Journal of evaluation in clinical practice
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General practice (GP) plays a core role in managing the clinical pathways of patients with chronic diseases. Despite well-established knowledge of the benefits of involvement and personalized care, involvement in GP appears to be challenged. This study aimed to explore patient involvement in GP from the patients' perspectives. ⋯ The six themes describing involvement in GP from the perspectives of patients with T2DM and/or COPD were deeply intertwined. Involvement is dependent on being seen, met and heard, all of which contribute to the patients' sense of feeling safe (or not). These aspects are dependent on accessibility to a general practitioner; thus, COVID-19 was a barrier during the data-collection period. Furthermore, it appeared that being resourceful not only contributed to a sense of being involved in GP but was perhaps even a prerequisite for being involved.
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Centred around the thesis that for those engaged in clinical practice there are two worlds present in parallel, this article defines the characteristics of the supposed second, qualitative world. Contrasting these characteristics to those of the world as seen in continuous metric dimensions of space and time, we derive the nature of the qualitative elements and their coherent interaction, as well as the rules governing these dynamic elements' interactions. ⋯ Following this theoretical process, two practical consequences are drawn. The first consists of an advanced model of biopsychosocial interaction, as extensively published throughout the years. The second presents the concept of quality-oriented self-aid groups open to all exposed to or working in care and healthcare. The corresponding training helps practitioners to consciously and deliberately move, perceive, and perform in the duplicity of worlds, the one the conventional quantifying, metric one, the other the mostly rationally unknown world emerging from qualifying interactive agency.
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Delivering quality healthcare services to people has become a core issue for the Bhutanese healthcare system. There are considerable challenges for healthcare policymakers to recognise and implement an appropriate healthcare model to enhance quality healthcare services in the Bhutanese healthcare system. ⋯ This article provides a brief concept analysis of person-centred care in the context of the Bhutanese socio-political and healthcare environment and describes why it is important to integrate person-centred care into the healthcare system. The article argues that person-centred care is important and relevant to the Bhutanese healthcare system to achieve quality healthcare services and Gross National Happiness.
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Shared decision making (SDM) is the process whereby patients and healthcare professionals work together to achieve a consensus management decision, based on best clinical evidence and patient's preferences. No formal approach to documentation of SDM conversations exists in setting of peri-operative medicine. ⋯ The BRAN tool is adaptable to many health decision settings, including discussions related to treatment, investigations, and procedures, which expands its potential to improve patient safety.