protective Factors Influencing the Life Course
6.3.4.2 The Need for a New Perspective on Healthcare
6.4 Conclusions
References
Chapter 7: Communication and Relationships in Person Centered Medicine
7.1 Introduction
7.2 The Nature of Doctor-Patient Communication
7.2.1 Incorporating the Tangible and Intangible in Clinical Communication: The Person-Centred Clinical Method
7.3 Inter-professional Relationships for Effective Person Centered Medicine
7.4 The Anthropology of Person-Centred Clinical Communication
7.5 The Ethics of Person-Centred Clinical Communication: The Clinical Encounter
7.6 The Essence of Person-Centred Communication
7.7 Conclusions
References
Chapter 8: People-Centered Health Services
8.1 Overview and Definition
8.2 Context of People-Centered Health Services
8.2.1 Empowering and Engaging People and Communities
8.2.2 Strengthening Governance and Accountability
8.2.3 Reorienting the Model of Care
8.2.4 Coordination of Services Within and Across Sectors
8.2.5 Creating an Enabling Environment
8.3 Methods
8.4 Clinical Fields
8.5 Clinician Perspectives on PCHS
8.6 Alma Ata, Astana and other Major International Declarations
8.7 Policy
8.8 Conclusions
References
Chapter 9: Person-Centered Health Education and Research
9.1 Introduction
9.2 Overview of Health Care Today and Its Impact on Health Care Professionals
9.3 Person-Centered Health Education: Concepts and Practice
9.3.1 A Proposed Path: The Third or Emerging School
9.3.2 Illustrative Competence-Based Training in Intensive Care Medicine in Europe (CoBaTrICE)
9.4 Person-Centered Health Research
9.4.1 Systematic Conceptualization and Measurement of Person Centered Medicine
9.4.2 Other Person-Centered Health Research Considerations
9.5 Practical Implications of Person-Centered Health Education and Research
9.6 Conclusions
References
Part II: Methods for Person Centered Clinical Care
Chapter 10: Establishing Common Ground, Engagement, and Empathy
10.1 Introduction
10.2 Strategies
10.2.1 Communication
10.2.2 Empathy
10.2.3 Comprehensive Collaborative Diagnosis
10.2.4 Shared Decision Making
10.3 Guiding Considerations
10.4 Implementation
10.5 Conclusions
References
Chapter 11: Person-Centered Interviewing and Diagnosis
11.1 Introduction
11.2 Person-Centered Clinical Interviewing
11.2.1 Organization of the Clinical Interview
11.3 The Development of Person Centered Diagnosis
11.3.1 Multiaxial Diagnosis and Comprehensive Diagnostic Models
11.3.2 Methodological Advances Leading to the IGDA and GLADP Diagnostic Models
11.3.3 The Person-Centered Integrative Diagnosis (PID) Model
11.3.4 The GLADP-VR Diagnostic Formulation
11.3.4.1 Health Status
11.3.4.2 Health Contributing Factors
11.3.4.3 Health Experiences and Expectations
11.3.5 GLADP-VR Formats for Personalized Diagnostic Formulation
11.4 Exploration of the Bases for Person-Centered Diagnosis in General Medicine
11.4.1 Overview of the Literature Towards Person-Centered Diagnosis in General Medicine
11.4.2 Key Proposals for Person-Centered Diagnosis in General Medicine.
11.5 Discussion
11.6 Conclusions
References
Chapter 12: Collaborative Treatment Planning
12.1 Introduction
12.2 A Person Is More Than His or Her Symptoms
12.3 How May a Clinician Understand Their Patient?
12.4 Communication Skills for Undertaking Collaborative Treatment Planning
12.5 The Role of the Treatment Plan
12.6 Formulating the Treatment Plan
12.7 Shared Decision Making/Collaborative Treatment Plans vs. Consent
12.8 Collaborative Clinical Team
12.9 Beyond the Basics: Practical Aspects of Undertaking Collaborative Treatment Planning
