An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes

Esther Li Ping Lim; Rebecca Hui Shan Ong; Johan Thor; Monika Allgurin; Boel Andersson Gäre; Julian Thumboo

doi:10.5334/ijic.7564

An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes

Int J Integr Care. 2023 Nov 24;23(4):11. doi: 10.5334/ijic.7564. eCollection 2023 Oct-Dec.

Authors

Esther Li Ping Lim^{1

2

3

4}, Rebecca Hui Shan Ong⁵, Johan Thor^{1

6}, Monika Allgurin¹, Boel Andersson Gäre^{1

6

7}, Julian Thumboo^{8

9

10}

Affiliations

¹ School of Health and Welfare, Jönköping University, Jönköping, Sweden.
² Allied Health Division, Singapore General Hospital, Singapore.
³ Centre for Person-centred Care, Singapore Health Services, Singapore.
⁴ Population Health and Integrated Care Office, Singapore General Hospital, Singapore.
⁵ Health Services Research, Changi General Hospital, Singapore.
⁶ Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.
⁷ Futurum, Region Jönköping County, Jönköping, Sweden.
⁸ SingHealth Office of Regional Health, Singapore Health Services, Singapore.
⁹ SingHealth Centre for Population Health Research and Implementation, Singapore Health Services, Singapore.
¹⁰ Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.

Abstract

Introduction: The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners' PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of "caring about the service user as a whole person" and the "sharing of power, control and information".

Methods: A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points - before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time.

Results: A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to "care" than to "share power" with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3).

Conclusion: Training as a specific intervention, appeared to have potential to increase health practitioners' person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.

Keywords: advocacy; coproduction; integrated care; person-centred care; power; practitioners; training.

Grants and funding

This paper is part of ELPL’s PhD work partially supported by the SingHealth Talent Development Fund Scholarship FY2019, Lee Kuan Yew Scholarship Fund (199104843M), and FY2019 Singapore General Hospital Scholarship. ELPL has no access to any publication budget at Jönköping University.