Running Head: PERSON CENTERED CARE

Critical Discussion of Person Centered Care

[Name of the Writer]
[Name of the Institute]
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Critical Discussion of Person Centered Care

Introduction
Nursing, like all disciplines, needs to continually renew its body of knowledge in order to
achieve autonomy, prestige and their credibility (Coyne et al., 2018). The importance of nursing
research, regardless of the area investigated, is today recognized for the development of
profession, to make appropriate, timely and intelligent decisions for excellent care delivery. This
opinion is corroborated by Coyne et al., (2018), when they report that the practice based on
evidence and scientific research promotes high standards of care quality and the way to
strengthen the identity of nursing. For Groves, (2016), the ability to produce new knowledge that
emerges of procedural reflection in view of the complexity of action contexts where develops
interactions with families, drives change structuring factors in their empirical domain. Therefore,
this essay aims at assessing the role played by nurses in delivering person centered care.

Discussion

Contemporary Concepts
The concept of healthcare in the UK has been described as impersonal and fragmented by
various authors (Kogan et al., 2016; Groves, 2016; Coyne et al., 2018). Previously the whole
system was built on the clinician-centered model which was more focused on the medicine than
the individual suffering from disease. Later on this approach changed to person-centered model
where the primary needs of each individual was regarded with more importance above all factors
(Barbosa et al., 2015). Since then person-centered care has been regarded as the most important
approach by National Health Services (NHS) in remodelling healthcare system of the UK (Fazio
et al., 2018). The nurses in this regard started to play important role as they are entrusted with
providing the required care to each of their patients. However, there are certain factors which
may pose challenges for nurses while delivering the person centered care. Therefore, this essay
aims at analysing those challenges while critically discussing the delivery of person centered
acre from nurses’ perspectives (Håkansson et al., 2019).
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Person Centered Care

Person centered care developed from the concepts presented by Ian McWhinney and
Moira Stewart's studies from Canada and Joseph Levenstein of South Africa on medical care and
the reasons that led people to seek care (Håkansson eta l., 2019). The term used to designate it
initially was Medical Person-Centered, but nowadays it is recognised that the method has wide
potential for application by health professionals in regardless of their background (Kogan et al.,
2016). Increasingly, the person-centered approach is being recognised as an important parameter
of care quality. An important premise for the person centered care is that there are differences
between what is called disease - that is, biochemical, cellular, tissues or organs that manifest in
the form of symptoms and signs - and the absolutely unique experience of each person with the
disease. This individual process can be called illness or experience with the disease.
It stems from the complex interaction of beliefs of the person with their body experience
and their interaction with including the family and psychosocial context. The traditional model of
approach, often referred to as “Biomedical model”, uses the symptoms and signs presented by
the patient as indicators of changes in the affected organism (Groves, 2016). From the analysis of
these symptoms and signs professionals elaborates a clinical reasoning to conclude correct
diagnosis of the pathology causative (Fazio et al., 2018). This diagnosis would allow treatment
selection “fight the disease” and restore the balance of organism to the “normal” or as close to it
as possible. In the extreme, a person may experience an intense process of falling ill without
being ill in the traditional sense- an individual with a recent near loss, for example.

Addressing Inequalities
With the delivery of person centered care, one of the most recurring issues has been the
biased behaviour of health professionals towards patients (Barbosa et al., 2015). This section
discusses both the concepts of equality and diversity in healthcare while delivering person
centered care.
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Equality
It is important for the healthcare professionals to exercise equality when treating the
individuals seeking help from them (Håkansson et al., 2019). The nurses in this regard when
delivering person centered care should offer competent, equal and sincere treatment to the
patients under their care. Although the healthcare model implemented in the UK health system
discourages the biased treatment of any individual, a number of care providers including nurses
continue to follow racial behaviours and biased treatment practices towards individuals with
different ethnic backgrounds (Groves, 2016). The treatment of patients with equality is one of the
primary rules of nurses’ code of conduct which requires the equal treatment of every individual
despite their language, race, religion and cultural background.

Diversity
Diversity refers to gender, skin colour, economic stability and religious affiliation of
people (Groves, 2016). The healthcare system in the UK has diverse policies to ensure that every
individual is treated in a similar manner. However, the reality is quite different as various
healthcare organisations and professionals continue to practice biased behaviours on the bases of
language, culture and skin colour (Fazio et al., 2018). When it comes to person centered care, the
issue becomes more complex as every culture or religion has some values and norms and the
individual demands to follow them. It is upon the nurses to make sure that the needs of such
individuals are fulfilled without compromising their diversified backgrounds (Coyne et al.,
2018).

Strategies
In order to ensure the delivery of person centered, the British government along with
NHS has implemented a number of policies and strategies (Barbosa et al., 2015). These policies
and strategies are put in place to ensure good practices on the part of nurses and healthcare
organisations.

Government and NHS Scotland Strategies

The person centered care proposes to elaborate a joint problem management plan. In this
process the caregiver and health professional seek to achieve a mutual understanding and agree
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on three key areas: the definition of the problem (s), the establishment of priorities and goals for
the treatment or management of the disease and the identification of the roles to be assumed by
each one (Kogan et al., 2016). The National Health Service (NHS) stresses that for the
establishment of a joint problem management plan, it is crucial that there is prior evaluation of
the person's illness experience, following the topics of feelings, ideas, effects on function and
expectations (Barbosa et al., 2015). When discussing with the person what they perceive as a
problem, it is important for the professional to use a language that they can understand, avoiding
complicated technical terms. People should take time and feel free to clarify their doubts, and not
being embarrassed by their lack of technical knowledge about their health condition (Coyne et
al., 2018).
After reaching a mutual understanding of the problem (s), the next step is to evaluate the
goals and priorities of the treatment and management. If they differ, finding a joint planning
could become a challenge (Håkansson et al., 2019). NHS provides special attention to ensuring
the delivery of person centered care as the British healthcare system firmly believes in
supporting patients to be actively involved in their own treatment and care (Groves, 2016). The
NHS has implemented strategies by assessing previous experiences of patients and it aims at
improving the outcomes by giving patients more personalised, supporting and commissioning
nurses who can help them in making informed decisions about their own health (Fazio et al.,
2018). In this regard, NHS has introduced guidance programs such as Medical and Nursing
Directorates and Commissioning Strategy. These guidelines are embedded with specialised
commissioning and new models of care. Moreover, the government has introduced programs
such as Personal Health Budgets), Learning Disability, Specialised Commissioning and New
Models of Care (Coyne et al., 2018).

Self-Actualisation
Self-actualisation refers to identification of one’s own potential and talents (Barbosa et
al., 2015). Self-actualisation is one of the most important aspects in nursing as it helps them in
determining their own potential so that they can perform better to provide the required care to
people under their care (Coyne et al., 2018). At time, what health professionals call “non-
adherence to treatment” may be a way of expressing disagreement with treatment or goals. It is
important to pay attention on the fact that various behaviours, such as hesitation in expressing
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something, or the repetition of a particular word may signal issues that have not become explicit
and they are not yet addressed (Coyne et al., 2018). The use of self-actualisation is an important
tool to achieve such a goal.

Conclusion
The degree of responsibility that a person takes on can also vary according to their own
health. In the end it is productive for the nurses to pass on the person the understanding and the
agreement as to what was established. By delivering the person centered care, the nurses are
making sure that each individual under their care makes informed decisions about his own
health. However, the practices involving inequality and diversity pose challenges for ensuring a
delivery of quality care services. The development and planning of cultural competence policies
is a challenge but it must be done as the UK health system requires practical approaches to
address the issues of inequality and diversity especially in person centered care.
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