The need to prioritize the person in nursing and healthcare

Abstract

https://doi.org/10.14528/snr.2018.52.4.2955 Over the past twenty years or more, a focus on person-centredness in healthcare has grown and developed. Global advancements in healthcare consistently advocate the need for person-centredness underpinning systems developments (Anjum, et al., 2015) as a core philosophy of healthcare delivery. Services organised around peoples' needs and expectations make them more socially relevant and responsive, while producing better outcomes (World Health Organization [WHO], 2007). Over the past 10 years there have been major advances in conceptual and theoretical developments in person-centredness, as well as a growing body of evidence evaluating processes and outcomes (Health Foundation, 2015a). Alongside these advances in the research and scholarly literature, there has been a proliferation of policy and strategy focused publications supporting the need for and development of person-centred cultures in healthcare (The Norwegian Ministry of Health and Care Services, 2009; Alzheimer Society Canada, 2014). The Health Foundation has been instrumental in ensuring that at least at the level of health systems, people are at the centre of care: 'We want a more person-centred healthcare system, where people are supported to make informed decisions about and to successfully manage their own health and care, and choose when to invite others to act on their behalf ... We want healthcare services to understand and deliver care responsive to people's individual abilities, preferences, lifestyles and goals' (Health Foundation, 2015b). The Health Foundation has produced a range of resources to enable an increased understanding of person-centred care and to support its development in organisations (Health Foundation, 2015b). The World Health Organisation has also promoted a person-centred approach, with a global goal of humanising healthcare by ensuring that health care is rooted in universal principles of human rights and dignity, non-discrimination, participation and empowerment, access and equity, and a partnership of equals: 'The overall vision for people-centred health care is one in which individuals, families and communities are served by and are able to participate in trusted health systems that respond to their needs in humane and holistic ways ...' (World Health Organization, 2007, p. 7). Despite these notable advancements in the area of person-centredness there is much still to be done in developing healthcare cultures towards ones that truly place people at the centre of their care in order to achieve effective and meaningful outcomes. Richards and colleagues (2015, p. 3) suggest that it requires a sea change in the mind-set of health professionals and service users alike. A significant part of this sea change is the need to shift the discourse away from person-centred 'care' per se to that of person-centred 'cultures'. Person-centredness can only happen if there is a person-centred culture in place in care settings that enables staff to experience personcentredness and work in a person-centred way. Thus person-centredness is defined as: "... an approach to practice established through the formation and fostering of healthful relationships between all care providers, service users and others significant to them in their lives. It is underpinned by values of respect for persons, individual right to self-determination, mutual respect and understanding. It is enabled by cultures of empowerment that foster continuous approaches to practice development" (McCormack & McCance, 2016, p. 3). This definition reflects a broader understanding of the context of practice and the kind of cultural Leading article / Uvodnik