Introduction
Person-centred care (PCC) is a fundamental concept in contemporary healthcare, particularly within the field of adult nursing. It prioritises the individual needs, preferences, and values of patients, ensuring they are at the heart of clinical decision-making. As a student of adult nursing, understanding PCC is essential for delivering compassionate and effective care, especially in a diverse and complex healthcare environment like the UK’s National Health Service (NHS). This essay aims to explore the definition and key principles of PCC, its historical development, and its practical application in adult nursing. Additionally, it will discuss the challenges and benefits of implementing this approach, supported by evidence from academic literature and official health guidelines. By examining these aspects, the essay seeks to highlight the significance of PCC in improving patient outcomes and fostering therapeutic relationships.
Defining Person-Centred Care
Person-centred care is often described as a holistic approach to healthcare that respects and responds to the unique circumstances of each individual. According to the Health Foundation (2016), PCC involves treating patients as partners in their care, ensuring their voice is heard in decisions about treatment and support. This contrasts with traditional, paternalistic models of healthcare, where decisions were predominantly made by professionals with little patient input. The concept is grounded in the belief that care should not only address physical health but also emotional, social, and psychological needs.
A seminal framework for understanding PCC comes from the work of Tom Kitwood (1997), who initially developed the concept in the context of dementia care. Kitwood argued that care must affirm a person’s identity, promote inclusion, and provide comfort, rather than reducing individuals to their diagnoses. This perspective has since been adapted across various healthcare settings, including adult nursing, where it underpins policies and guidelines such as those outlined by the Nursing and Midwifery Council (NMC) (2018). The NMC Code emphasises the need to prioritise people, ensuring their dignity and autonomy are upheld in all interactions (NMC, 2018). Thus, PCC is not merely a theoretical ideal but a practical standard for nursing practice.
Historical Context and Development
The evolution of PCC reflects broader shifts in healthcare philosophy over the past century. Historically, medical care in the early 20th century was often disease-focused, with little regard for patient individuality. However, by the mid-20th century, thinkers like Carl Rogers, a psychologist, introduced humanistic approaches that emphasised empathy and individual experience in therapeutic settings (Rogers, 1951). These ideas gradually influenced healthcare, leading to the formalisation of PCC in clinical practice.
In the UK, the concept gained prominence through policy initiatives in the late 1990s and early 2000s. The NHS Plan (2000) marked a turning point by advocating for patient involvement in care decisions, a principle that has since been reinforced by frameworks like the NHS Constitution (Department of Health and Social Care, 2015). These documents underscore the importance of tailoring care to individual needs, a principle that is particularly relevant in adult nursing where patients often present with complex, chronic conditions requiring personalised interventions. While the historical trajectory of PCC demonstrates progress, it also reveals ongoing challenges in fully integrating this approach into overstretched healthcare systems, a point that will be elaborated upon later.
Key Principles and Application in Adult Nursing
The application of PCC in adult nursing is guided by several core principles, including respect for patient autonomy, effective communication, and the promotion of dignity. Firstly, respecting autonomy involves recognising a patient’s right to make informed decisions about their care. For instance, when managing a patient with diabetes, a nurse might collaborate with them to develop a manageable treatment plan that aligns with their lifestyle, rather than imposing a rigid regimen. This empowers patients, fostering a sense of control over their health (Entwistle and Watt, 2013).
Secondly, effective communication is vital for PCC. Nurses must actively listen to patients’ concerns and provide clear, accessible information. This is particularly crucial when dealing with older adults or those with cognitive impairments, where misunderstandings can lead to distress. The Royal College of Nursing (RCN) highlights that empathetic communication builds trust, which is foundational for therapeutic relationships (RCN, 2016). Finally, promoting dignity ensures that patients are treated with respect, regardless of their condition or circumstances. Simple actions, such as ensuring privacy during personal care, exemplify this principle in daily practice.
In practical terms, PCC is evident in care planning and delivery within the NHS. For example, individualised care plans for patients with long-term conditions often incorporate their personal goals and preferences, ensuring that interventions are meaningful to them. However, implementing PCC is not without challenges, as discussed in the following section.
Challenges and Benefits of Person-Centred Care
While the benefits of PCC are widely acknowledged, its implementation in adult nursing can be complex. One significant challenge is resource constraints within the NHS. Time pressures and staffing shortages often limit the ability of nurses to engage deeply with patients on an individual level. A study by McCormack et al. (2010) found that nurses frequently struggle to balance administrative duties with the time-intensive demands of PCC, which can lead to inconsistent application. Furthermore, cultural and language barriers may hinder effective communication, particularly in diverse communities, requiring additional training and resources to address these issues.
Despite these challenges, the benefits of PCC are substantial. Research indicates that it can lead to improved patient satisfaction, better adherence to treatment plans, and enhanced health outcomes (Ekman et al., 2011). For instance, patients who feel valued and involved in their care are more likely to follow medication regimes, reducing hospital readmissions. Moreover, PCC fosters a positive working environment for nurses by strengthening therapeutic relationships and reducing burnout through meaningful patient interactions. Therefore, while obstacles exist, the potential rewards of PCC justify efforts to overcome them.
Conclusion
In conclusion, person-centred care is a cornerstone of modern adult nursing, emphasising the importance of tailoring healthcare to individual needs, preferences, and values. This essay has explored the definition and principles of PCC, tracing its historical development and examining its practical application within the NHS. While challenges such as resource limitations and communication barriers persist, the benefits of improved patient outcomes and satisfaction underscore the necessity of this approach. For nursing students and professionals alike, embedding PCC into practice is not only a professional obligation, as outlined by the NMC Code, but also a pathway to delivering compassionate and effective care. Looking forward, ongoing training and systemic support within healthcare organisations are essential to fully realise the potential of PCC, ensuring that patients remain at the heart of nursing practice.
References
- Department of Health and Social Care. (2015) The NHS Constitution for England. GOV.UK.
- Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., … & Sunnerhagen, K. S. (2011) Person-centered care—Ready for prime time. European Journal of Cardiovascular Nursing, 10(4), 248-251.
- Entwistle, V. A., & Watt, I. S. (2013) Treating patients as persons: A capabilities approach to support delivery of person-centered care. American Journal of Bioethics, 13(8), 29-39.
- Health Foundation. (2016) Person-centred care made simple. Health Foundation.
- Kitwood, T. (1997) Dementia Reconsidered: The Person Comes First. Open University Press.
- McCormack, B., Dewing, J., Breslin, L., Coyne-Nevin, A., Kennedy, K., Manning, M., … & Tobin, C. (2010) Developing person-centred practice: Nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing, 5(2), 93-107.
- Nursing and Midwifery Council. (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. NMC.
- Rogers, C. R. (1951) Client-Centered Therapy: Its Current Practice, Implications, and Theory. Houghton Mifflin.
- Royal College of Nursing. (2016) Principles of Nursing Practice. RCN.
