Mezzich Juan Enrique, Perales Alberto
Icahn School of Medicine at Mount Sinai. New York, EE.UU.
Colegio Internacional de Medicina Centrada en la Persona. New York, EE.UU.
Rev Peru Med Exp Salud Publica. 2016 Oct-Dec;33(4):794-800. doi: 10.17843/rpmesp.2016.334.2567.
The development of person-centered clinical care is inscribed within an international programmatic movement towards a medicine focused on the totality of the person. This movement, with broad historical bases, has been maturing since 2008 through conferences among global health institutions, research projects and academic publications. This paper is aimed at elucidating the conceptual principles of person-centered medicine (PCM) and to delineate strategies for the practical application of such principles in clinical care services. The above objectives have been approached through literature reviews, international consultations, and reflections on the patterns and indications obtained. The principles identified for person-centered medicine are the following: Ethical commitment, holistic framework, cultural awareness and responsiveness, communication and relational focus, individualized clinical care, common ground among clinicians, patient and family for joint diagnostic understanding and shared decision making, person- and community-centered organization of integrated services, and person-centered medical education and research. Additionally, pertinent strategies have been delineated for the implementation of such principles in clinical care. The authors conclude that the presented principles and strategies are consistent with suggestions offered in the literature and may serve as bases for the design of indices and scales. Their continuous refinement is proposed through future international and local studies. to clarify the key concepts of the movement as well as strategies for their practical clinical application.
以患者为中心的临床护理发展是国际项目运动的一部分，该运动旨在推动以关注人的整体为重点的医学发展。这一运动有着广泛的历史基础，自2008年以来，通过全球卫生机构间的会议、研究项目和学术出版物不断成熟。本文旨在阐明以患者为中心的医学（PCM）的概念原则，并阐述在临床护理服务中实际应用这些原则的策略。上述目标是通过文献综述、国际咨询以及对所获模式和指征的思考来实现的。确定的以患者为中心的医学原则如下：伦理承诺、整体框架、文化意识与响应性、沟通与关系重点、个性化临床护理、临床医生、患者及家属之间达成共同理解以进行联合诊断和共同决策、以个人和社区为中心组织综合服务，以及以患者为中心的医学教育与研究。此外，还阐述了在临床护理中实施这些原则的相关策略。作者得出结论，所提出的原则和策略与文献中的建议一致，可作为指标和量表设计的基础。建议通过未来的国际和本地研究对其不断完善，以阐明该运动的关键概念及其临床实际应用策略。
