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Person-centred care dialectics-Inquired in the context of palliative care.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
Kanada.
Kanada.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Sophiahemmet högskola.
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2017 (English)In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 18, no 4Article in journal (Refereed) Published
Abstract [en]

Although a widely used concept in health care, person-centred care remains somewhat ambiguous. In the field of palliative care, person-centred care is considered a historically distinct ideal and yet there continues to be a dearth of conceptual clarity. Person-centred care is also challenged by the pull of standardization that characterizes much of health service delivery. The conceptual ambiguity becomes especially problematic in contemporary pluralistic societies, particularly in the light of continued inequities in healthcare access and disparities in health outcomes. Our aim was to explicate premises and underlying assumptions regarding person-centred care in the context of palliative care with an attempt to bridge the apparently competing agendas of individualization versus standardization, and individuals versus populations. By positioning person-centredness in relation to the hermeneutics of the self according to Paul Ricœur, dialectics between individualization and standardization, and between individuals and populations were constructed. The competing agendas were related in a dialectic manner in the way that population health is of importance for the individual, and standardization is of importance for the population. The analysis suggests that person-centred care is an ethical stance, which gives prominence to both suffering and capability of the individual as a person. The dialectic analysis points towards the importance of extending person-centred care to encompass population and societal perspectives and thereby avoiding a problematic tendency of affiliating person-centred care with exclusively individualistic perspectives. Considerations for person-centred palliative care on micro-, meso- and macrolevels conclude the paper.

Place, publisher, year, edition, pages
2017. Vol. 18, no 4
Keywords [en]
End of life, Family, Hermeneutics, Nursing philosophy, Palliative care, Patient, Patient-centred, Person-centred, Public health nursing
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:esh:diva-6652DOI: 10.1111/nup.12177PubMedID: 28497868OAI: oai:DiVA.org:esh-6652DiVA, id: diva2:1183009
Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-16Bibliographically approved

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