The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi.

chronic care conceptualisation diabetes mellitus elements perceptions patient involvement patient-centred care quality of care

Journal

African journal of primary health care & family medicine
ISSN: 2071-2936
Titre abrégé: Afr J Prim Health Care Fam Med
Pays: South Africa
ID NLM: 101520860

Informations de publication

Date de publication:
20 Sep 2021
Historique:
received: 06 09 2020
accepted: 29 05 2021
revised: 27 05 2021
entrez: 12 10 2021
pubmed: 13 10 2021
medline: 15 10 2021
Statut: epublish

Résumé

Patient-centred care (PCC) is one of the pillars of Malawi's quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific. The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management. This study was conducted in DM clinics in Southern Malawi. Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower's work. Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants' conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic. Patient-centred care conceptualisation in Malawi goes beyond the patient-HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

Sections du résumé

BACKGROUND BACKGROUND
Patient-centred care (PCC) is one of the pillars of Malawi's quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific.
AIM OBJECTIVE
The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management.
SETTING METHODS
This study was conducted in DM clinics in Southern Malawi.
METHODS METHODS
Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower's work.
RESULTS RESULTS
Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants' conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.
CONCLUSION CONCLUSIONS
Patient-centred care conceptualisation in Malawi goes beyond the patient-HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

Identifiants

pubmed: 34636606
doi: 10.4102/phcfm.v13i1.2755
pmc: PMC8517774
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1-e10

Références

Health Serv Res. 2019 Jun;54(3):623-635
pubmed: 30815858
BMJ Glob Health. 2017 Oct 31;2(4):e000486
pubmed: 29225953
Am J Pharm Educ. 2019 Oct;83(8):7627
pubmed: 31831911
Health Expect. 2019 Jun;22(3):275-283
pubmed: 30478979
J Gen Intern Med. 2016 Apr;31 Suppl 1:10-20
pubmed: 26951271
West J Nurs Res. 2015 Aug;37(8):1100-31
pubmed: 24757047
PLoS One. 2015 Aug 11;10(8):e0135621
pubmed: 26262840
Malawi Med J. 2014 Dec;26(4):109-14
pubmed: 26167259
Health Expect. 2018 Feb;21(1):300-307
pubmed: 28841264
BMC Health Serv Res. 2019 Nov 27;19(1):900
pubmed: 31775809
Patient Educ Couns. 2016 Dec;99(12):1923-1939
pubmed: 27450481
BMJ. 2001 Feb 24;322(7284):444-5
pubmed: 11222407
Diabetes Care. 2006 Jun;29(6):1249-55
pubmed: 16732004
Chronic Illn. 2020 Mar;16(1):3-22
pubmed: 29895167
Patient Educ Couns. 2012 Aug;88(2):170-6
pubmed: 22360841
Health Educ Res. 2003 Apr;18(2):191-206
pubmed: 12729178
J Diabetes. 2017 Jun;9(6):596-605
pubmed: 27368146
Soc Sci Med. 2000 Oct;51(7):1087-110
pubmed: 11005395
Am J Public Health. 1978 Jun;68(6):547-56
pubmed: 655313
J Adv Nurs. 2012 Dec;68(12):2664-73
pubmed: 22416890
BMJ Glob Health. 2018 Dec 30;3(6):e001077
pubmed: 30687524
BMC Fam Pract. 2015 Feb 27;16:27
pubmed: 25887759
Br J Gen Pract. 2007 Feb;57(535):162-3
pubmed: 17263942
Med Care. 2009 Aug;47(8):826-34
pubmed: 19584762
Diabet Med. 2016 Jun;33(6):742-51
pubmed: 27105298
Diabet Med. 2014 Jan;31(1):61-7
pubmed: 23869848
J Diabetes Res. 2016;2016:2830910
pubmed: 26682229

Auteurs

Martha Makwero (M)

Department of Family Medicine, School of Public Health and Family Medicine, University of Malawi, Blantyre, Malawi; and, Department of Public Health, School of Public Health, University of the Witwatersrand, Johannesburg. mmakwero@cartafrica.org.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH