Sorry, Phyll and Group. One additional thought.

 

The person-centered, individual decision making is so tricky because people are (to state the obvious) very different from each other. We can argue about the evidence base for Myers Briggs, Honey and Mumford etc., but my experience is that their use helps me very much in understanding why some people process information, make decisions and generally operate in a very different way from each other - and especially from me. If using such tools helps me understand better about people, they work for me.

 

My Myers Briggs is above and if “I’m a T” I’ll find it bemusing at best when someone who “is an F” takes a different path from the one I’d take. And so on……….. unless I have at my core an understanding of how people as individuals make decisions, a fundamental acknowledgement that they’ll all do it differently, and especially that their approaches and eventual choices are as legitimate as mine.  

 

We are of course a million miles away in this third translation from, for example, technical issues in the construction of a systematic review in the first translation – but that’s the beauty of working in this fascinating world of EBP.

 

That’s it now. Back to the day job!

 

Best wishes

 

 

Neal

Professor Neal Maskrey

Consultant Clinical Adviser, Medicines and Prescribing Centre

National Institute for Health and Care Excellence
Ground Floor Building 2000 Vortex Court | Enterprise Way | Wavertree Technology Park | Liverpool L13 1FB | United Kingdom

Tel: +44 (151) 353 7729 | Fax: +44 (151) 220 4334

Honorary Professor of Evidence-informed Decision Making, Keele University, Staffordshire. ST5 5BG.

Web: http://nice.org.uk

 

 

 

 

 

 

-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Phyll Buchanan
Sent: 07 May 2013 16:52
To: [log in to unmask]
Subject: EBM and Person-centred care - can you have one without the other?

 

Dear all,

 

This list has helped me many times, thank you. 

 

I am about to do a presentation and would like some help in thinking this through - and I would really like some critical feedback before I do this for real.

 

At a previous research conference we challenged experienced researchers, working in the field of person-centred care, to be clear about their definitions, in order to help us understand the findings and perhaps incorporate them into our work.

 

My colleague and I are tutors with a voluntary organisation which provides breastfeeding support to new mothers, so already feeling a bit overawed when our challenge was accepted and  we were invited back to present our own thoughts on defining person-centred care. The deadline is getting close - about a month away.

 

Now I know more about evidence-based healthcare I realise they were not using reporting techniques familiar to this list. So, if we are to do a decent presentation, it means showing this distinguished, but perhaps sceptic, audience the relevance of evidence-based healthcare for their work as well as explain our understanding of person-centred care.

 

Taking this challenge further, and having looked at the definitions pasted below, I would like to argue that person-centred care is at the centre of the EBM definition but EBM is not explicitly within definitions of person-centred care.

 

Is this reasonable?

I would then like to explore methods of testing whether care given is perceived by the person at the receiving end as both evidence-based and person-centred.

 

 

I will follow-up the leads given by Hudon ( 2011) on appropriate measurement tools but would be very grateful if anyone knew of any existing work testing how patients experience EBM care?

 

Definitions

 

EBM definition (Straus, 2011:1)

Evidence-based medicine (EBM) requires the integration of the best research evidence with our clinical expertise and our patient’s unique values and circumstances.

Values are defined as … unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient.

 

Person centred care

Duncan seems the closest with the inclusion of effective care.

“Responsive to individual personal preferences, needs and values and assuring that patients values guide all clinical decisions”

Scottish Government (2010) Healthcare Quality Strategy (cited by Duncan, 2011)

 

‘Health care services and staff: Have characteristics that equip them to deliver consistently good care; act in ways that show they are willing and competent to attend to my health and care needs, and respect me as a person as they do so; and enable me to be and do what I value being and doing within and beyond my health care encounters’. (Entwistle, 2012)

 

…the patient needs to perceive that his or her individual needs and circumstances are at the heart of the clinical care he or she receives… (Hudon, 2011)

 

Phyll

 

My background: I am completing my MSc in Evidence-based Healthcare which has transformed my thinking, I was a nurse many years ago, co-founded a voluntary organisation 17 years ago and am involved in training women to become peer supporters for new mothers.

 

Duncan, E. (2011) Person Centred Care : what is it and how can it be improved? : University of Stirling.

 

Entwistle, V., Firnigl, D., Ryan, M., Francis, J. & Kinghorn, P. (2012) Which experiences of health care delivery matter to service users and why? A critical interpretive synthesis and conceptual map. J Health Serv Res Policy. 17, 70-8.

 

Hudon, C., Fortin, M., Haggerty, J. L., Lambert, M. & Poitras, M. E. (2011) Measuring patients' perceptions of patient-centered care: a systematic review of tools for family medicine. Ann Fam Med. 9, 155-64.

 

Straus, S. E., Glasziou, P., Richardson, S. W. & Haynes, R. B. (2011) Evidence-based medicine: how to practice and teach it. London, Churchill Livingstone /Elsevier.

 

 

 

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