Person-centred care: clarifying the concept in the context of inpatient psychiatry

In nursing science, concept development is a necessary prerequisite for meaningful basic research. Rodgers' evolutionary concept analysis is a method for developing knowledge in nursing science. The purpose of this article is to present Rodgers' evolutionary concept analysis as a valid scientific method. A brief description of the evolutionary process, from data collection to data analysis, with the concepts' context, surrogate and related terms, antecedents, attributes, examples and consequences, is presented. The phases used in evolutionary concept analysis are illustrated with eight actual studies (1999-2009) from nursing research. The strength of the method is that it is systematic, with a focus on clear-cut phases during the analysis process, and that it can contribute to clarifying, describing and explaining concepts central to nursing science by analysing how a chosen concept has been used both within the discipline itself and other health sciences. While an interdisciplinary perspective which stresses the similarities and dissimilarities of how a concept is used in various disciplines can increase knowledge of a concept, it is important to clarify the specific with the discipline. Nursing research should focus on the unambiguous use of concepts, for which Rodgers' method constitutes a possible method. The importance of using quality criteria to determine the inclusion of material should, however, be emphasised in the continued development of the method. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Patient-centered care, shared decision-making, patient participation and the recovery model are models of care which incorporate user involvement and patients' perspectives on their treatment and care. The aims of this paper are to examine these different care models and their association with user involvement in the mental health context and discuss some of the challenges associated with their implementation. The sources used are health policy documents and published literature and research on patient-centered care, shared decision-making, patient participation and recovery. The policy documents advocate that mental health services should be oriented towards patients' or users' needs, participation and involvement. These policies also emphasize recovery and integration of people with mental disorders in the community. However, these collaborative care models have generally been subject to limited empirical research about effectiveness. There are also challenges to implementation of the models in inpatient care. What evidence there is indicates tensions between patients' and providers' perspectives on treatment and care. There are issues related to risk and the person's capacity for user involvement, and concerns about what role patients themselves wish to play in decision-making. Lack of competence and awareness among providers are further issues. Further work on training, evaluation and implementation is needed to ensure that inpatient mental health services are adapting user oriented care models at all levels of services.