12.10 Barriers and Challenges to Practising Collaborative Treatment Planning
12.11 Conclusion
References
Chapter 13: Education and Counselling for Person-Centered Care
13.1 Introduction
13.1.1 Basic Definitions
13.1.2 Disease and the Subjective Reaction to Disease (Psychological or Spiritual “Aching” or “Distress”)
13.2 Education and Counselling in PCM Clinical Practice
13.2.1 Profile of the Patient as a Person
13.3 The General Health Educational Process
13.3.1 Illustratively Understanding the Patient in His Disease Process to Obtain His Collaboration
13.3.2 Illustrative Patient’s Collaboration on His Own Diagnosis and Treatment Formulation
13.3.2.1 On His Diagnosis
13.3.2.2 On His Therapy
13.4 Practical Implications for the Implementation of Person-Centered Care
13.4.1 How to Exercise in Practice a Medical Act Centered on the Person
13.5 Conclusions
References
Chapter 14: Narrative Medicine
14.1 Introduction
14.2 What Is Narrative?
14.3 The Relevance of Narrative to Person-Centred Medicine
14.4 Social Science Approaches to Illness Narratives
14.5 The Limits of Narrative
14.6 Narrative in the Clinical Encounter
14.7 Narrative Methods in Clinical Practice
14.8 Narrative and the Clinical Alliance
14.9 Narrative Interventions
14.10 The Ethics of Narrative and Narrative Ethics
14.11 Teaching and Learning Narrative Medicine
14.12 Conclusions and Implications for Person-Centered Care
References
Chapter 15: Digital Technology for Person-Centered Care
15.1 Introduction: Why Is a Chapter on Digital Technology Important in a Book on Person-Centered Medicine?
15.2 Scope of Digital Health Technology
15.2.1 List of Domains in Digital Health
15.2.1.1 The Digitized Medical Device
15.2.1.2 The Digitized Clinic/Hospital/Healthcare System
15.2.1.3 The Digitized Patient
15.3 Opportunities for Using Digital Technology in Person-Centered Medicine
15.4 Challenges to Utilizing Digital Health Technology in Person-Centered Medicine, and Strategies to Overcome Them
15.4.1 Challenges Faced by the Person
15.4.2 Challenges Faced by Their Clinician
15.5 Conclusion
References
Chapter 16: Person-Centered Rehabilitation
16.1 Introduction
16.1.1 Person-Centered Care in Rehabilitation
16.2 Psychiatric Rehabilitation
16.3 For Whom Is Person Centered Psychiatric Rehabilitation (PCPR) Designed?
16.4 Recovery and Person-Centered Psychiatric Rehabilitation
16.5 Basic Recovery Values That Guide PCPR
16.6 The Process: Values Plus Techniques
16.7 Neurorehabilitation: Applied Neuroplasticity and Resilience in Practice
16.7.1 Resilience in Neurological Disorders
16.7.2 The Importance of Neuroplasticity
16.8 Conclusions and Practical Issues on Implementation of Person Centered Care
References
Chapter 17: Person-Centered Prevention
17.1 Introduction
17.2 The Knowledge Base of Person-Centred Prevention
17.2.1 Prevention Vs Curative Approach
17.2.1.1 Primary Prevention
17.2.1.2 Secondary and Tertiary Prevention
17.2.1.3 Person-Centred Prevention in Psychiatry
17.2.2 The Added Value
17.2.3 The Challenges to Person-Centred Prevention
17.2.4 An Environment Conducive to Person-Centred Prevention
17.2.4.1 Inform and Educate About Healthy Choices
17.3 Opportunistic and Systematic Screening
17.4 Preventable Risk Factors
17.5 Stakeholder Engagement
17.6 The Public Health Laws
17.7 Practical Implications
17.7.1 A Model for Person-Centred Prevention
17.7.2 Assessing the Implementation of Person-Centred Prevention
17.8 Discussion
17.9 Conclusions
References
Chapter 18: Person-Centered Health Promotion
18.1 Placing the Person at the Center of Health Promotion
18.1.1 What Is Health Promotion?
