College of Nursing, The Pennsylvania State University, University Park.
Department of Sociology and Gerontology, Miami University, Oxford, Ohio.
Gerontologist. 2020 Apr 2;60(3):376-384. doi: 10.1093/geront/gnz075.
Knowledge of individuals' everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person-environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.
了解个人的日常偏好是以人为本的护理（PCC）的基石。初步证据表明，在为接受长期服务和支持（LTSS）的老年人提供护理时尊重偏好会产生积极影响。然而，偏好护理影响个人幸福感的机制仍知之甚少。本文提出了一个名为“偏好护理模式”的 PCC 理论模型，该模型整合了人类动机理论、自我决定理论、人与环境适配的能力-压力模型、生命系统框架和积极情绪的拓宽-构建理论，以加深我们对偏好护理通过哪些方式影响接受 LTSS 的老年人幸福感的过程的理解。偏好护理模式说明了目标导向行为如何通过表达个人偏好来促进需求的满足，以及这些行为如何在特定的社会、文化和政治背景下调节人与环境适配和情感平衡之间的关系。偏好护理模式可以促进 LTSS 中的 PCC 研究，并为无论功能或认知能力如何的老年人的 LTSS 临床实践指南提供信息。
