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Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis

BACKGROUND: The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm t...

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Autores principales: Boeykens, Dagje, Boeckxstaens, Pauline, De Sutter, An, Lahousse, Lies, Pype, Peter, De Vriendt, Patricia, Van de Velde, Dominique
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8815876/
https://www.ncbi.nlm.nih.gov/pubmed/35120137
http://dx.doi.org/10.1371/journal.pone.0262843
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author Boeykens, Dagje
Boeckxstaens, Pauline
De Sutter, An
Lahousse, Lies
Pype, Peter
De Vriendt, Patricia
Van de Velde, Dominique
author_facet Boeykens, Dagje
Boeckxstaens, Pauline
De Sutter, An
Lahousse, Lies
Pype, Peter
De Vriendt, Patricia
Van de Velde, Dominique
author_sort Boeykens, Dagje
collection PubMed
description BACKGROUND: The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm the treatment goals can be in contrast with what patients value. The concept of goal-oriented care is proposed as an alternative way of providing care as meeting patients’ goals could have potential benefits. Though, there is a need to translate this concept into tangible knowledge so providers can better understand and use the concept in clinical practice. The aim of this study is to address this need by means of a concept analysis. METHOD: This concept analysis using the method of Walker and Avant is based on a literature search in PubMed, Embase, Cochrane Library, PsychInfo, CINAHL, OTSeeker and Web of Science. The method provides eight iterative steps: select a concept, determine purpose, determine defining attributes, identify model case, identify additional case, identify antecedents and consequences and define empirical referents. RESULTS: The analysis of 37 articles revealed that goal-oriented care is a dynamic and iterative process of three stages: goal-elicitation, goal-setting, and goal-evaluation. The process is underpinned by the patient’s context and values. Provider and patient preparedness are required to provide goal-oriented care. Goal-oriented care has the potential to improve patients’ experiences and providers’ well-being, to reduce costs, and improve the overall population health. The challenge is to identify empirical referents to evaluate the process of goal-oriented care. CONCLUSION: A common understanding of goal-oriented care is presented. Further research should focus on how and what goals are set by the patient, how this knowledge could be translated into a tangible workflow and should support the development of a strategy to evaluate the goal-oriented process of care.
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spelling pubmed-88158762022-02-05 Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis Boeykens, Dagje Boeckxstaens, Pauline De Sutter, An Lahousse, Lies Pype, Peter De Vriendt, Patricia Van de Velde, Dominique PLoS One Research Article BACKGROUND: The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm the treatment goals can be in contrast with what patients value. The concept of goal-oriented care is proposed as an alternative way of providing care as meeting patients’ goals could have potential benefits. Though, there is a need to translate this concept into tangible knowledge so providers can better understand and use the concept in clinical practice. The aim of this study is to address this need by means of a concept analysis. METHOD: This concept analysis using the method of Walker and Avant is based on a literature search in PubMed, Embase, Cochrane Library, PsychInfo, CINAHL, OTSeeker and Web of Science. The method provides eight iterative steps: select a concept, determine purpose, determine defining attributes, identify model case, identify additional case, identify antecedents and consequences and define empirical referents. RESULTS: The analysis of 37 articles revealed that goal-oriented care is a dynamic and iterative process of three stages: goal-elicitation, goal-setting, and goal-evaluation. The process is underpinned by the patient’s context and values. Provider and patient preparedness are required to provide goal-oriented care. Goal-oriented care has the potential to improve patients’ experiences and providers’ well-being, to reduce costs, and improve the overall population health. The challenge is to identify empirical referents to evaluate the process of goal-oriented care. CONCLUSION: A common understanding of goal-oriented care is presented. Further research should focus on how and what goals are set by the patient, how this knowledge could be translated into a tangible workflow and should support the development of a strategy to evaluate the goal-oriented process of care. Public Library of Science 2022-02-04 /pmc/articles/PMC8815876/ /pubmed/35120137 http://dx.doi.org/10.1371/journal.pone.0262843 Text en © 2022 Boeykens et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Boeykens, Dagje
Boeckxstaens, Pauline
De Sutter, An
Lahousse, Lies
Pype, Peter
De Vriendt, Patricia
Van de Velde, Dominique
Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title_full Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title_fullStr Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title_full_unstemmed Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title_short Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis
title_sort goal-oriented care for patients with chronic conditions or multimorbidity in primary care: a scoping review and concept analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8815876/
https://www.ncbi.nlm.nih.gov/pubmed/35120137
http://dx.doi.org/10.1371/journal.pone.0262843
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