Person Centered Medicine

Description

The 21st is being recognized as the Century of the Person, particularly in Medicine and Health. Person Centered Medicine, as a concept and global programmatic movement developed in collaboration with the World Medical Association, World Health Organization, International Council of Nurses and 30 other institutions over a decade of annual Geneva Conferences, places the whole person as the center of health and as the goal and protagonist of health actions. Seeking the person at the center of medicine, has meant a medicine of the person, for the person, by the person and with the person. Articulating science and humanism, it strives for a medicine informed by evidence, experience and values and aimed at the restoration and promotion of health for all.   The textbook on Person Centered Medicine reviews this perspective as it has evolved to date and its resulting knowledge base. The book structure encompasses an Introduction to the field and four sections on Principles, Methods, Specific Health Fields, and Empowerment Perspectives. Its 42 chapters are authored by 105 clinician-scholars from 25 different countries across world regions (North America, Latin America, Europe, Africa, the Middle East, Asia and Oceania). Its vision and goals involve total health for a total person. Ongoing work and upcoming publications would focus on redesigning health systems fit to purpose, and integrating ancestral knowledge and wisdom, community members’ self- and mutual-care, advances in medical science, and the contributions of health-relevant social sectors.       Contents Contributors Chapter 1: Introduction to Person Centered Medicine 1.1 Introduction 1.2 Historical Development of Person Centered Medicine 1.3 Collaborative and Institutional Development of Person Centered Medicine 1.4 Conceptual Development of Person Centered Medicine 1.4.1 Systematic Conceptualization and Measurement of Person-centered Medicine and Care 1.4.2 The Person-Centered Integrative Diagnosis Model 1.5 Scholarly Development of Person Centered Medicine 1.5.1 Research on Person-Centered Diagnosis 1.5.2 Research on Person-Centered Care 1.5.3 Educational Programs on Person-Centered Healthcare 1.5.4 The International Journal of Person Centered Medicine 1.5.5 The Person-Centered Books Program 1.6 Presentation of the Person Centered Medicine Book 1.6.1 Section Highlights 1.7 Colophon References Part I: Principles of Person Centered Medicine Chapter 2: Historical Overview of Person Centered Medicine 2.1 Introduction 2.2 Pre-history (Up to 4000 BC) 2.3 Early History (4000 BC to 476 AC) 2.4 Middle Age (476–1493 AC) 2.4.1 Pre-islamic Period 2.4.2 Islamic Medicine Golden Age 2.4.3 Other Salient and Late Middle Age Events 2.5 Modern Age (1493–1789) 2.5.1 Impact of Travel and Publications 2.5.2 Influence of Religion and Churches 2.5.3 Further Advances in Medicine 2.6 Contemporary Age (1789–Present) 2.7 Articulating Person Centered Medicine Concepts and Historical Eras 2.8 Conclusions References Chapter 3: Ontological and Epistemological Bases of Person Centered Medicine 3.1 Introduction 3.2 Objectives 3.3 Approaches to Fulfil the Objectives and Knowledge Base #1: The Ontological Presuppositions of PCM 3.4 Approaches to Fulfil the Objectives and Knowledge Base #2: The Epistemological Presuppositions of PCM 3.5 Other Necessary Conditions for PCM? 3.6 Practical Implications 3.7 Discussion and Conclusions References Chapter 4: Human Rights, Ethics and Values in Person Centered Medicine 4.1 Introduction 4.1.1 Mutual Recognition 4.1.2 Identity 4.2 Inclusion and Forgiveness 4.3 Core Values 4.4 The Importance of Dialogue 4.4.1 Consensus 4.5 Human Rights 4.6 Highlighting the Articles of the UN Declaration of Human Rights 4.7 The WHO Constitution 4.8 The UN International Covenant on Economic, Social