18.1.2 Obstacles for Individual Health Promotion at the Primary Care Level
18.1.2.1 Persons Centered Health Promotion
18.1.2.2 People Centered Health Promotion
18.2 Evidence-Based Medicine and the Disappearing Person
18.2.1 When There Are No Individuals, Only Categories
18.3 Adding Person-Centered Approaches to Medicine
18.3.1 A First Person’s Story
18.3.2 Population Level Risks: Environment, Social Connectedness and Epigenetics
18.3.3 Individual Risks: Adversity and Resilience
18.4 Person-Centered Health Promotion
18.4.1 The Doctor-Patient Relationship as Medicine
18.5 Research Directions
18.6 Conclusions
References
Part III: Clinical/Health Fields for Person-Centered Care
Chapter 19: Person-Centered Family Medicine and General Practice
19.1 Introduction
19.2 Health Systems Must Become More Responsive to Person-Centered Needs
19.3 Proactive Versus Reactive Approaches in Person-Centered Care
19.4 Person Centered Approaches in Family Medicine and General Practice
19.5 The Seven Shared Principles of Person-Centered Primary Care
19.6 The Value of Person-Centered Primary Care
19.7 The Outcome of the 2015 Geneva Declaration of Person-Centered Primary Healthcare
19.8 The Rural Paradigm and Person-Centered Approach
19.9 Key Factors for the Implementation of a Person-Centered Approach in Family Medicine and General Practice
19.10 Conclusions
References
Chapter 20: Person-Centered Internal Medicine
20.1 Conceptual Bases of Person-centered Internal Medicine
20.2 Health, Medicine and Professionalism
20.3 The Comprehensive Clinical Approach
20.3.1 Clinical Thinking
20.3.2 Basic Clinical Skills
20.3.3 Primary Health Care and Person-Centered Medicine Considerations
20.4 Generic and Specific Clinical Professional Competences
20.4.1 Generic Clinical Professional Competences
20.4.2 Specific Clinical Professional Competences
20.5 Practical Implications for the Implementation of Person-Centered Clinical Care
20.5.1 Key Factors in Internal Medicine Useful to Evaluate the Implementation of Person-Centered Medicine
20.5.2 The Degree to Which Current Clinical Care Is Person-Centered
20.5.3 Obstacles for the Implementation of Person-Centered Care (Skills, Workload, Financial Aspects, Organization of Services)
20.5.4 What Would Have to Change for the Implementation of Person-Centered Clinical Care
20.5.4.1 Training Level
20.5.4.2 Professional Level
20.5.4.3 Proposed Solution
20.6 Conclusions
References
Chapter 21: Person-centered Women’s Health and Maternity Care
21.1 Introduction
21.1.1 Why a Chapter on Women’s Health?
21.2 Objectives
21.3 Women as Persons in Medicine: Historical Context
21.4 Definition of Women’s Health
21.5 Women Live Longer but Suffer More
21.6 The Health Workforce Is Predominantly Female
21.7 Person Centered Women’s Health
21.8 Towards Person Centered Women’s Health Care: Safe Maternity Care
21.9 Obstacles and Costs for the Implementation of Person-centered Care
21.10 Considerations in Implementing Person Centered Women’s Health
21.11 Conclusions
References
Chapter 22: Person-centered Neonatal Health Care
22.1 Introduction
22.2 Approaches to Fulfill the Objectives
22.3 Conceptual Frameworks
22.4 Knowledge Base
22.5 Practical Implications
22.5.1 Around the Time of Birth in the Delivery Room
22.5.2 Transportation from Delivery Room to Neonatal Unit and Referral
22.5.3 Neonatal Unit: Intermediate and Minimal Care Unit
22.5.4 Neonatal Intensive Care Unit
22.5.5 Mother-Infant Ward and Kangaroo Mother Care Ward
22.5.6 Ambulatory Program for all High-Risk Newborns, Including Preterm Infant or Low Birth Weight (LBW) Infants: An Integral FCC Unit up to 40 Weeks and in a Second Step from Term to up 1 or 2 Years of Corrected Age
