What is Patient-centred care?

Individuals, families and communities can play distinct roles in promoting health in the following ways:

• by understanding the causes of disease and the factors that influence health;
• by self-diagnosing and treating minor self-limiting conditions;
• by selecting the most appropriate form of treatment for acute
• conditions in partnership with health professionals;
• by monitoring symptoms and treatment effects;
• by being aware of safety issues and reporting them;
• by learning to manage the symptoms of chronic disease;
• by adopting healthy behaviors
• to prevent occurrence or recurrence of disease; and
• by critiquing and feeding back on the quality and appropriateness of health care services.

Recognizing these roles and seeking to strengthen them is fundamental to securing a more patient centred approach to health care delivery. It also provides the essential underpinning for strategies aimed at reducing health inequalities and improving health for all.

The research evidence tells us about the effects of engaging individuals, families and communities in their health care in relation to the following goals:

• improving self-care;
• improving treatment decisions;
• improving health literacy; and
• improving responsiveness.

Why is patient centered care important?

Self-care (actions that people take to recognize, treat and manage their own health problems independently of the medical system) is the most prevalent form of health care. Most people cope with minor illnesses without recourse to professional help. Those with long-term conditions spend far more time looking after themselves than being under the care of health professionals, yet health service planning tends to ignore this important fact. Failure to recognize and support people’s self-care efforts encourages unnecessary dependency on professionals. The result is increased demand for expensive health care resources, which threatens to undermine the long-term sustainability of many health systems.

Much self-care consists of the day-to-day management of long-term and chronic illnesses such as asthma, diabetes and arthritis. The growing caseload of these conditions will be a major future challenge for health services. Self-management is what most people with long-term conditions do all the time.

They manage their daily lives and cope with the effects of their condition as best they can, for the most part without any intervention from professionals.

When people with chronic conditions seek professional advice, they need appropriate help and support to enhance their self-management skills.

Unfortunately, they do not always receive it. Too often, the way in which clinicians and patients interact tends to promote passivity and dependence instead of self-reliance, sapping patients’ self-confidence and undermining their ability to cope.

People with chronic conditions, for example depression, eating disorders, asthma, arthritis and hypertension, have benefited from lay-led self-management education in which they learn from other people with the same chronic condition. This type of self-help education can bring benefits in terms of improvements in knowledge, coping behavior, adherence to treatment recommendations and self-efficacy. It can also bring

modest short-term improvements in pain, disability, fatigue and depression, but there is little evidence of a reduction in the number of doctor’s visits or hospital admissions. Self-management education seems to work best when it is integrated into primary and secondary health care systems and the learning is reinforced by professionals. Many professionally led self-management education programs are aimed at specific patient groups. These can be very effective. Diabetes patients have been seen to gain health benefits from self-management education. Moreover, some studies have shown that these can lead to a reduction in health service costs.

Source: World health organization (WHO)