L’atenció centrada en la persona a Catalunya: identificació de les seves bases a partir d’un procés de participació i consens

Trabal Tañá, Rosa Maria
Introduction: Person-Centred Care (PCC) considers the preferences, needs and values of individuals and allows them to participate in clinical decision making. The PCC appears as a result of the need to provide an adequate answer to the new challenges posed by the current social, medical, epidemiological, economic and demographic context; and the growing interest of the health system to meet the needs of the people. In addition, there is clear evidence of the beneficial effects of the PCC for individuals and their families, professionals, communities and for the health system. Objective: The objective of this study was to describe the process of participation and consensus of various stakeholders in order to identify the basis of the model PCC in the region of Catalonia in relation to the following dimensions: health literacy, rights and responsibilities, shared decision making, planning decisions on anticipated demand and non-attendance healthcare model. Methodology: Descriptive study of a process of participation and consensus through a stage of development of nominal groups and a step of verification and synthesis of the results. It was conducted in the region of Catalonia with professionals from the Catalan Institute of Health (ICS) from different disciplines and areas of attention, members of the Expert Patient Programme Catalunya® and representatives of the society. A modified version of the nominal group technique was used for data collection. Up to 200 people were selected and distributed in 5 groups according to each of the dimensions of the PCC. The participants of the study were asked to get consensus on proposals to reach a suitable model for PCC within ICS by 2025. Afterwards, 28 people undertook a process of verification and synthesis of the results of the technical consensus. Results: Among all the proposals made by the 5 groups, a total of 10 key elements were identified for the development of PCC, which are mainly related to the organization level. Categorization of the proposals shows that developing healthcare models is the most important action. Regarding the elements of consensus about what should be done, there was only consensus between two groups in one of the five dimensions concerning the prioritization of the proposals. While for proposals on what should be changed, there was consensus in three dimensions. Conclusions: The nominal group technique facilitated the involvement of participants when proposals were presented. The implementation of the PCC requires a change of the model and of the healthcare strategies were individuals aret he focus of attention. The main proposals agreed by participants in all dimensions of the PCC are that, on one hand, suitable information should be provided to users so they can participate in decision-making, and on the other hand, training of professionals should be improved to enable the PCC. The PCC focuses mainly on the organizational level ​
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