22.5.7 Obstacles to Person Centered Care and Potential Solutions
22.6 Conclusions
References
Chapter 23: Person-centered Pediatrics
23.1 Objectives
23.2 Approaches
23.3 Body of Knowledge
23.3.1 Respect the Human Rights of Children
23.3.2 Convention on the Rights of the Child 1989
23.3.3 The Ethics of Paediatric Practice
23.3.4 Sustainable Developmental Goals
23.3.5 The Value of Children
23.3.6 The Importance of Early Development
23.3.7 Empathy
23.3.8 Longitudinal Studies
23.3.9 Integrated Support Throughout Childhood
23.4 Practical Implications for Person Centered Practice
23.4.1 Preventive Strategies for the Child
23.4.2 Person Centred Paediatric Care
23.4.3 Prenatal and Postnatal Care Centered on the Person, the Family and the Community
23.4.4 Person-centred Care and Empowerment in Practice
23.5 Barriers to Empowerment
23.5.1 Empowerment Interventions
23.6 Framework for Paediatric Consultation
23.6.1 Listening
23.6.2 Attention
23.6.3 Attitude
23.6.4 Attire
23.6.5 Accurate Records
23.6.6 Profile
23.7 Barriers to a Change Towards a Fully Person-centred Service
23.8 Conclusions
References
Chapter 24: Person-centered Geriatric Medicine
24.1 Historical Account
24.2 Person Centered Medicine in the Elderly
24.3 Comprehensive Geriatric Assessment
24.4 Falls and Fractures
24.5 Sarcopenia and Frailty
24.6 Delirium and Dementia
24.7 Practical Implications for Person Centered Care
24.7.1 Key Factors for the Implementation of Person-centered Care in Geriatric Medicine
24.7.2 To What Extent Is Geriatric Medicine Currently Centered on the Person?
24.7.3 Current Obstacles in Geriatric Medicine for the Implementation of Person-centered Care
24.7.4 Changes Necessary to Make the Practice of Geriatric Medicine More Person-centered
24.8 Conclusions
References
Chapter 25: Person-centered Neurology
25.1 Introduction
25.2 New Knowledge and Their Professional Engagement
25.3 Neuroplasticity
25.4 Resilience
25.5 Activity: Physical and Cognitive
25.6 Assessment of Neurorehabilitation Strategies
25.7 Multidisciplinary and Person-centered Approaches
25.8 Practical Issues in the Implementation of Person-centered Care
25.8.1 Key Factors for the Implementation of Person-centered Care in Neurology
25.8.2 To What Extent Is Neurology Currently Centered on the Person?
25.8.3 Current Obstacles in Neurology for the Implementation of Person-centered Care
25.8.4 Changes Necessary to Make the Practice of Neurology More Person-centered
25.9 Conclusions
References
Chapter 26: Person-Centered Psychiatry and Psychology
26.1 Introduction
26.2 Person Centered Diagnosis Models
26.3 Person-Centered Approach for Specific Psychiatric Disorders
26.4 Theoretical Consequences for the Treatments in Psychiatry
26.4.1 Pharmacotherapy
26.4.2 Psychotherapy
26.5 Sociotherapy
26.6 Practical Implications for the Implementation of Person-Centered Care in Psychiatry
26.7 Conclusions
References
Chapter 27: Person-Centered Emergency Medicine
27.1 Introduction
27.2 Person-Centered Care in Emergency Medicine
27.3 Challenges to Person-Centered Care in the Emergency Department
27.4 The Future of Person-Centered Care in Emergency Medicine and Practical Implications
27.5 Conclusions
References
Chapter 28: Person-Centered Infectious Diseases and Pandemics
28.1 Person Centered Medicine Perspectives on Infectious Diseases and Pandemics
28.1.1 A Person as a Living Being in Nature
28.1.2 The Nature of Infectious Diseases: Relationships Among Human Being, Infectious Agent, and Environment for the Disease to Occur