and Cultural Rights 4.9 Criteria for Right to Health 4.10 Limitations of the Health and Human Rights Perspective 4.10.1 Ethical Principles 4.10.2 Virtue Ethics 4.10.3 Casuistry 4.10.4 Deontological Theory 4.10.5 Utilitarianism 4.11 Principlism 4.12 Practical Application of Ethical Principles 4.13 Instilling Ethics in Medical Education 4.14 The Essence of Medical Professionalism 4.15 The Eight Characteristics of a Profession 4.15.1 Code of Ethics 4.15.2 The Physician’s Pledge 4.15.3 Autonomy 4.15.4 Morality and Integrity 4.15.5 Altruism 4.15.6 Knowledge 4.15.7 Service 4.15.8 Accountability 4.15.9 Professional Associations 4.16 Conclusions References Chapter 5: Holistic Framework in Person Centered Medicine 5.1 Introduction: Zooming-In and Zooming-Out in Medicine 5.2 Zooming-Out from Patient-Centered Medicine to Person-Centered Medicine 5.3 The Concept of a Person in a Holistic Framework 5.4 The Concept of Health in a Holistic Framework 5.4.1 What Is a Healthy Personality? 5.4.2 Benefits of Promoting Well-Being 5.5 Conclusion: A Holistic Perspective on Both a Person and Health References Chapter 6: Individualized Care in Person Centered Medicine 6.1 Introduction 6.2 Narrative Competence and Individualized Care 6.2.1 Person-Physician Relationship and the Importance of a Person’s Narrative 6.2.2 The Inner Consultation 6.2.3 The Clinical Consultation 6.2.4 Listening 6.2.5 Effective Practice 6.2.6 Ethical Framework 6.2.7 Integrating Knowledge into Clinical Practice 6.2.8 Gothenburg Model of Person-Centred Healthcare 6.3 Multilevel Person-Centered Assessments and Individualized Care 6.3.1 The Person-centered Integrative Diagnosis Model: From Disease Focus to Whole Health Focus 6.3.2 Person-Centered Approach as a Promising Model for Individualized Care 6.3.2.1 Ill Health Status 6.3.2.2 Contributors to Ill Health 6.3.2.3 Experience of Ill Health 6.3.2.4 Positive Health Status 6.3.2.5 Contributors to Positive Health 6.3.2.6 Experience of Positive Health 6.3.3 Shared Decision Making 6.3.4 Life Course and Continuing of Care 6.3.4.1 Risk and Protective Factors Influencing the Life Course 6.3.4.2 The Need for a New Perspective on Healthcare 6.4 Conclusions References Chapter 7: Communication and Relationships in Person Centered Medicine 7.1 Introduction 7.2 The Nature of Doctor-Patient Communication 7.2.1 Incorporating the Tangible and Intangible in Clinical Communication: The Person-Centred Clinical Method 7.3 Inter-professional Relationships for Effective Person Centered Medicine 7.4 The Anthropology of Person-Centred Clinical Communication 7.5 The Ethics of Person-Centred Clinical Communication: The Clinical Encounter 7.6 The Essence of Person-Centred Communication 7.7 Conclusions References Chapter 8: People-Centered Health Services 8.1 Overview and Definition 8.2 Context of People-Centered Health Services 8.2.1 Empowering and Engaging People and Communities 8.2.2 Strengthening Governance and Accountability 8.2.3 Reorienting the Model of Care 8.2.4 Coordination of Services Within and Across Sectors 8.2.5 Creating an Enabling Environment 8.3 Methods 8.4 Clinical Fields 8.5 Clinician Perspectives on PCHS 8.6 Alma Ata, Astana and other Major International Declarations 8.7 Policy 8.8 Conclusions References Chapter 9: Person-Centered Health Education and Research 9.1 Introduction 9.2 Overview of Health Care Today and Its Impact on Health Care Professionals 9.3 Person-Centered Health Education: Concepts and Practice 9.3.1 A Proposed Path: The Third or Emerging School 9.3.2 Illustrative Competence-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) 9.4 Person-Centered Health Research 9.4.1 Systematic Conceptualization and Measurement of Person Centered Medicine 9.4.2 Other Person-Centered Health Research Considerations 9.5 Practical Implications of Person-Centered Health Education