Barriers to tuberculosis case finding in primary and secondary health facilities in Ghana: perceptions, experiences and practices of healthcare workers

Ghana’s national tuberculosis (TB) prevalence survey conducted in 2013 showed higher than expected TB prevalence indicating that many people with TB were not being identified and treated. This study showa that TB case finding was undermined by few diagnostic facilities; inconsistent referral mechanisms; poor implementation, training and quality control of a screening tool and guidelines; and HCWs fearing infection and not being motivated. We recommend training for and quality monitoring of TB diagnosis and treatment with a focus on patient-centred care, an effective sputum transport system, provision of the TB symptom screening tool and consistent referral pathways from peripheral ...

A Large-Scale Screening Responding Sporadic Epidemic of COVID-19 in China by an Integrated Health-Care System

In the post-pandemic period of COVID-19, the majority of cities in China try to balance the normalization of epidemic prevention and social-economic development. However, the appearance of asymptomatic infected patients poses threats to public health, which might be infectious without clinical symptoms and only be detected by testing approaches. Along with the appearance of one symptomatic case, a regional large-scale screening program was carried out in Shenzhen City charged by a regionally integrated healthcare system. The large-scale screening contributed to preventing epidemic transmission. The integrated healthcare system coordinating regional medical institutions and optimizing regional medical recourse had advantages to address ...

Have we forgotten the moral justification for patient-centred care?

Patient-centred care has attracted intense attention over the last 50 years. First articulated in the late 1960s, and inspired by Roger’s Client-Centred Therapy and Balint’s concept of the therapeutic relationship, its early focus was on the relationship between a patient and their physician. Over the last couple of decades, patient-centred care has become a foundation for health professional education, a guiding principle for health disciplines and an explicit focus of the patient-centred medical home. Perhaps the debates about frameworks, definitions and terminology have distracted us. Is it time for educators, researchers and clinicians to move their focus beyond ...

Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce

While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory. Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. 

Supporting retention in HIV care through a holistic, patient-centred approach: a qualitative evaluation

HIV is a complex disease which affects different facets (social, economic, physical, emotional and spiral) of an individual’s life, making the goals of retention in care and adherence to treatment difficult to achieve. Holistic patient-centred approaches to providing care for people living with HIV bind together economic, social, emotional and physiological aspects and have the potential to improve retention in care and ART adherence. Case management is a holistic, patient-centred approach which is increasingly being implemented in the management of chronic illnesses.

Facilitating integration through team-based primary healthcare: A cross-case policy analysis of four Canadian provinces

Team-based care can improve integrated health services by increasing comprehensiveness and continuity of care in primary healthcare (PHC) settings. Collaborative models involving providers from different professions can help to achieve coordinated, high-quality person-centred care.

In Canada, five key components were found that influenced IPHC and integrated health services: patient-centred care; team structures; information systems; financial management; and performance measurement. 

Representations of personalised medicine in family medicine: a qualitative analysis

The promise of personalised medicine (PM) to transform healthcare has sparked great enthusiasm in the last years. Yet, its lack of consensus around the nature and scope of the concept has ended in terminological confusion amongst the users in primary care. We aimed to investigate the perceptions of doctors and their patients in response to this evolving concept.

Integrated care in Western Europe: a wise solution for the future?

Integrated care (IC) is a term commonly adopted across the world underpinning a positive attitude against fragmentation of healthcare service provision. While the principles supporting IC are simple, their implementation is more controversial.

Framework for countries to achieve an integrated continuum of long-term care

The framework for countries to achieve an integrated continuum of long-term care identifies key aspects necessary to achieve an integrated continuum of long-term care service provision and to facilitate the integration of long-term services within existing health and social care systems.

The framework will guide countries in assessing system-level components to implement sustainable and equitable long-term care actions. By applying this framework, countries can begin to develop and shape their long-term care systems as part of their universal health coverage programmes and promote investment in long-term care and the health workforce, including carers.

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Nurses’ perceived barriers to the delivery of person-centred care to complex patients: A qualitative study using theoretical domains framework

Complex patients have multiple physical and mental health problems, and their life is also greatly affected by sociocultural and economic determinants of health. These patients require person-centred care, but nurses often find it challenging to provide effective care to these patients due to their complex health needs. This study aims to determine nurses’ perceived barriers to the delivery of person-centred care to complex patients with multiple chronic conditions in acute care settings.