Patient-centredness: a conceptual framework and review of the empirical literature

被引:1852
作者
Mead, N [1 ]
Bower, P [1 ]
机构
[1] Univ Manchester, Natl Primary Care Res & Dev Ctr, Manchester M13 9PL, Lancs, England
关键词
patient-centred care; process assessment; literature review; physician-patient relations; quality of health care; communication;
D O I
10.1016/S0277-9536(00)00098-8
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
A 'patient-centred' approach is increasingly regarded as crucial for the delivery of high quality care by doctors. However, there is considerable ambiguity concerning the exact meaning of the term and the optimum method of measuring the process and outcomes of patient-centred care. This paper reviews the conceptual and empirical literature in order to develop a model of the various aspects of the doctor-patient relationship encompassed by the concept of 'patient-centredness' and to assess the advantages and disadvantages of alternative methods of measurement. Five conceptual dimensions are identified: biopsychosocial perspective; 'patient-as-person'; sharing power and responsibility; therapeutic alliance; and 'doctor-as-person'. Two main approaches to measurement are evaluated: self-report instruments and external observation methods. A number of recommendations concerning the measurement of patient-centredness are made. (C) 2000 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:1087 / 1110
页数:24
相关论文
共 121 条
  • [1] [Anonymous], 1989, Communicating with medical patients
  • [2] [Anonymous], 1987, INNER CONSULTATION
  • [3] [Anonymous], 1967, PATIENTS THEIR DOCTO
  • [4] [Anonymous], PAT PARTN BUILD COLL
  • [5] [Anonymous], 1991, PAT CHART
  • [6] EMANCIPATION OF BIOGRAPHICAL MEDICINE
    ARMSTRONG, D
    [J]. SOCIAL SCIENCE & MEDICINE PART A-MEDICAL SOCIOLOGY, 1979, A13 (01): : 1 - 8
  • [7] Badger L W, 1994, Arch Fam Med, V3, P899, DOI 10.1001/archfami.3.10.899
  • [8] Bain D J, 1973, J R Coll Gen Pract, V23, P474
  • [9] BAKER R, 1990, BRIT J GEN PRACT, V40, P487
  • [10] Bales R, 1950, INTERACTION PROCESS