and Research 9.6 Conclusions References Part II: Methods for Person Centered Clinical Care Chapter 10: Establishing Common Ground, Engagement, and Empathy 10.1 Introduction 10.2 Strategies 10.2.1 Communication 10.2.2 Empathy 10.2.3 Comprehensive Collaborative Diagnosis 10.2.4 Shared Decision Making 10.3 Guiding Considerations 10.4 Implementation 10.5 Conclusions References Chapter 11: Person-Centered Interviewing and Diagnosis 11.1 Introduction 11.2 Person-Centered Clinical Interviewing 11.2.1 Organization of the Clinical Interview 11.3 The Development of Person Centered Diagnosis 11.3.1 Multiaxial Diagnosis and Comprehensive Diagnostic Models 11.3.2 Methodological Advances Leading to the IGDA and GLADP Diagnostic Models 11.3.3 The Person-Centered Integrative Diagnosis (PID) Model 11.3.4 The GLADP-VR Diagnostic Formulation 11.3.4.1 Health Status 11.3.4.2 Health Contributing Factors 11.3.4.3 Health Experiences and Expectations 11.3.5 GLADP-VR Formats for Personalized Diagnostic Formulation 11.4 Exploration of the Bases for Person-Centered Diagnosis in General Medicine 11.4.1 Overview of the Literature Towards Person-Centered Diagnosis in General Medicine 11.4.2 Key Proposals for Person-Centered Diagnosis in General Medicine. 11.5 Discussion 11.6 Conclusions References Chapter 12: Collaborative Treatment Planning 12.1 Introduction 12.2 A Person Is More Than His or Her Symptoms 12.3 How May a Clinician Understand Their Patient? 12.4 Communication Skills for Undertaking Collaborative Treatment Planning 12.5 The Role of the Treatment Plan 12.6 Formulating the Treatment Plan 12.7 Shared Decision Making/Collaborative Treatment Plans vs. Consent 12.8 Collaborative Clinical Team 12.9 Beyond the Basics: Practical Aspects of Undertaking Collaborative Treatment Planning 12.10 Barriers and Challenges to Practising Collaborative Treatment Planning 12.11 Conclusion References Chapter 13: Education and Counselling for Person-Centered Care 13.1 Introduction 13.1.1 Basic Definitions 13.1.2 Disease and the Subjective Reaction to Disease (Psychological or Spiritual “Aching” or “Distress”) 13.2 Education and Counselling in PCM Clinical Practice 13.2.1 Profile of the Patient as a Person 13.3 The General Health Educational Process 13.3.1 Illustratively Understanding the Patient in His Disease Process to Obtain His Collaboration 13.3.2 Illustrative Patient’s Collaboration on His Own Diagnosis and Treatment Formulation 13.3.2.1 On His Diagnosis 13.3.2.2 On His Therapy 13.4 Practical Implications for the Implementation of Person-Centered Care 13.4.1 How to Exercise in Practice a Medical Act Centered on the Person 13.5 Conclusions References Chapter 14: Narrative Medicine 14.1 Introduction 14.2 What Is Narrative? 14.3 The Relevance of Narrative to Person-Centred Medicine 14.4 Social Science Approaches to Illness Narratives 14.5 The Limits of Narrative 14.6 Narrative in the Clinical Encounter 14.7 Narrative Methods in Clinical Practice 14.8 Narrative and the Clinical Alliance 14.9 Narrative Interventions 14.10 The Ethics of Narrative and Narrative Ethics 14.11 Teaching and Learning Narrative Medicine 14.12 Conclusions and Implications for Person-Centered Care References Chapter 15: Digital Technology for Person-Centered Care 15.1 Introduction: Why Is a Chapter on Digital Technology Important in a Book on Person-Centered Medicine? 15.2 Scope of Digital Health Technology 15.2.1 List of Domains in Digital Health 15.2.1.1 The Digitized Medical Device 15.2.1.2 The Digitized Clinic/Hospital/Healthcare System 15.2.1.3 The Digitized Patient 15.3 Opportunities for Using Digital Technology in Person-Centered Medicine 15.4 Challenges to Utilizing Digital Health Technology in Person-Centered Medicine, and Strategies to Overcome Them 15.4.1 Challenges Faced by the Person 15.4.2 Challenges Faced by Their Clinician 15.5 Conclusion References Chapter 16: Person-Centered Rehabilitation 16.1 Introduction 16.1.1 Person-Centered Care in Rehabilitation 16.2 Psychiatric Rehabilitation 16.3 For Whom Is Person Centered Psychiatric Rehabilitation (PCPR) Designed? 