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Adv Health Sci Educ Theory Pract ; 24(2): 353-381, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30632026

RESUMO

While person-centred care has gained increasing prominence in recent decades as a goal for healthcare systems, mainstream implementation remains tentative and there is a lack of knowledge about how to develop person-centred care in practice. This study therefore aimed to explore what may be required in order for person-centred care programmes to be successful. The study used an ethnographic method of data collection. This consisted of closely following an implementation programme on a medical emergency ward in a Swedish hospital. Data consisted of participant observation and informal interviews with healthcare providers and their management leaders while they were in the process of training to use person-centred care. These interlocutors were using action learning methods under the guidance of facilitators. Our findings revealed that although the programme resulted in some of the processes that are central for person-centred care being developed, organisational factors and a lack of attention to ethics in the programme counteracted these positive effects. The study highlights the importance of facilitating mechanisms to produce desired results. These include management leaders' learning about the dynamic and collective nature of learning processes and change. They also include allowing for inter-professional dialogue to enable managers and professionals to reflect deeply on professional boundaries, disciplinary knowledge and power relations in their teams. Teamwork is essential for the development of person-centred care and documentation, in accordance with this specific implementation programme, is also indispensable. The space for inter-professional dialogue should also accommodate their various perspectives on the aims of care and organizational reality.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Pessoal de Saúde/educação , Equipe de Assistência ao Paciente/organização & administração , Assistência Centrada no Paciente/organização & administração , Aprendizagem Baseada em Problemas/organização & administração , Antropologia Cultural , Processos Grupais , Humanos , Comunicação Interdisciplinar , Liderança , Pesquisa Qualitativa , Suécia
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