Seeing the Elephant: A Systematic Scoping Review and Comparison of Patient-Centeredness Conceptualizations from Three Seminal Perspectives

• Main Authors: Olson AW, Stratton TP, Isetts BJ, Vaidyanathan R, Van Hooser JC, Schommer JC
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-04-01
• Series: Journal of Multidisciplinary Healthcare
• Subjects: patient-centeredness; medicine; nursing; health policy; pharmacy; systematic scoping review
• Online Access: https://www.dovepress.com/seeing-the-elephant-a-systematic-scoping-review-and-comparison-of-pati-peer-reviewed-fulltext-article-JMDH

Anthony W Olson,1,2 Timothy P Stratton,2 Brian J Isetts,3 Rajiv Vaidyanathan,4 Jared C Van Hooser,2 Jon C Schommer3 1Research Division, Essentia Institute of Rural Health, Duluth, MN, USA; 2Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota – College of Pharmacy, Duluth, MN, USA; 3Department of Pharmaceutical Care and Health Systems, University of Minnesota – College of Pharmacy, Minneapolis, MN, USA; 4Department of Marketing, University of Minnesota Duluth – Labovitz School of Business and Economics, Duluth, MN, USACorrespondence: Anthony W Olson 502 E 2nd Street, Duluth, MN, 55805, USATel [phone]Fax [phone]Email [e-mail]: “Patient-Centeredness” (PC) is a theoretical construct made up of a diverse constellation of distinct concepts, processes, practices, and outcomes that have been developed, arranged, and prioritized heterogeneously by different communities of professional healthcare practice, research, and policy. It is bound together by a common ethos that puts the holistic individual at the functional and symbolic center of their care, a quality deemed essential for chronic disease management and health promotion. Several important contributions to the PC research space have adeptly integrated seminal PC conceptualizations to improve conceptual clarity, measurement, implementation, and evaluation in research and practice. This systematic scoping review builds on that work, but with a purpose to explicitly identify, compare, and contrast the seminal PC conceptualizations arising from the different healthcare professional groups. The rationale for this work is that a deeper examination of the underlying development and corresponding assumptions from each respective conceptualization will lead to a more informed understanding of and meaningful contributions to PC research and practice, especially for healthcare professional groups newer to the topic area like pharmacy. The literature search identified four seminal conceptualizations from the healthcare professions of Medicine, Nursing, and Health Policy. A compositional comparison across the seminal conceptualizations revealed a shared ethos but also six distinguishing features: (1) organizational structure; (2) predominant level of care; (3) methodological approach; (4) care setting origin; (5) outcomes of interest; and (6) language. The findings illuminate PC’s stable theoretical foundations and distinctive nuances needed to appropriately understand, apply, and evaluate the construct’s operationalization in contemporary healthcare research and practice. These considerations hold important implications for future research into the fundamental aims of healthcare, how it should look when practiced, and what should reasonably be required of it.Keywords: patient-centeredness, medicine, nursing, health policy, pharmacy, systematic scoping review