16.4 Recovery and Person-Centered Psychiatric Rehabilitation 16.5 Basic Recovery Values That Guide PCPR 16.6 The Process: Values Plus Techniques 16.7 Neurorehabilitation: Applied Neuroplasticity and Resilience in Practice 16.7.1 Resilience in Neurological Disorders 16.7.2 The Importance of Neuroplasticity 16.8 Conclusions and Practical Issues on Implementation of Person Centered Care References Chapter 17: Person-Centered Prevention 17.1 Introduction 17.2 The Knowledge Base of Person-Centred Prevention 17.2.1 Prevention Vs Curative Approach 17.2.1.1 Primary Prevention 17.2.1.2 Secondary and Tertiary Prevention 17.2.1.3 Person-Centred Prevention in Psychiatry 17.2.2 The Added Value 17.2.3 The Challenges to Person-Centred Prevention 17.2.4 An Environment Conducive to Person-Centred Prevention 17.2.4.1 Inform and Educate About Healthy Choices 17.3 Opportunistic and Systematic Screening 17.4 Preventable Risk Factors 17.5 Stakeholder Engagement 17.6 The Public Health Laws 17.7 Practical Implications 17.7.1 A Model for Person-Centred Prevention 17.7.2 Assessing the Implementation of Person-Centred Prevention 17.8 Discussion 17.9 Conclusions References Chapter 18: Person-Centered Health Promotion 18.1 Placing the Person at the Center of Health Promotion 18.1.1 What Is Health Promotion? 18.1.2 Obstacles for Individual Health Promotion at the Primary Care Level 18.1.2.1 Persons Centered Health Promotion 18.1.2.2 People Centered Health Promotion 18.2 Evidence-Based Medicine and the Disappearing Person 18.2.1 When There Are No Individuals, Only Categories 18.3 Adding Person-Centered Approaches to Medicine 18.3.1 A First Person’s Story 18.3.2 Population Level Risks: Environment, Social Connectedness and Epigenetics 18.3.3 Individual Risks: Adversity and Resilience 18.4 Person-Centered Health Promotion 18.4.1 The Doctor-Patient Relationship as Medicine 18.5 Research Directions 18.6 Conclusions References Part III: Clinical/Health Fields for Person-Centered Care Chapter 19: Person-Centered Family Medicine and General Practice 19.1 Introduction 19.2 Health Systems Must Become More Responsive to Person-Centered Needs 19.3 Proactive Versus Reactive Approaches in Person-Centered Care 19.4 Person Centered Approaches in Family Medicine and General Practice 19.5 The Seven Shared Principles of Person-Centered Primary Care 19.6 The Value of Person-Centered Primary Care 19.7 The Outcome of the 2015 Geneva Declaration of Person-Centered Primary Healthcare 19.8 The Rural Paradigm and Person-Centered Approach 19.9 Key Factors for the Implementation of a Person-Centered Approach in Family Medicine and General Practice 19.10 Conclusions References Chapter 20: Person-Centered Internal Medicine 20.1 Conceptual Bases of Person-centered Internal Medicine 20.2 Health, Medicine and Professionalism 20.3 The Comprehensive Clinical Approach 20.3.1 Clinical Thinking 20.3.2 Basic Clinical Skills 20.3.3 Primary Health Care and Person-Centered Medicine Considerations 20.4 Generic and Specific Clinical Professional Competences 20.4.1 Generic Clinical Professional Competences 20.4.2 Specific Clinical Professional Competences 20.5 Practical Implications for the Implementation of Person-Centered Clinical Care 20.5.1 Key Factors in Internal Medicine Useful to Evaluate the Implementation of Person-Centered Medicine 20.5.2 The Degree to Which Current Clinical Care Is Person-Centered 20.5.3 Obstacles for the Implementation of Person-Centered Care (Skills, Workload, Financial Aspects, Organization of Services) 20.5.4 What Would Have to Change for the Implementation of Person-Centered Clinical Care 20.5.4.1 Training Level 20.5.4.2 Professional Level 20.5.4.3 Proposed Solution 20.6 Conclusions References Chapter 21: Person-centered Women’s Health and Maternity Care 21.1 Introduction 21.1.1 Why a Chapter on Women’s Health? 