Table 2 Strategies to tailor patient-centred care for women
PCC domain | Themes and corresponding strategies |
|---|---|
Foster a healing relationship | Establish rapport • Engage in brief, friendly discussion prior to clinical discussion • Ask patients to share some information about themselves • Share some information about yourself to find common Build trust • Listen to the patient • Adopt non-judgmental facial expression/tone of voice • Make eye contact by facing the patient (not a computer) • Sit in a relaxed manner across or beside the patient |
Exchange information | Explore patient context • Set aside clinical agenda/allocate time to explore patient context • Identify contextual factors such as age, lifestyle, culture or race, and socioeconomic status • Discuss patient values and goals/revisit over time Assess and support patient knowledge • Ask patients what they understand about their health care issue, condition or treatment • Use lay language • Employ visual aids to supplement discussion • Ask patients to summarize details in their own words |
Address emotions or concerns | Elicit emotions or concerns • Ask if patient has emotions, concerns, worries or discomfort • Allocate time to discuss those issues Validate emotions or concerns • Assure patient that what they feel is normal and common • Provide enough time for patient to fully express themselves • Allow the patient to take breaks if needed or revisit the topic at a later time Provide or refer to supportive resources • Provide advice or informational material about issues causing emotions or concerns, or to help patient manage them • Refer women to resources: informational material, support groups, social worker, etc. |
Manage uncertainty | Acknowledge uncertainties • Explicitly mention uncertainties about prognosis, and the risks and benefits of treatment options • Discuss uncertainties related to patient’s contextual factors (i.e. age, lifestyle, health status) Provide educational material • To supplement discussion, provide educational material to help patients understand the nature, risk and impact of uncertainties |
Make decisions | Collaborate on decisions • Describe available management options • Ask patients about preferences given their contextual factors • Allow patient to make final choice; otherwise, they may not comply Involve family members or care partners • If desired by the patient, extend collaboration to family members or care partners • Invite them to ask questions by telephone • Involve them in appointments |
Enable self-management | Offer flexible follow-up options • In addition to traditional in-person visits, offer home-based follow-up through telephone or computer Tailor self-care plans • Jointly plan self-management strategies with patients to accommodate preferences and contextual factors • Provide instructions and informational material to support self-care including how to self-monitor health and what to do if symptoms change or worsen • Refer patients to informational material or support groups |
Additional conditions | Ensure privacy so that women feel safe and comfortable sharing information • Offer women-only hours or services • Maintain a separate waiting area or clinic space for women • Provide access to female clinicians Accommodate children so that women can seek care/manage their own health • Allow women to bring children to appointments • Offer a play area or child care • Maintain flexible appointment schedules (evening/weekend) for women who must remain at home with children during the day |