Kogan Alexis Coulourides, Wilber Kathleen, Mosqueda Laura
Department of Family Medicine and Geriatrics, Keck School of Medicine of USC, University of Southern California, Alhambra, California.
Davis School of Gerontology, University of Southern California, Los Angeles, California.
J Am Geriatr Soc. 2016 Jan;64(1):e1-7. doi: 10.1111/jgs.13873. Epub 2015 Dec 2.
Person-centered care (PCC) shifts focus away from the traditional biomedical model in favor of embracing personal choice and autonomy for people receiving health services. It has become an important avenue for improving primary care, and older adults remain a priority target for PCC because they are more likely to have complex care needs than younger individuals. Nevertheless, despite a growing body of evidence regarding its use, PCC still lacks an agreed-upon definition. A literature review was conducted to explore extant scholarship on PCC for older adults, assess corresponding definitions of PCC, and identify important elements of quality PCC. Nearly 3,000 articles published between 1990 and 2014 were identified. Excluding search results outside the parameters of this study, the final review comprised 132 nonduplicate sources focused on patient-centered care or PCC in older adults. Fifteen descriptions of PCC were identified, addressing 17 central principles or values. The six most-prominent domains of PCC were holistic or whole-person care, respect and value, choice, dignity, self-determination, and purposeful living. The body of evidence reviewed suggests that PCC is an important area of growing interest. Although multiple definitions and elements of PCC abound-with many commonalities and some overlap-the field would benefit from a consensus definition and list of essential elements to clarify how to operationalize a PCC approach to health care and services for older adults. This work guided the development of a separate American Geriatrics Society expert panel statement presenting a standardized definition and a list of PCC elements for older adults with chronic conditions or functional impairment.
以患者为中心的护理（PCC）将重点从传统的生物医学模式转移开来，转而支持接受健康服务的人们的个人选择和自主权。它已成为改善初级护理的重要途径，老年人仍然是PCC的优先目标，因为他们比年轻人更有可能有复杂的护理需求。然而，尽管关于其使用的证据越来越多，但PCC仍然缺乏一个公认的定义。进行了一项文献综述，以探索关于老年人PCC的现有学术研究，评估PCC的相应定义，并确定高质量PCC的重要要素。共识别出1990年至2014年间发表的近3000篇文章。排除本研究参数范围之外的搜索结果后，最终综述包括132个非重复来源，重点关注老年人以患者为中心的护理或PCC。确定了15种PCC描述，涉及17条核心原则或价值观。PCC最突出的六个领域是整体或全人护理、尊重和重视、选择、尊严、自决和有意义的生活。所审查的证据表明，PCC是一个越来越受关注的重要领域。尽管PCC有多种定义和要素，有许多共性且有些重叠，但该领域将受益于一个共识定义和基本要素清单，以阐明如何将PCC方法应用于老年人的医疗保健和服务。这项工作指导了美国老年医学会一个单独的专家小组声明的制定，该声明提出了一个标准化定义以及针对患有慢性病或功能障碍的老年人的PCC要素清单。