21.2 Objectives 21.3 Women as Persons in Medicine: Historical Context 21.4 Definition of Women’s Health 21.5 Women Live Longer but Suffer More 21.6 The Health Workforce Is Predominantly Female 21.7 Person Centered Women’s Health 21.8 Towards Person Centered Women’s Health Care: Safe Maternity Care 21.9 Obstacles and Costs for the Implementation of Person-centered Care 21.10 Considerations in Implementing Person Centered Women’s Health 21.11 Conclusions References Chapter 22: Person-centered Neonatal Health Care 22.1 Introduction 22.2 Approaches to Fulfill the Objectives 22.3 Conceptual Frameworks 22.4 Knowledge Base 22.5 Practical Implications 22.5.1 Around the Time of Birth in the Delivery Room 22.5.2 Transportation from Delivery Room to Neonatal Unit and Referral 22.5.3 Neonatal Unit: Intermediate and Minimal Care Unit 22.5.4 Neonatal Intensive Care Unit 22.5.5 Mother-Infant Ward and Kangaroo Mother Care Ward 22.5.6 Ambulatory Program for all High-Risk Newborns, Including Preterm Infant or Low Birth Weight (LBW) Infants: An Integral FCC Unit up to 40 Weeks and in a Second Step from Term to up 1 or 2 Years of Corrected Age 22.5.7 Obstacles to Person Centered Care and Potential Solutions 22.6 Conclusions References Chapter 23: Person-centered Pediatrics 23.1 Objectives 23.2 Approaches 23.3 Body of Knowledge 23.3.1 Respect the Human Rights of Children 23.3.2 Convention on the Rights of the Child 1989 23.3.3 The Ethics of Paediatric Practice 23.3.4 Sustainable Developmental Goals 23.3.5 The Value of Children 23.3.6 The Importance of Early Development 23.3.7 Empathy 23.3.8 Longitudinal Studies 23.3.9 Integrated Support Throughout Childhood 23.4 Practical Implications for Person Centered Practice 23.4.1 Preventive Strategies for the Child 23.4.2 Person Centred Paediatric Care 23.4.3 Prenatal and Postnatal Care Centered on the Person, the Family and the Community 23.4.4 Person-centred Care and Empowerment in Practice 23.5 Barriers to Empowerment 23.5.1 Empowerment Interventions 23.6 Framework for Paediatric Consultation 23.6.1 Listening 23.6.2 Attention 23.6.3 Attitude 23.6.4 Attire 23.6.5 Accurate Records 23.6.6 Profile 23.7 Barriers to a Change Towards a Fully Person-centred Service 23.8 Conclusions References Chapter 24: Person-centered Geriatric Medicine 24.1 Historical Account 24.2 Person Centered Medicine in the Elderly 24.3 Comprehensive Geriatric Assessment 24.4 Falls and Fractures 24.5 Sarcopenia and Frailty 24.6 Delirium and Dementia 24.7 Practical Implications for Person Centered Care 24.7.1 Key Factors for the Implementation of Person-centered Care in Geriatric Medicine 24.7.2 To What Extent Is Geriatric Medicine Currently Centered on the Person? 24.7.3 Current Obstacles in Geriatric Medicine for the Implementation of Person-centered Care 24.7.4 Changes Necessary to Make the Practice of Geriatric Medicine More Person-centered 24.8 Conclusions References Chapter 25: Person-centered Neurology 25.1 Introduction 25.2 New Knowledge and Their Professional Engagement 25.3 Neuroplasticity 25.4 Resilience 25.5 Activity: Physical and Cognitive 25.6 Assessment of Neurorehabilitation Strategies 25.7 Multidisciplinary and Person-centered Approaches 25.8 Practical Issues in the Implementation of Person-centered Care 25.8.1 Key Factors for the Implementation of Person-centered Care in Neurology 25.8.2 To What Extent Is Neurology Currently Centered on the Person? 