Person-centred care: more than just improving patient satisfaction?

This editorial refers to ‘Effects of person-centred care in patients with chronic heart failure: the PCC-HF study’†, by I. Ekman et al. , on page 1112 ARTICLE Health policy has increasingly signalled a move away from an emphasis on specific organs and disease, towards placing the ‘whole’ person at the centre of medicine.1 The health professional must try to understand what the illness means for the individual, within a social and psychological context. This necessitates listening to that particular person's point of view, with the ultimate goal of sharing responsibility with them.2 Clinicians should learn to ask not only ‘what is the matter?’, but ‘what matters?’ In other words, what are the patient's interests, concerns, and fears about the specific conditions, symptoms, or treatment options?3 This moves us from the strictly biomedical view to a broader bio-psycho-social and spiritual view, with power shared between the healthcare professional and the patient.4 Despite widespread pressure for a move from the paternalistic ‘doctor knows best’ approach, progress has been rather slow. All agree that improved communication between patients and professionals is a legitimate goal, but a survey across several developed countries has reported that the majority of patients are not asked for their ideas or opinions about treatment.5 This is particularly troubling as disease management shifts towards chronic rather than acute disease. Many factors influence how person-centred the interactions between a healthcare professional and a patient may be, including the characteristics of the patient and the professional, the context of the interaction, and …