How to Answer There Potential Misunderstanding Questions (Complete Guide)

Understanding this question requires applying core subject principles.

What This Question Is About

This question relates to there potential misunderstanding and requires a structured academic response.

How to Approach This Question

Break the problem into smaller parts and analyze each logically.

Key Explanation

This topic involves there potential misunderstanding. A strong answer should include explanation, application, and examples.

Original Question

There is potential for a misunderstanding between patients, providers, and policy makers of what patient-centered care is. This study sets out to understand what health care professionals delivering maternity services understand by the term patient-centered care. Our focus is on how providers delivering patient-centered care believe they enhance care for all women, and in particular, vulnerable women. We used The Commonwealth Fund’s definition of vulnerability. It includes people without health insurance, low-income families, and racial and ethnic minorities. The concept of patient-centered care has gained traction in health care organizations over the last few years. Evidence shows that practicing elements of patient-centered care can produce favourable outcomes such as reduction in the utilization of health care services and related costs, improvement in patient and family satisfaction with care increased patient adherence to medication regimen, and a reduction in decisional conflict between patients and clinicians Authors who describe patient-centered care include the provision of health promotion and self-care as part of the process of delivering patient-centered care The heterogenous effects of patient-centered care may be related to the lack of a generalized definition of patient-centered care. The Institute of Medicine’s frequently cited definition says it “entails medical care processes that ensure decisions regarding the care received respects each patient’s wants, needs and preferences, and for which the patient has the education and support he or she needs to make decisions and participate in his or her own care” . The Institute of Patient and Family-Centered Care, which is a US not for profit organization, sets out four core constructs: respect and dignity, information sharing, participation, and collaboration . Understanding how professionals approach the concept of patient-centered care in maternity services may help us to ensure that clinicians and policy makers, who cite the benefits of patient-centered care, understand each other’s perspectives. It may also help organizations to commission or deliver maternity care to vulnerable women more effectively and in doing so improve the quality of care they offer to all pregnant women. Our research questions were(i)How do clinicians describe patient-centered care?(ii)How does being patient-centered affect how care is delivered?(iii)Are the answers different for vulnerable populations? And if so, how? . Methods In 2013 Childbirth Connection (now part of the National Partnership for Women and Families) released its Listening to Mothers 3 report. This report investigated women’s views on how maternity care was delivered across the geographical United States. The authors were careful to represent all demographics in the survey. We developed a qualitative interview guide using(i)Listening to Mothers 3,(ii)NHS choices a freely available patient comment, rating and information website run by the UK’s National Health Service,(iii)Kaiser Permanente’s HCAHPS survey responses from 2008 to 2014. We used a qualitative approach to explore what clinicians think patient-centered care is and whether it is different for vulnerable patients. We wanted to draw out whether there were differences in what patient-centered care meant when treating different patients, in terms of health status, health care coverage, income, area of domicile, socioeconomic status, and racial profile. We chose qualitative investigation in preference to quantitative methods as qualitative study is more suited to understanding the beliefs, qualities, and motivations of professionals . We wanted to capture the potentially diverse views of different maternity service clinicians across various types of organizations. We used a purposive sampling approach. This also increased transferability of our results. We spoke to 16 individuals, undertaking 13 interviews and one focus group, lasting between 40 and 90 mins. The interviews were semi structured and followed a written interview guide. The interview guide was piloted and received specific IRB approval. The guide was divided into three main sections. We asked clinicians to explain What gave them joy at work.(2)What they thought patient-centered care was and their opinion of the construct. We then asked them to expand their thoughts on patient-centered care in the light of a clinical scenario whereby a woman requested a Caesarean section. At the end of each section, we prompted the clinicians to say whether and how their answers would be different for a vulnerable woman. This paper reports on the latter two sections. We planned to speak to obstetricians, midwives, family physicians, and physician’s assistants across 9 sites in California and Virginia that were chosen to represent the diversity of women treated by providers. We originally approached 15 sites for interviewees. The basic demographic data of our participants is available in Table 1. Nine sites provided at least one person for interview; six sites did not. After agreeing to be interviewed, no participants refused to participate; however one site withdrew prior to interview because of illness. No participants withdrew after interview. All the interactions were face to face and undertaken by the same person in the interviewee’s office or home. No other person was present during the interviews. The interviewer had undergone training with The Commonwealth Fund prior to undertaking the first interview. The interviews were carried out between January and May 2015. During the interview, the interviewer’s position as a visiting obstetrician from outside the country was stressed with the aim of enhancing the interviewer’s credibility and encouraging candid response. Field notes were taken during the interview. Table 1 Participants’ demographics and other relevant information. The organization types involved were a large managed care organization and two smaller fee-for-service physician groups. In California, the population covered by the clinicians we interviewed was mixed, ranging from the affluent areas of the Napa Valley to the less affluent areas of the California Central Valley. In Virginia, the populations were mainly a mixture of women covered by private insurers and Medicaid (the U.S. government program, financed by federal, state, and local funds, of hospitalization and medical insurance for persons of all ages within certain income limits). The interviews were recorded and professionally transcribed verbatim. The transcripts were read before being coded using an inductive approach by two separate coders, using Atlas.ti® v7 (Berlin, Germany). One coder (TA) was the interviewer; the other coder was a nonclinician with experience of the social sciences and qualitative research (DS) to improve triangulation [15]. A preliminary code book was developed independently by each coder after the first two interviews. The transcripts were then reviewed by both coders and each code was systematically discussed with the other coder to ensure congruence in the development of the code book. These steps were performed each time after two interviews had been transcribed. After transcript six, the code book was sense-checked by JC. The systematic discussion after each transcription continued to ensure that saturation was achieved. The codes were thematically analyzed and then relationships between the codes were defined using linkages and co-occurrences between codes. The study was approved by the Northern California Kaiser Permanente IRB.

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