25.8.3 Current Obstacles in Neurology for the Implementation of Person-centered Care 25.8.4 Changes Necessary to Make the Practice of Neurology More Person-centered 25.9 Conclusions References Chapter 26: Person-Centered Psychiatry and Psychology 26.1 Introduction 26.2 Person Centered Diagnosis Models 26.3 Person-Centered Approach for Specific Psychiatric Disorders 26.4 Theoretical Consequences for the Treatments in Psychiatry 26.4.1 Pharmacotherapy 26.4.2 Psychotherapy 26.5 Sociotherapy 26.6 Practical Implications for the Implementation of Person-Centered Care in Psychiatry 26.7 Conclusions References Chapter 27: Person-Centered Emergency Medicine 27.1 Introduction 27.2 Person-Centered Care in Emergency Medicine 27.3 Challenges to Person-Centered Care in the Emergency Department 27.4 The Future of Person-Centered Care in Emergency Medicine and Practical Implications 27.5 Conclusions References Chapter 28: Person-Centered Infectious Diseases and Pandemics 28.1 Person Centered Medicine Perspectives on Infectious Diseases and Pandemics 28.1.1 A Person as a Living Being in Nature 28.1.2 The Nature of Infectious Diseases: Relationships Among Human Being, Infectious Agent, and Environment for the Disease to Occur 28.1.3 The Person’s Environment and Infectious Diseases 28.1.3.1 The Community and Infectious Diseases 28.1.3.2 The Reason for Pandemics, Endemics and Epidemics 28.1.3.3 Stigma and Infectious Diseases 28.1.4 The Commitment of the Physician and the Health Authorities 28.1.4.1 Early Diagnosis and Treatment of Infectious Diseases 28.1.4.2 Hospital/Health System and Infectious Diseases 28.1.4.3 Infection Control Measures and the Health Worker 28.2 Evaluation, Treatment and Care of the Person With Covid-19 28.2.1 The Community Response in the Prevention and Control of COVID-19 28.3 Practical Implications for the Implementation of Person Centered Care in Pandemics 28.4 China’s Management of the COVID-19 Pandemic and Its People-Centered Strategies 28.5 Conclusions References Chapter 29: Person-Centered Genetic Counselling 29.1 Introduction 29.2 Non-directiveness as Key Approach 29.3 Developing Models of Care 29.4 What Is Covered in Genetic Counselling? 29.5 Precision Medicine 29.6 Practical Implications for Implementing Person Centered Care 29.7 Conclusions References Chapter 30: Person-Centered Endocrinology (Including Diabetes and Obesity) 30.1 Introduction 30.2 Limitations of Evidence-Based Medicine in Endocrinology 30.3 Towards Person-Centred Endocrinology 30.3.1 Pituitary Disorders 30.3.2 Bone and Mineral Disease 30.3.3 Adrenal Disease 30.3.4 Gonadal Disorders 30.3.5 Disorders of Sexual Differentiation 30.3.6 Gender Identity Disorders 30.3.7 Obesity 30.3.8 Thyroid Disorders 30.3.9 Diabetes 30.4 Practical Implications for Person Centered Care 30.5 Conclusions References Chapter 31: Person-Centered Cardiology 31.1 Introduction 31.2 Evidence-Based in Cardiology 31.3 The Person with Coronary Artery Disease (CAD) 31.3.1 The Person with ST-Segment Elevation Myocardial Infarction (STEMI) 31.3.2 Potential Barriers for PCCC in the Person with STEMI 31.3.3 Persons with Unstable Angina (UA) and Those with Non-ST Elevation Myocardial Infarction (NSTEMI) 31.3.4 Potential Barriers for PCCC in Persons with UA/NSTEMI 31.3.5 Persons with Chronic Stable Coronary Artery Disease (SCAD) 31.3.6 Potential Barriers for PCCC in Persons with SCAD 31.4 The Person with Congestive Heart Failure (HF) 31.4.1 Chronic HF with Reduced Ejection Fraction (HFrEF) 31.4.2 Chronic HF with Preserved Ejection Fraction (HFpEF) 31.4.3 Acute Decompensated HF 31.4.4 Potential Barriers for PCC in Persons with HF 31.5 The Person with Dyslipidemia 31.5.1 Secondary Prevention 31.5.2 Primary Prevention 31.5.3 Potential Barriers to PCC in Persons with Dyslipidemia 31.6 The Person with Hypertension 31.6.1 Potential Barriers for PCC in Persons with Hypertension 31.7 The Person with Other Chronic Cardiac Conditions 31.8 An Important Principle of Shared-Decisions in PCCC 31.9 Practical Issues for