Person-centered care (PCC) has traditionally been equated with patient-centered care. The Institute of Medicine describes patient-centered care as including qualities of compassion, empathy, respect and responsiveness to the needs, values, and expressed desires of each individual patient. It is inclusive of care that ensures that patient values guide clinical decisions (IOM, 2001, pp. 48-50). However, it is worth noting that person-centered care is more holistic and inclusive of family, significant others, context, prevention, promotion, and preferences, among other elements (Santana et al., 2018). In their concept analysis of person-centered care, Morgan and Yoder (2011) identified four attributes of person-centered care, which includes that it is holistic, individualized, respectful, and empowering. They further stated that leaders in person-centered care environments set the tone for how they and others enact and maintain a person-centered care culture and that they put the relationship before the task when planning and delivering care.
A person-centered care philosophy is uniquely supported by Jean Watson’s definition of nursing and the ten carative factors that she identified in her theory of nursing. Watson defined nursing as, “a human science of persons and human health-illness experiences mediated by professional, personal, scientific, esthetic and ethical human transactions” (Watson, 2007, p. 54). The crucial carative or caring factors as identified by Watson that support her theory, include altruism, enabling of faith and hope, sensitivity to self and others, human care (helping and developing trust), allowing for and accepting of positive and negative expressions of feelings, using creative problem solving solutions, being authentic when coaching / teaching, practicing from a position of dignity and respect (protective and corrective), providing for basic human needs and attending to life changes such as supporting a peaceful death (Wagner, 2010, pp. 3-7; Watson, 2007, p. 75) .
Kristen Swanson in her theory of caring (1991; 1993) describes nursing practice as including passion and commitment; viewing the other with high regard; being physically, emotionally and mindfully present while conveying the message that the patient is not alone; performing activities to assist in health, recovery or when the other is unable to care for self or when the patient needs assistance with a peaceful death/transition. The last phase of her theory, enabling, includes various forms of communication, including touch, support, and presence.
A third theorist, Madeleine Leininger, adds to our understanding of the connection between nursing care and culture in Culture Care Diversity & Universality: A Theory of Nursing (Leininger, 1991). The strength of this theory is the acknowledgement and inclusion of culture and context in our caring behaviors when engaging with others who believe, hold and practice various perspectives. It asks us to think about the stated and unstated needs of all people and to develop interventions that are respectful and intentionally inclusive of the lifeways of those for whom we provide care.
The Center for Medicare and Medicaid Services (CMS) has endorsed person-centered care as critical to providing quality care. The following model illustrates this perspective and identifies the components underpinning person-centered care.
Questions and exercises to consider with classmates and/or colleagues:
Patient-Centered Care: Elements, Benefits and Examples Resources complied by Health Leads
What is Patient-Centered Care? NEJM Catalyst Article
Putting Patients Back at the Center of Healthcare: How CMS Measures Prioritize Patient-Centered Outcomes (February 2020) An Article from the Editors of Health Catalyst
Leininger, M.M. (2001). Culture Care Diversity and Universality: A Theory of Nursing. New York, NY: Jones and Bartlett Publishers.
Morgan, S.S. & Yoder, L. (2012). A concept analysis of person-centered care. Journal of Holistic Nursing, 30(1), 6-15. doi: 10.1177/ 0898010111412189.
Swanson, K. (1991). Empirical development of a middle range theory of caring. Nursing Research, 40, 161-166.
Swanson, K. (1993). Nursing as informed caring for the well-being of others. Image: Journal of Nursing Scholarship, 25(4), 352-357.
Wagner, A.L. (2010). Evolution of Jean Watson’s Carative Factors/Caritas Processes Over Time. Boulder, CO: Watson Caring Science Institute.
Watson, J. (2007). Nursing: Human Science and Human Care: A Theory of Nursing. Boston, MA: Jones and Bartlett Publishers.