Care in emergencies and disasters: Can it be person-centered?

Amir Khorram-Manesh; Lesley Gray; Krzysztof Goniewicz; Annelise Cocco; Jamie Ranse; Phatthranit Phattharapornjaroen; Nebil Achour; Jarle Sørensen; Mahmoudreza Peyravi; Attila J Hertelendy; Kevin Kupietz; Jana Bergholtz; Eric Carlström

doi:10.1016/j.pec.2023.108046

Care in emergencies and disasters: Can it be person-centered?

Patient Educ Couns. 2024 Jan:118:108046. doi: 10.1016/j.pec.2023.108046. Epub 2023 Nov 1.

Affiliations

¹ Centre for Person-centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Disaster Medicine Center, Gothenburg University, 405 30 Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska Academy, 413 45 Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden. Electronic address: amir.khorram-manesh@surgery.gu.se.
² Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand; Joint Centre for Disaster Research, Massey University, Wellington, New Zealand.
³ Department of Security, Polish Air Force University, Dęblin, Poland.
⁴ Translational Health Research Institute, Western Sydney University, Sydney, Australia.
⁵ Department of Emergency Medicine, Griffith University, Gold Coast, QLD 4215, Australia; Menzies Health Institute, Griffith University, Gold Coast, QLD 4215, Australia.
⁶ Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden; Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
⁷ School of Allied Health, Anglia Ruskin University, East Road, Cambridge CB1 1PT, United Kingdom.
⁸ USN School of Business, University of South-Eastern Norway, 3199 Borre, Norway.
⁹ Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁰ Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, Florida, USA; Fellowship in Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, Boston, MA, USA.
¹¹ Department of Aviation and Emergency Management, Elizabeth City State University, Elizabeth, NC, USA.
¹² Centre for Person-centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Disaster Medicine Center, Gothenburg University, 405 30 Gothenburg, Sweden; European Cavernoma Alliance, Rare Diseases Sweden, P.O. Box 1386, 17227 Sundbyberg, Sweden.
¹³ Centre for Person-centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Disaster Medicine Center, Gothenburg University, 405 30 Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska Academy, 413 45 Gothenburg, Sweden; USN School of Business, University of South-Eastern Norway, 3199 Borre, Norway.

PMID: 37924742
DOI: 10.1016/j.pec.2023.108046

Abstract

Objectives: While person-/patient-centered care aims to influence policymakers' rules and regulations to improve the care of individuals worldwide, exploration of the concept in the context of disaster and public health emergencies as an alternative ethical approach is lacking. This study aims to provide a nuanced understanding of the advantages and challenges of diverse ethical approaches in emergencies, to improve patient care.

Methods: A survey, created after several rounds of Delphi methodology, with 22 statements, was applied to 39 participants from nine different countries. The questionnaire's results, including participants' comments, were analyzed.

Results: The results show that practitioners chose to use a combination of diverse ethical approaches in managing victims of disasters and public health emergencies.

Conclusion: The selection of an approach is context- and situation-dependent and seems to primarily respond to the nature of underlying etiology, creating a possibility to use diverse approaches to offer individualized care on a later occasion and when a flexible surge capacity is available.

Practice implications: The outcomes of this study will enhance the future ethical discussion in person/patient-centered care during situations with limited resources and help to develop necessary ethical and educational guidelines.

Keywords: Disaster; Healthcare; Patient-centered; Person-centered; Public Health.

MeSH terms

Delivery of Health Care*
Disasters*
Emergencies*
Humans
Patient-Centered Care*
Public Health