the Implementation of Person Centered Care in Cardiology 31.10 Summary and Future Directions References Chapter 32: Person-Centered Pulmonary Medicine 32.1 Introduction 32.2 Patients 32.3 Current Practice 32.4 Health Systems 32.5 Case Study 1 32.5.1 Comment 32.5.2 “The Common Cold” 32.6 Case Study 2 32.6.1 Comment 32.7 Practical Implications for Person Centered Care 32.8 Conclusions References Chapter 33: Person-Centered Intensive Care Medicine 33.1 Introduction 33.2 Barriers to Person-Centered Care in the ICU 33.2.1 Patient Loss of Autonomy and Agency 33.2.2 Difficulty Knowing Patients as Persons 33.2.3 Provider Burnout 33.2.4 Acuity and Time Constraints 33.2.5 Complexity of ICU Decisions 33.3 Bringing Person-Centered Medicine to the Intensive Care Unit 33.3.1 Person-Centered Decision-Making in the ICU 33.4 Conclusions References Chapter 34: Person-Centered Oncology 34.1 Introduction 34.2 A Brief Word on Our Science 34.3 Beyond Biology and Overall Survival 34.4 Person-Centered Communication and Patient Participation 34.5 Highlighting the Patient Voice and Personal Values 34.6 Primary Palliative Care and Person-Centered Advance Care Planning 34.7 Person-Centered Survivorship 34.8 Cancer Care in Croatia and the European Union (EU) 34.9 Cancer Care in Vietnam and Asia 34.10 Practical Implications for Person-Centered Care 34.11 Conclusions References Chapter 35: Person-Centered Surgery and Anesthesiology 35.1 Introduction 35.2 The Surgeon-Patient Relationship 35.3 Principles of Person-Centered Medicine as Applied to Surgery 35.3.1 Ethical Commitment 35.3.2 Holistic Approach of the Patient’s Personhood 35.3.3 Cultural Sensitivity 35.3.4 Relationship Focus 35.3.5 Collaborative Care and Shared Decision Making 35.3.6 Empathic, Complete and Transparent Communication 35.3.7 Personalization of Care 35.3.8 Organization of Services Focused on the Person and the Community 35.3.9 People-Centered Health Education and Research 35.4 Implementation of Person-Centeredness Through Surgical Care Phases 35.4.1 Person-Centered Pre-operative Phase 35.4.2 Person-Centered Operative Care 35.4.3 Optimizing Care of Persons Post-operatively 35.5 Illustrative Cultural Perspectives on Person-Centered Surgery 35.6 Practical Implications for Person Centered Care in Surgery 35.6.1 To What Extent is Surgery and Anaesthesia Currently Person-Centered? 35.6.2 Obstacles to implementation of Person-Centered Surgery and Anesthesiology 35.6.3 The Changes that Are Needed to Make Surgery and Anaesthesia More Person-Centered 35.7 Conclusions References Chapter 36: Person-Centered Pain Medicine 36.1 Introduction 36.2 Objectives 36.3 Approach to Fulfilling the Objectives 36.4 The Knowledge Base of Person-Centred Pain Medicine 36.4.1 An Integrated Systems Approach to Health 36.4.2 System Integration in the Pain Context 36.4.3 Biomedical 36.4.4 Mindbody 36.4.5 Connection 36.4.6 Activity 36.4.7 Nutrition 36.4.8 Group Pain Management Programs 36.4.9 Telehealth 36.4.10 Primary Care Application 36.4.11 Cultural and Spiritual Perspectives 36.5 The Consequences of an Over-Emphasis on Biomedicine in Chronic Pain Management 36.6 Why Pain Management is not more Person-Centered Currently 36.6.1 Opioids 36.6.2 Cannabinoids 36.6.3 Procedural Interventions 36.7 Practical Implications for the Implementation of Person-Centered Care 36.7.1 Benefits of Greater Person Centeredness 36.7.2 Challenges to more Widespread Implementation of Person Centered Pain Medicine 36.7.3 Measuring Outcomes of Implementation 36.7.4 Future Challenges 36.8 Conclusions References Chapter 37: Person-Centered Palliative Care 37.1 Introduction 37.2 What is Palliative Care? 37.3 The Origins of Modern Palliative Care-a Brief History 37.4 The Concept of Person-Centredness in Palliative Care 37.5 Practical Implications for Person-Centered Palliative Care 37.5.1 Key Factors to Assess the Implementation of Person-Centered Palliative Care 37.5.2 The Extent to Which Current Palliative Care is Actually Person-Centered 37.5.3 Specific Barriers that Interfere with the Implementation of Person-Centered Palliative Care 37.5.4 What Would Have to Change in Health Systems and Actual Practice to Enable or Facilitate more Person-Centered Palliative Care 37.6 Palliative Care for Diagnoses Other than Cancer 37.7 Key Issues in Cardiology Palliative Care 37.8 Pediatric Palliative Care 37.8.1 How is Paediatric Palliative Care Person-Centred? 