28.1.3 The Person’s Environment and Infectious Diseases
28.1.3.1 The Community and Infectious Diseases
28.1.3.2 The Reason for Pandemics, Endemics and Epidemics
28.1.3.3 Stigma and Infectious Diseases
28.1.4 The Commitment of the Physician and the Health Authorities
28.1.4.1 Early Diagnosis and Treatment of Infectious Diseases
28.1.4.2 Hospital/Health System and Infectious Diseases
28.1.4.3 Infection Control Measures and the Health Worker
28.2 Evaluation, Treatment and Care of the Person With Covid-19
28.2.1 The Community Response in the Prevention and Control of COVID-19
28.3 Practical Implications for the Implementation of Person Centered Care in Pandemics
28.4 China’s Management of the COVID-19 Pandemic and Its People-Centered Strategies
28.5 Conclusions
References
Chapter 29: Person-Centered Genetic Counselling
29.1 Introduction
29.2 Non-directiveness as Key Approach
29.3 Developing Models of Care
29.4 What Is Covered in Genetic Counselling?
29.5 Precision Medicine
29.6 Practical Implications for Implementing Person Centered Care
29.7 Conclusions
References
Chapter 30: Person-Centered Endocrinology (Including Diabetes and Obesity)
30.1 Introduction
30.2 Limitations of Evidence-Based Medicine in Endocrinology
30.3 Towards Person-Centred Endocrinology
30.3.1 Pituitary Disorders
30.3.2 Bone and Mineral Disease
30.3.3 Adrenal Disease
30.3.4 Gonadal Disorders
30.3.5 Disorders of Sexual Differentiation
30.3.6 Gender Identity Disorders
30.3.7 Obesity
30.3.8 Thyroid Disorders
30.3.9 Diabetes
30.4 Practical Implications for Person Centered Care
30.5 Conclusions
References
Chapter 31: Person-Centered Cardiology
31.1 Introduction
31.2 Evidence-Based in Cardiology
31.3 The Person with Coronary Artery Disease (CAD)
31.3.1 The Person with ST-Segment Elevation Myocardial Infarction (STEMI)
31.3.2 Potential Barriers for PCCC in the Person with STEMI
31.3.3 Persons with Unstable Angina (UA) and Those with Non-ST Elevation Myocardial Infarction (NSTEMI)
31.3.4 Potential Barriers for PCCC in Persons with UA/NSTEMI
31.3.5 Persons with Chronic Stable Coronary Artery Disease (SCAD)
31.3.6 Potential Barriers for PCCC in Persons with SCAD
31.4 The Person with Congestive Heart Failure (HF)
31.4.1 Chronic HF with Reduced Ejection Fraction (HFrEF)
31.4.2 Chronic HF with Preserved Ejection Fraction (HFpEF)
31.4.3 Acute Decompensated HF
31.4.4 Potential Barriers for PCC in Persons with HF
31.5 The Person with Dyslipidemia
31.5.1 Secondary Prevention
31.5.2 Primary Prevention
31.5.3 Potential Barriers to PCC in Persons with Dyslipidemia
31.6 The Person with Hypertension
31.6.1 Potential Barriers for PCC in Persons with Hypertension
31.7 The Person with Other Chronic Cardiac Conditions
31.8 An Important Principle of Shared-Decisions in PCCC
31.9 Practical Issues for the Implementation of Person Centered Care in Cardiology
31.10 Summary and Future Directions
References
Chapter 32: Person-Centered Pulmonary Medicine
32.1 Introduction
32.2 Patients
32.3 Current Practice
32.4 Health Systems
32.5 Case Study 1
32.5.1 Comment
32.5.2 “The Common Cold”
32.6 Case Study 2
32.6.1 Comment
32.7 Practical Implications for Person Centered Care
32.8 Conclusions
References
Chapter 33: Person-Centered Intensive Care Medicine
33.1 Introduction
33.2 Barriers to Person-Centered Care in the ICU
33.2.1 Patient Loss of Autonomy and Agency
33.2.2 Difficulty Knowing Patients as Persons
33.2.3 Provider Burnout
33.2.4 Acuity and Time Constraints
33.2.5 Complexity of ICU Decisions
