Person Centered Care Foundations Shared Decision Making and Self Management
Key Points
- Person-centered care integrates patient goals, values, social context, and beliefs into care planning.
- Shared decision-making and self-management support improve outcomes in chronic and complex care.
- Physical, emotional, and spiritual needs should be assessed together rather than in isolation.
- Developmental stage and life events can change care preferences and barriers over time.
Pathophysiology
Person-centered care is a care-delivery framework, not a disease mechanism. It shapes how nurses gather cues, prioritize problems, and co-create plans with patients and families. Better alignment between the care plan and patient priorities improves adherence, engagement, and continuity.
When care excludes preferences or context, distress rises and participation often falls. By contrast, person-centered planning supports trust, realistic goals, and safer decisions during changing clinical conditions.
Classification
- Patient-centered care: Emphasizes active patient participation, communication, and coordinated services.
- Person-centered care: Expands focus to social, cultural, and spiritual values with individualized goals and preferences.
- Holistic care: Integrates mind, body, and spirit, including complementary approaches when safe and appropriate.
Nursing Assessment
NCLEX Focus
Priority questions test whether the nurse elicits values and preferences before finalizing interventions.
- Assess patient goals, beliefs, and preferred role in shared decision-making.
- Assess physical and physiologic priorities such as pain, mobility, elimination, and safety.
- Assess emotional factors such as fear, grief, anxiety, and readiness for self-management.
- Assess spiritual preferences, practices, and desired supports.
- Assess developmental and life-event factors that may alter coping, consent, and treatment participation.
Nursing Interventions
- Use shared decision-making to compare options and align plans with patient priorities.
- Teach self-management skills with clear language and return-demonstration where needed.
- Coordinate interdisciplinary resources for complex physical, emotional, and spiritual needs.
- Involve family or legal decision makers according to patient preference and capacity.
- Reassess goals after major transitions, new diagnoses, or significant life events.
Preference-Plan Mismatch
Plans that ignore values, developmental context, or spiritual preferences increase nonadherence and avoidable poor outcomes.
Pharmacology
Pharmacologic treatment remains important, but outcomes improve when medication plans are built into a person-centered strategy that supports understanding, adherence, and ongoing self-management.
Clinical Judgment Application
Clinical Scenario
A postoperative patient reports uncontrolled pain, fear of another procedure, and requests prayer support before treatment decisions.
Recognize Cues: Physical, emotional, and spiritual needs are all active. Analyze Cues: Single-domain planning will likely fail. Prioritize Hypotheses: Immediate priorities are pain control, safety, and trust-building. Generate Solutions: Use shared decision-making, add spiritual support, and provide clear self-management teaching. Take Action: Implement the interdisciplinary plan and document preferences. Evaluate Outcomes: Participation and symptom control improve.
Related Concepts
- person-and-family-centered-care - Expands inclusive family and identity-sensitive care implementation.
- organizational-culture-patient-centered-collaborative-and-safety-frameworks - Connects person-centered goals to team and system workflows.
- self-management-and-collaborative-chronic-care - Operationalizes long-term self-management support.
- holistic-health-and-interventions - Adds whole-person and complementary intervention strategies.
- spiritual-assessment-and-patient-centered-care-planning - Provides structured spiritual inquiry and planning.
Self-Check
- How is person-centered care broader than patient-centered care in daily nursing decisions?
- Which findings signal the need to update a care plan after a life event?
- Why should self-management support be treated as an ongoing process rather than a single education event?