Person-centred care Resources

Welcome to another issue of the JCN, which, as always, includes articles relevant to your day-to-day practice. I was particularly interested to read the editorial from the Queen’s Institute of Community Nursing on its new Faculty of Homeless and Inclusion Health, and would encourage you all to find out more and get involved. This focus on inclusion and equity is reinforced by Rebecca Bullingham’s important article on health equity, which explores the relationship between language, health equity and community nursing. The terminology we use matters, as it can influence how people are perceived, how they experience services and their access to care. Rebecca highlights the importance of looking beyond individual practice to consider how systems and services can change to reduce health inequalities and ensure that everyone can access care that meets their needs.

Here we talk to Lexi Chambers, a former nurse and Army veteran, whose experience of illness has turned personal adversity into extraordinary achievements. After choosing to undergo below-knee amputation in 2019 as a result of complex regional pain syndrome (CRPS), Lexi went on to face further health challenges, including nerve issues and fibromyalgia, and more than 20 surgeries. Her experiences as both a nurse and patient have given her a unique perspective on healthcare, recovery and the importance of compassionate, person-centred care. Now a seven-time Guinness world record holder, with further records in the pipeline, she reflects on her nursing career, her experiences on the other side of healthcare, and what has driven her to achieve so much despite adversity.

Here, Ellie Lindsay OBE, founder and lifetime president of the Lindsay Leg Club Foundation, looks at how innovations in technology and an increased focus on patient-centred care positively influenced her experience of undergoing hip replacement surgery.

Modern healthcare requires an integrated approach, bringing together diverse disciplines to meet the physical and non-physical needs of individuals. In orthopaedic care, particularly hip replacement, technological innovation has dramatically improved patient outcomes, while person-centred care ensures that these outcomes are meaningful for everyone. The hip replacement model, from which I have recently benefitted, offers valuable lessons for us all.

Lymphoedema is a chronic condition that can lead to pain, reduced mobility, and significant emotional and psychosocial burden. While standardised patient-reported outcome measures capture physical and psychological impacts, they may overlook important aspects of the lived experience. This service evaluation aimed to explore patient experiences of lymphoedema at first contact with the service by analysing open-text responses from LYMPROM© submitted to a single lymphoedema service, and to identify concerns not captured by fixed-response items. A retrospective thematic analysis was conducted on 229 anonymised open-text responses submitted via LYMPROM© for patients newly referred to the Swansea Bay University Health Board (SBUHB) lymphoedema service between November 2020 and December 2022. Data were analysed using Braun and Clarke’s six-phase framework, with coding and theme development undertaken collaboratively by three researchers to enhance rigour. Four overarching themes were identified: the burden of multiple comorbidities, disrupted sleep often linked to pain and discomfort, the emotional toll of lymphoedema, and behaviour changes related to social withdrawal and diminished confidence. Patient narratives revealed experiences not easily captured through structured assessment alone. The findings support the integration of narrative data to inform more holistic, person-centred care.

Several crucial documents have identified the need for integrated care to meet patient requirements in the current financial climate, developed from the concepts of self-care and joining up care to improve health outcomes. These include the Five Year Forward View (2014), Next Steps on the Five Year Forward View (2017), NHS Long Term Plan (2019) and now the introduction of the Health and Care Act (2022) — all of which provide a contextualised approach to care. Integrated care is aimed at the way that organisations work together to support self-care (which incorporates the principles of holistic care considering physical, emotional, social, spirtual and ecomonc health [Mills, 2017]), with a commitment to improve patient outcomes by avoiding confusion and repetition. It  enhances comprehensive care planning by listening to patients — perhaps best summed up by the phrase, ‘No decision about me, without me’ (Department of Health [DH], 2012).

Storytelling is the act of telling or writing stories, or narratives. Typically, stories are told for entertainment, for informational or educational purposes. Telling stories and storymaking is integral to our human consciousness and lived experience

Here, Ellie Lindsay OBE explores why, with the increased use of virtual technology in health care, good communication skills are more vital than ever to ensure person-centred, holistic care.

The evolution of technology and electronic devices, such as smart phones, has greatly influenced the way we communicate today, improving the speed and ease of reaching out to others. But, the downside of the speed of, for example, a text messaging service, may be that individuals are no longer taking the time to converse in person and to be truly present — in mind and body.