Recognition of client values as a basis for tailored care: the view of Dutch expert patients and family caregivers

• Published in: Scandinavian journal of caring sciences Vol. 19; no. 2; pp. 169 - 176
• Main Authors: Schoot, Tineke, Proot, Ireen, Meulen, Ruud ter, de Witte, Luc
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-06-2005
• Subjects: Adult; Attitude of Health Personnel; Bioethics; Caregivers - psychology; Carers; Chronic Disease - psychology; Client centred practice; client perspective; client-centred care; Clinical Competence; Continuity of Patient Care - standards; Decision Making, Organizational; demand-driven care; expert patients; Family - psychology; Female; Focus Groups; Grounded theory; Health care; Health Care Reform - organization & administration; Humans; Male; Middle Aged; Models, Psychological; National Health Programs - organization & administration; Needs Assessment - organization & administration; Netherlands; nurse-client interaction; Nurse-Patient Relations; Nursing; Nursing Methodology Research; Nursing Staff - psychology; Patient Participation - methods; Patient Participation - psychology; Patient-Centered Care - organization & administration; Patients - psychology; Personal Autonomy; Qualitative Research; Quality of care; recognition; Supply and demand; tailored care; Value systems; Netherlands; Empirical Approach; Professional Patient Relationship
• ISSN: 0283-9318; 1471-6712
• DOI: 10.1111/j.1471-6712.2005.00327.x

In the Netherlands confusion is signalled about the introduction of new care concepts like demand‐oriented care. The aim of this article is to explore the phenomenon ‘interaction aimed at care tailored to the client demand’ as seen by expert clients: patients and their family caregivers. Focus interviews were held with expert patients and expert family caregivers of the ‘Dutch Council of the Chronically ill and the Disabled’. Grounded theory methodology was used to analyse the results.
Recognition by the professional of client values underlying their demand (uniqueness, comprehensiveness, continuity of life, fairness and autonomy) and underlying the care‐relationship (equality, partnership and interdependence) emerged as central element within the interaction. Feelings of recognition with the client seem to reinforce autonomy, self‐esteem and participation. Recognition was optimally felt in a dialogue. Four professional competencies could be identified related to recognition: attentiveness (ongoing actions to know and understand the patient); responsiveness (active, committed and responsible care guided by respect of patient identity); being a critical partner in care (giving and grounding professional opinion and discuss boundaries); being a developer of client competencies (facilitating and developing client participation within care). The findings offer possibilities to operationalize care concepts aimed at tailored care. Further research aimed at refining and testing the hypothesis developed is recommended.