Person-centred care in the Dutch primary care setting: Refinement of middle-range theory by patients and professionals

Abstract

In a previous rapid realist review (RRR) of international literature insight was provided into how, why, and under what circumstances person-centred care (PCC) in primary care works (or not) among others for people with low health literacy skills and for people with a diverse ethnic and socioeconomic background, by establishing a middle-range programme theory (PT), which describes the relationship between context items, mechanisms, and outcomes. Since the application of PCC in primary care in the Dutch setting is expected to differ from other countries, the objective of this study is to validate the items (face validity) resulting from the RRR for the Dutch setting by assessing consensus on the relevance of items. Four focus group discussions with patient representatives and patients with limited health literacy skills (n = 14), and primary care professionals (n = 11) were held partly combined with a Delphi-study. Items were added to refine the middle-range PT for the Dutch primary care setting. These items indicated that in order to optimally align care to the patient tailored supporting material that is developed together with the target group is important, next to providing tailored communication. Healthcare providers (HCPs) and patients need to have a shared vision and set up goals and action plans together. HCPs should stimulate patient’s self-efficacy, need to be aware of the patient’s (social) circumstances and work in a culturally sensitive way. Better integration between information and communications technology systems, flexible payment models, and patients access to documents, and recorded consultations should be in place. This may result in better alignment of care to the needs of patients, improved accessibility to care, improved patient’s self-efficacy, and improved health-related quality of life. On the long-term higher cost-effectiveness and a higher quality of healthcare can be realised. In conclusion, this study shows that for PCC to be effective in Dutch primary care, the PT based on international literature was refined by leaving out items and adding new items for which insufficient or sufficient consensus, respectively, was found.

Citation
Ahmed A, van den Muijsenbergh METC, Vrijhoef HJM (2023) Person-centred care in the Dutch primary care setting: Refinement of middle-range theory by patients and professionals. PLoS ONE 18(3): e0282802. https://doi.org/10.1371/journal.pone.0282802

Editor
Sara Rubinelli, Universitat Luzern, SWITZERLAND

Received
July 25, 2022; Accepted: February 22, 2023; Published: March 9, 2023

Copyright
© 2023 Ahmed et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All data generated or analysed during this study are included in this article and its supplementary information files.
Funding: Panaxea B.V. received funding for this study from the Dutch National Health Care Institute (grant number: 2017055441). The funding party had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the article for publication.
Competing interests: The authors have declared that no competing interests exist.