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Mats Gustafsson, Chief Physician Psychiatry Psychosis unit Sahlgrenska University Hospital

The implementation of person-centred care at the Psychiatry/ Psychosis unit, Sahlgrenska University Hospital resulted in a re-think.

 

The Chief Physician Mats Gustafsson at The Psychiatry Psychosis Unit, Sahlgrenska University Hospital, testifies that person-centred psychosis care gives all the patients as well as care personnel a more active role in the care process.

A collaboration venture between the University of Gothenburg and the Sahlgrenska University Hospital/Östra has been working with person-centred care (PCC) for the past couple of years. The development of person-centred care is being coordinated at the University of Gothenburg Centre for Person-centred care (GPCC). GPCC is a Swedish multidisciplinary research centre inaugurated in 2010, supported by the Government’s strategic investment in care research.

In person-centred care, the patients are seen as being more than their illness. Patients are whole persons with many resources along with their challenges. Person-centred care emanates from the patient’s perception of his/her situation, and the individual’s preconditions, resources and barriers. Thus, the patient becomes a partner in the care process.

Person-centred care is a partnership between patients, close family, friends and the professional care givers. The outset is the patient narrative. Noted down in a structured way along with the medical assessment, the patient narrative is the basis for the care plan. In a dialogue between the patient, physician, contact person and possibly other invited people, Psychiatry Psychosis aims to achieve an agreement in each patient case regarding the care plan consisting of goals and strategies to be carried out and followed up in the short and the long term.

Psychiatry/Psychosis Operations Manager Pia Rydell decided a few years ago that all four 24-hour closed wards were to participate in person-centred care research.

– We call this method PCPC – person-centred psychosis care, says Chief Physician Mats Gustafsson at Psychiatry Psychosis, Sahlgrenska University Hospital.

Person-centred care is hopefully more efficient

As the patient little by little is given a more active responsibility for his/her care, Psychiatry/Psychosis is hoping that care given to each patient automatically will become more efficient. Even in orthopaedics, normally not so affected by person-centred nursing methods, the Swedish care has noticed some very positive results on the duration of the hospital stay after the implementation of person-centred care.

– The goal with PCPC is that the patient after being discharged from 24-hour care should feel like he/she has been treated like a human being, been listened to and been involved in the dialogue regarding his/her care and care plan.

The 24-hour care at Psychiatry Psychosis is receiving support from GPCC Implement, a non-profit company started by the GPCC to help different organisations to implement person-centred care.
Following the first phase, the implementation has slowed down slightly
– We need to focus on the core issues and that we really are getting the patient on board, and that his/her narrative is being included when working out his/her care plan.

A pilot-group is developing the contact person’s responsibility for the patient

Now, the 24-hour care team is working in a pilot group with the specialist nurse Eva Andreasson as their supervisor. The group is developing the method for the contact person’s collaboration with the patient. The contact person is a health care professional with special responsibility for a given patient.

The working group will be talking to patients in order to find out which are the important success factors in psychosis care.
There is no ready-made template for how PCPC should be applied. Each contact person develops his/her method for applying PCPC together with the patient. It has never happened in the past that psychosis care staff has been involved in the research and development of new working methods.
– Basically, PCPC is about changing the attitudes and the routines for all our staff.

A new type of relationship between the health care professional and the patient

PCPC is about a new type of relationship between the health care professional and the patient. The partnership in PCPC is built on mutual respect between the patient and the care giver and seeing each other as human beings without stepping outside of their roles as professionals and patients.

– The nature of the dialogue when deciding whether to commit a patient to compulsory treatment becomes totally different if the physician doesn’t start by investigating the patient’s problems but who the person is as a whole.

The decision to commit the patient and give him/her compulsory treatment may still become relevant but the decision will be based on grounds that are much more respectful.
– Our approach to psychosis patients has to change and we need to see them as capable persons even though many of them are having major problems. More or less all patients want to take care of themselves and not be a bother or a burden for others. This is possible to a much higher extent than we thought earlier on.

Positive healthcare outcomes with PCPC

Possible effects from PCPC may be more motivated health care professionals, fewer coercive measures and a more structured handling of Human Rights in psychosis care. With PCPC, the contact person shares a more active responsibility for having dialogues with the patient about his/her disease.

– Not all of our staff are used to having this type of responsibility for the patient. Therefore, it is important to increase the competence of all our staff, their self-confidence and ability to take responsibility for collecting the patient’s narrative and to support the patient in managing his/her illness.

The physicians also need to allow other healthcare professionals to take more responsibility in the treatment.

TEXT: Oskar Brandt
 

Page Manager: Jeanette Tenggren Durkan|Last update: 12/13/2018
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