TITLE:
Patient-centered care through internal and external participation in medical rehabilitation
AUTHORS:
Mirjam Körner
KEYWORDS:
Patient-Centeredness; Participation; Rehabilitation; Shared Decision-Making; Teamwork
JOURNAL NAME:
Health,
Vol.5 No.6B,
June
17,
2013
ABSTRACT: Patient-centeredness is one of the
most important quality and outcome criteria in health care. Health care organizations
are continually searching for approaches that will enable them to establish
sustainable patient-centeredness in their daily practice. Existing approaches
frequently focus on interaction between patient and health care professional
(external participation). However,
this is often not sufficient; other elements,
such as good teamwork among the health care professionals (internal participation), are also
essential. The model of integrated patient-centeredness differentiates between
these two participations forms, both of which are explored from a patient and
health care professional perspective in our study. The aim of the study was to confirm
the model from the viewpoint of staff and patients. To this end we conducted a multi-center
cross-sectional study consisting of a patient and staff survey to assess
internal and external participation and patient-centeredness. A total of 15
rehabilitation clinics were involved, with 272 staff members and 536 patients included in the final analysis. Although evaluation was positive
(mainly slightly above the middle of the scale), there was potential for improvement
for both types of participation. Internal and external rating differed between
patients and health care staff, with the first group assessing internal
significantly better and external lower than the second group. The low to
middle correlation of both types, as well as the correlation and regression
with patient-centeredness, confirmed the model of integrated patient-centeredness. The model underlines the importance of both participation forms for patient-centeredness, as well as their interdependence. Further
studies are needed in order to verify the impact of internal and external
participation, as well as that of further possible dimensions of patient-centeredness,
on clinical and functional outcome criteria.