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Collaborative care planning as a person-centred practice -Interpreted synthesis of four empirical studies and their results

Author:

Ingela Jobe

Luleå University Of Technology, Sweden, SE
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Abstract

Introduction: To involve patients in decision-making has been a guiding principle for many decades. Paternalistic approaches have gradually been losing ground and policies of person-centredness have become the norm in health and social care¹.  Collaborative care planning, taking place at primary health care with professionals from health and social care, can be used to facilitate coordination and integrate the person’s perspective in the decision-making process.  A PhD project carried out, 2017-2020, explored the collaborative care planning process between health and social care organizations as a person-centred practice.

Method: With the aim to achieve deeper knowledge and understanding of collaborative care planning as a person-centred practice an interpreted synthesis of four empirical studies and their results was conducted. The studies described different aspects and challenges of the collaborative care planning taking place between health and social care organizations for older adults 65 years and above². A framework based on the French philosophers Paul Ricoeur’s little ethics and the ethical intention of “aiming for a good life with and for others in just institutions” was used for the analysis. The synthesis revealed two common threads: personhood and power asymmetry.

Highlights: All the professionals said they conducted the collaborative care planning as a person-centred practice. However, the older adults expressed feelings of being invisible and they wanted to be seen and acknowledged as unique persons in their own context. By accepting to participate in the collaborative care planning process, the older adults stepped into the unknown, reinforcing their vulnerability. They were dependent on the professionals' willingness to acknowledge them and involve them as partners in the process. Using critical dialectic of interpretations would allow the collaborative care planning to be a forum where the participants together, could consider and discuss their different perspectives. There is a need for a variety of perspectives to be able to create a complete picture of the older adult's situation and co-create a new understanding. By challenging the collaborative care planning with a constructive conflict perspective and affirm reciprocity the outcome, the collaborative care plan will improve and facilitate the participants' continuous partnership.

Conclusion: Collaborative care planning is a complex process. However, Ricoeur’s philosophy contributed to a greater understanding of the collaborative care planning as a person-centred practice and accentuated that ethics, human values, and the older adults and care partners perspectives need to be given the same importance and considerations as the medical and social sciences perspectives for the collaborative care planning to truly become person-centred.

Implications for applicability: Transformation of practice is not easy and requires insights and actions on all levels of the organisations. Health and social care organisations are relational practices and organisations. During the collaborative care planning the older adults, their care partners and the health and social care professionals become interwoven. The organizations and professionals need to be permeated of ethics and human values, and these must be visible in every action and practice.
How to Cite: Jobe I. Collaborative care planning as a person-centred practice -Interpreted synthesis of four empirical studies and their results. International Journal of Integrated Care. 2022;22(S3):2. DOI: http://doi.org/10.5334/ijic.ICIC22262
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Published on 04 Nov 2022.

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