Patient guardians as an instrument for person centered care

Globalization and Health

Humphrey Kiwelu²  Ruben Frescas³  Lopa Basu¹ 

[1] University of Chicago, Chicago, Illinois, USA;Mbeya Referral Hospital, Mbeya, Tanzania;Northwestern University McGaw Medical Center, Chicago, Illinois, USA

关键词: Patient education;    Health worker force;    Advocacy;    Reverse innovation;    Global partnerships;    Patient guardian;    Patient centered care;   

Others  :  802377
DOI  :  10.1186/1744-8603-10-33

 received in 2013-02-20, accepted in 2014-03-03,  发布年份 2014

【 摘 要 】

Person-centered care involves keeping the person at the center of the care planning and decision-making process. While the theory behind person-centered care is commonly shared, its application in healthcare settings is more challenging. In a number of African countries, a lesson emerges involving the application of person-centered care through the use of patient guardians. Patient guardians, often family or close friends, act as an extension of the patient’s hospital care team. Medical teams engage with these self-designated individuals who invest their time and efforts in the care of the patient. More importantly, the guardian continues this role and relationship when the patient is released from the hospital to return home. Healthcare workers view patient guardians as a valuable resource. In a structured manner, guardians become stewards of information regarding topics such as hand hygiene and infection control. The knowledge gained can help the recovering patient upon discharge and potentially spread the information to others in the community. Further study of this model may show clear applicability to help improve health literacy in underserved settings in both low-income and high-income countries.

【 授权许可】

   
2014 Basu et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Davis K, Schoenbaum SC, Audet AM: A 2020 vision of patient-centered primary care. J Gen Intern Med 2005, 20(Suppl 10):953-957.
• [2]Maizes V, Rakel D, Niemiec C: Integrative Medicine and Patient-Centered Care. Institute of Medicine Summit on Integrative Medicine and Health of the Public 2009 February
• [3]Starfield B: Is patient-centered care the same as person-focused care? Perm J 2011, 15(2):63-69.
• [4]Syed SB, Dadwal V, Rutter P, Storr J, Hightower JD, Gooden R, Carlet J, Nejad SB, Kelley ET, Donaldson L, Pittet D: Developed-developing country partnerships: benefits to developed countries? Glob Health 2012, 8:17. BioMed Central Full Text
• [5]US Legal Definitions, accessed February 2014 http://definitions.uslegal.com/g/guardianship/ webcite
• [6]Zachariah R, Harries AD, Manzi M, Gomeni P, Teck R, Phillips M, Firmenich P: Acceptance of anti-retroviral therapy among patients infected with HIV and tuberculosis in rural Malawi is low and associated with cost of transport. PLoS ONE 2006, 1(1):e121. doi:10.1371/journal/pone.0000121
• [7]Zachariah R, Teck R, Ascurra O, Gomani P, Manzi M, Humblet P, Nunn P, Salaniponi FML, Harries AD: Can we get more HIV positive tuberculosis patients on antiretroviral treatment in a rural district of Malawi? Int J Tuberc Lung Dis 2005, 9(3):238-247.
• [8]Massaquoi M, Zachariah R, Manzi M, Pasulani O, Misindi D, Mwagomba B, Bauernfeind A, Harries AD: Patient retention and attrition on antiretroviral treatment at district level in rural Malawi. Trans R Soc Trop Med Hyg 2009, 103:594-600.
• [9]Owunna C, Witt H: Managing Pharmaceutical TB/HIV Collaboration: Lessons Learned from a Five Country Study in East Africa. Arlington: U.S. Agency for International Development; 2007.
• [10]Rawlins BL: A Performance and Quality Improvement Process to Improve Infection Prevention: Malawi Case Study. Baltimore: Jhpiego Corporation; 2004.
• [11]Shulkin D, O’Keefe T, Visconi D, Robinson A, Rooke AS, Neighber W: Eliminating visiting hour restrictions in hospitals. J Healthc Qual 2013. doi:10/1111/jhq.12035
• [12]Helgesen AK, Larsson M, Athlin E: How do relatives of persons with dementia experience their role in the patient participation process in special care units? J Clin Nurs 2012. doi: 10.1111/jocn.12028.10
• [13]Congressional Budget Office: Financing Long-Term Care for the Elderly. Washington, DC: Congressional Budget Office; 2004.
• [14]Bensing JM, Verhaak PF, van Dulmen AM, Visser AP: Communication: the royal pathway to patient- centered medicine. Patient Educ Couns 2000, 39:1-3.
• [15]Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, Salivaras S: The expanded chronic care model: an integration of strategies from population health promotion and the chronic care model. Healthc Q 2003, 7(1):73-82.
• [16]International Conference on Primary Health Care: Declaration of Alma Ata. Alma Ata, USSR; 1978. Accessed on 1/20/13 from http://www.who.int/publications/almaata_declaration_en.pdf webcite