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The integration of a person-centered approach in palliative care

Published online by Cambridge University Press:  07 February 2013

Mireille Lavoie ,
Danielle Blondeau  and
Isabelle Martineau
Mireille Lavoie*
Affiliation:
Faculté des Sciences Infirmières, Université Laval, Centre de recherche du Centre Hospitalier Universitaire du Québec – L'Hôtel-Dieu de Québec, Québec, Canada
Danielle Blondeau
Affiliation:
Faculté des Sciences Infirmières, Université Laval, Centre de recherche du Centre Hospitalier Universitaire du Québec – L'Hôtel-Dieu de Québec, Québec, Canada
Isabelle Martineau
Affiliation:
Maison Michel-Sarrazin, Québec, Canada
*
Address correspondence and reprint requests to: Mireille Lavoie, Faculté des Sciences Infirmières, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Université Laval, Québec (Québec), G1V 0A6Canada. E-mail: mireille.lavoie@fsi.ulaval.ca
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Abstract

Objective:

The philosophy underlying palliative care places the respect of patients and their autonomy at the heart of clinical practice. A study was conducted at a palliative care facility to document changes that occurred after the integration of a person-centered approach focusing on human freedom (which is linked to autonomy): the humanbecoming school of thought. It aimed to describe changes observed in the beliefs and practices of healthcare providers, the concept and respect of autonomy by healthcare providers, care and respect of autonomy experienced by patients' relatives, and consideration of patients' wishes through their documentation.

Method:

The method adopted consisted of a pre-project – process – post-project descriptive qualitative design and was inspired by teaching-learning and mentoring models. Data were collected from 51 healthcare providers and 10 relatives through semistructured interviews and from the medical records of 30 patients during the pre- and post-project phases. They were analyzed and compared at the end of the study. The process phase consisted of offering training sessions and mentoring, encouraging the involvement of healthcare providers, and cocreating integration and care tools.

Results:

While the analysis exposed some discrepancies with the language of the approach and differences between nurses and other healthcare providers, it revealed, above all, similarities in the changes observed between the different sources of data. The focus moved from being task-centered to being person-centered; the affirmation of the priority of respecting patients' choices, desires, and needs; a presence shifting from being available to true listening; the affirmation of following the ever-changing rhythm of the patient; and a notion of respect of autonomy now including the other.

Significance of results:

In line with the philosophy of palliative care, the project demonstrated that the integration of the humanbecoming approach can result in changes that contribute to the development of a more person-centered practice.

Keywords

Palliative careAutonomyPerson-centered approachHumanbecoming
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 6 , December 2013 , pp. 453 - 464
Copyright
Copyright © Cambridge University Press 2013 

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