33.3 Bringing Person-Centered Medicine to the Intensive Care Unit
33.3.1 Person-Centered Decision-Making in the ICU
33.4 Conclusions
References
Chapter 34: Person-Centered Oncology
34.1 Introduction
34.2 A Brief Word on Our Science
34.3 Beyond Biology and Overall Survival
34.4 Person-Centered Communication and Patient Participation
34.5 Highlighting the Patient Voice and Personal Values
34.6 Primary Palliative Care and Person-Centered Advance Care Planning
34.7 Person-Centered Survivorship
34.8 Cancer Care in Croatia and the European Union (EU)
34.9 Cancer Care in Vietnam and Asia
34.10 Practical Implications for Person-Centered Care
34.11 Conclusions
References
Chapter 35: Person-Centered Surgery and Anesthesiology
35.1 Introduction
35.2 The Surgeon-Patient Relationship
35.3 Principles of Person-Centered Medicine as Applied to Surgery
35.3.1 Ethical Commitment
35.3.2 Holistic Approach of the Patient’s Personhood
35.3.3 Cultural Sensitivity
35.3.4 Relationship Focus
35.3.5 Collaborative Care and Shared Decision Making
35.3.6 Empathic, Complete and Transparent Communication
35.3.7 Personalization of Care
35.3.8 Organization of Services Focused on the Person and the Community
35.3.9 People-Centered Health Education and Research
35.4 Implementation of Person-Centeredness Through Surgical Care Phases
35.4.1 Person-Centered Pre-operative Phase
35.4.2 Person-Centered Operative Care
35.4.3 Optimizing Care of Persons Post-operatively
35.5 Illustrative Cultural Perspectives on Person-Centered Surgery
35.6 Practical Implications for Person Centered Care in Surgery
35.6.1 To What Extent is Surgery and Anaesthesia Currently Person-Centered?
35.6.2 Obstacles to implementation of Person-Centered Surgery and Anesthesiology
35.6.3 The Changes that Are Needed to Make Surgery and Anaesthesia More Person-Centered
35.7 Conclusions
References
Chapter 36: Person-Centered Pain Medicine
36.1 Introduction
36.2 Objectives
36.3 Approach to Fulfilling the Objectives
36.4 The Knowledge Base of Person-Centred Pain Medicine
36.4.1 An Integrated Systems Approach to Health
36.4.2 System Integration in the Pain Context
36.4.3 Biomedical
36.4.4 Mindbody
36.4.5 Connection
36.4.6 Activity
36.4.7 Nutrition
36.4.8 Group Pain Management Programs
36.4.9 Telehealth
36.4.10 Primary Care Application
36.4.11 Cultural and Spiritual Perspectives
36.5 The Consequences of an Over-Emphasis on Biomedicine in Chronic Pain Management
36.6 Why Pain Management is not more Person-Centered Currently
36.6.1 Opioids
36.6.2 Cannabinoids
36.6.3 Procedural Interventions
36.7 Practical Implications for the Implementation of Person-Centered Care
36.7.1 Benefits of Greater Person Centeredness
36.7.2 Challenges to more Widespread Implementation of Person Centered Pain Medicine
36.7.3 Measuring Outcomes of Implementation
36.7.4 Future Challenges
36.8 Conclusions
References
Chapter 37: Person-Centered Palliative Care
37.1 Introduction
37.2 What is Palliative Care?
37.3 The Origins of Modern Palliative Care-a Brief History
37.4 The Concept of Person-Centredness in Palliative Care
37.5 Practical Implications for Person-Centered Palliative Care
37.5.1 Key Factors to Assess the Implementation of Person-Centered Palliative Care
37.5.2 The Extent to Which Current Palliative Care is Actually Person-Centered
37.5.3 Specific Barriers that Interfere with the Implementation of Person-Centered Palliative Care
37.5.4 What Would Have to Change in Health Systems and Actual Practice to Enable or Facilitate more Person-Centered Palliative Care