37.9 Conclusions References Chapter 38: People-Centered Public Health 38.1 Introduction 38.1.1 Public Health: A Dynamic Field 38.1.1.1 What Is P.ublic Health? 38.1.1.2 What Are the Functions of Public Health? 38.2 Public Health Perspectives in Person Centered Medicine 38.3 Additional Considerations for the Further Development of People-Centered Public Health 38.3.1 Person-Centered Public Health in Practice Including the Pandemics 38.3.1.1 Liberty, Autonomy, and Respect for Person 38.3.1.2 Wellbeing and Solidarity 38.3.1.3 Social Justice, Equity, Access and Right to Health and Dignity 38.3.1.4 Sustainable Development and Ecological Protection 38.3.1.5 Systemic Complex Reasoning 38.3.1.6 Evidence Informed and Supported by Technology 38.4 Integrating Person Centered Medicine, Social Determinants of Health, Sustainable Development Goals, and Essential Public Health Functions and Services (EPHF) 38.5 Conclusions References Chapter 39: Person-Centered Nursing and Other Health Professions 39.1 Introduction 39.2 Current Paradigm of Health Care 39.3 Person-Centred Care 39.4 Components of Person-Centred Care 39.5 Outcome of Person-Centred Care 39.6 How Person-Centered Is Currently by Nursing and Allied Professions? 39.7 What Are the Current Barriers for Nursing and Allied Health to Be More Person-Centred? 39.8 Going Forward, What Would Need to Change to Make Nursing and Allied Health More Person-Centered? 39.8.1 Interprofessional Collaboration and Communication for Person-Centred Care (IPCC) 39.8.2 Learning Together to Work Together 39.9 Conclusions References Chapter 40: Person-Centered Traditional Medicine 40.1 Introduction 40.1.1 Cultural Space and Time 40.1.2 Objectives, Approaches and Knowledge Base 40.2 The Example of China 40.2.1 Historical Development 40.2.2 The Person-Centered Ideas of TCM and Obstacles for Implementation 40.2.3 How Research on Modern Nature Healing Can Explain TCM and Person Centered Approaches 40.3 Traditional Medicine in India 40.4 Traditional Medicine in the Americas 40.4.1 Traditional Andean Medicine 40.5 Traditional Medicine in the Sahul Continent: Australia, Tasmania and Papua New Guinea 40.6 Traditional Medicine in Africa 40.7 Discussion and Practical Implications 40.8 Conclusions References Part IV: Empowerment Perspectives Chapter 41: Empowerment of Community Members 41.1 Introduction 41.2 Self-Care and Inter-Care and Three Levels of Contextualization 41.2.1 Whole Contextualised Individuals 41.2.1.1 Self-Care The Self-Care Continuum The Seven Pillars of Self-Care The Self-Care Matrix: A Unifying Framework of Self-Care The Inverse Relationship Between Self-Care and Diseases of the Lifestyle 41.2.1.2 The Emerging Concept of Inter-Care 41.2.2 The Community Level of Contextualization 41.2.2.1 Social Prescribing 41.2.3 The Broader Environment Level of Contextualization 41.2.3.1 City Health 41.2.3.2 WHO Guideline on Self-Care Interventions 41.3 Conclusions References Chapter 42: Empowerment of Health Professionals 42.1 Introduction 42.2 What Is Burn-Out? 42.3 What Are the Basic Processes for Professionals’ Empowerment of Health and Well-Being? 42.4 Practical Methods for Promoting Well-Being 42.5 How Can Medicine Regain Its Person-Centered Values and Practices? 42.6 Conclusions References Index