37.6 Palliative Care for Diagnoses Other than Cancer
37.7 Key Issues in Cardiology Palliative Care
37.8 Pediatric Palliative Care
37.8.1 How is Paediatric Palliative Care Person-Centred?
37.9 Conclusions
References
Chapter 38: People-Centered Public Health
38.1 Introduction
38.1.1 Public Health: A Dynamic Field
38.1.1.1 What Is P.ublic Health?
38.1.1.2 What Are the Functions of Public Health?
38.2 Public Health Perspectives in Person Centered Medicine
38.3 Additional Considerations for the Further Development of People-Centered Public Health
38.3.1 Person-Centered Public Health in Practice Including the Pandemics
38.3.1.1 Liberty, Autonomy, and Respect for Person
38.3.1.2 Wellbeing and Solidarity
38.3.1.3 Social Justice, Equity, Access and Right to Health and Dignity
38.3.1.4 Sustainable Development and Ecological Protection
38.3.1.5 Systemic Complex Reasoning
38.3.1.6 Evidence Informed and Supported by Technology
38.4 Integrating Person Centered Medicine, Social Determinants of Health, Sustainable Development Goals, and Essential Public Health Functions and Services (EPHF)
38.5 Conclusions
References
Chapter 39: Person-Centered Nursing and Other Health Professions
39.1 Introduction
39.2 Current Paradigm of Health Care
39.3 Person-Centred Care
39.4 Components of Person-Centred Care
39.5 Outcome of Person-Centred Care
39.6 How Person-Centered Is Currently by Nursing and Allied Professions?
39.7 What Are the Current Barriers for Nursing and Allied Health to Be More Person-Centred?
39.8 Going Forward, What Would Need to Change to Make Nursing and Allied Health More Person-Centered?
39.8.1 Interprofessional Collaboration and Communication for Person-Centred Care (IPCC)
39.8.2 Learning Together to Work Together
39.9 Conclusions
References
Chapter 40: Person-Centered Traditional Medicine
40.1 Introduction
40.1.1 Cultural Space and Time
40.1.2 Objectives, Approaches and Knowledge Base
40.2 The Example of China
40.2.1 Historical Development
40.2.2 The Person-Centered Ideas of TCM and Obstacles for Implementation
40.2.3 How Research on Modern Nature Healing Can Explain TCM and Person Centered Approaches
40.3 Traditional Medicine in India
40.4 Traditional Medicine in the Americas
40.4.1 Traditional Andean Medicine
40.5 Traditional Medicine in the Sahul Continent: Australia, Tasmania and Papua New Guinea
40.6 Traditional Medicine in Africa
40.7 Discussion and Practical Implications
40.8 Conclusions
References
Part IV: Empowerment Perspectives
Chapter 41: Empowerment of Community Members
41.1 Introduction
41.2 Self-Care and Inter-Care and Three Levels of Contextualization
41.2.1 Whole Contextualised Individuals
41.2.1.1 Self-Care
The Self-Care Continuum
The Seven Pillars of Self-Care
The Self-Care Matrix: A Unifying Framework of Self-Care
The Inverse Relationship Between Self-Care and Diseases of the Lifestyle
41.2.1.2 The Emerging Concept of Inter-Care
41.2.2 The Community Level of Contextualization
41.2.2.1 Social Prescribing
41.2.3 The Broader Environment Level of Contextualization
41.2.3.1 City Health
41.2.3.2 WHO Guideline on Self-Care Interventions
41.3 Conclusions
References
Chapter 42: Empowerment of Health Professionals
42.1 Introduction
42.2 What Is Burn-Out?
42.3 What Are the Basic Processes for Professionals’ Empowerment of Health and Well-Being?
42.4 Practical Methods for Promoting Well-Being
42.5 How Can Medicine Regain Its Person-Centered Values and Practices?
42.6 Conclusions
References
Index