Person-Centered Care, Autonomy, and Nursing Practice: A Case Study

This essay delves into the concept of person-centered care within the contemporary Australian healthcare setting, emphasizing its importance in providing meaningful and respectful patient care. It examines the core principles of person-centered care, including respecting patient autonomy, ensuring coordination of care, providing information and education, and promoting physical comfort. The essay explores the ethical principle of autonomy, its relevance to nursing practice, and how it applies to a case study of an 83-year-old woman named Gwen Martin, who is dealing with osteoporosis and a recent fall. The discussion includes how the principle of autonomy is applied in everyday nursing care, potential challenges to its implementation, and the importance of balancing patient preferences with healthcare best practices. The essay underscores the significance of patient-centered care in enhancing patient outcomes and the role of nurses in upholding ethical principles to optimize patient care. The essay also provides references to support the discussion.

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Concept of person centered care in the contemporary Australian Healthcare setting
Introduction
Person centered care, involves providing care to patients in a meaningful and respected way. It
involves respecting the decision of the patient (patient autonomy). Person centered care improves
the well-being and outcomes while caring for Aboriginals and other patients. Healthcare
professions should therefore master this concept and incorporate it while providing care to
patients. Within the framework of this assignment, there will be an analysis of the concept of
person centered care and the concept of autonomy and how it relates to the provided case study.
Discussion
Person centered care, according to the Australian healthcare setting is caring for patients
in a meaningful and valuable manner. This involves listening, informing and finally involving
the patients and their families in the decision making processes (Bardes, 2012). Similarly, the
Institute of Medicine describe patient centered care as offering healthcare that is respectful,
responsive and in accordance to the preferences, needs and values of the patient. Actually, there
is no standard definition of person centered care (Barry & Edgman-Levitan, 2012). The
definitions vary depending with context. The rationale of person centered care is to improve
healthcare outcomes or the quality of healthcare provided to patients.
In the Australian healthcare setting, there are eight overarching principles of person
centered care. First of all, there should be respect for patient’s values, preferences as well as their
expressed needs. In this principle, the healthcare experts are supposed to involve patients in the
decision making process. Furthermore, the patients should be treated with dignity, respect as well
as sensitivity (Constand, MacDermid, Dal Bello-Haas, & Law, 2014). Like for the case of Gwen,

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whatever she desires of feels is correct for she should be respected. The second principle of
person centered care is coordination and integration of care. In the Australian healthcare setting,
majority of patients report feeling vulnerable and powerless when they are ill (Lusk & Fater,
2013). However, the principle of coordination according to studies, can alleviate such feelings.
Majority of patients note that improved coordination of clinical care, ancillary and support
services and finally front line patient care can alleviate feeling of vulnerability. Different
stakeholders should therefore coordinate in the case of Gwen to achieve the best for her. The
third principle of person centered care is information and education (Elwyn et al., 2014). In some
cases, healthcare experts fail to inform patients about their conditions and prognosis. This in
return creates fear among patients and this can cause deterioration of the condition. This
principle therefore ensures that patients are regularly informed about both their clinical status
and prognosis (Morgan & Yoder, 2011). Besides, education equips the patient with necessary
information to make sound decisions and this also enhances autonomy of the patient.
Physical comfort is an important principle of patient centered care. Studies note that
physical comfort reported by patients affects the outcome of care. In the case of Gwen, she does
not feel comfortable engaging in physical exercise. She claims that sitting on the chair and
watching television makes her feel comfortable. That is what a nurse should stick to.
Involvement of family members and friends also play a critical role in healthcare (Kupfer &
Bond, 2012). However, it is unfortunate that Gwen stays alone at home and it therefore becomes
difficult to incorporate either of the two. Other principles of person centered care include
continuity and transition and access to care. Since some patients are concerned about taking care
of themselves once discharged, I am supposed as a nurse, to make Gwen for example understand
dietary, physical and other needs once discharged. I can for example educate her on the risk of

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staying alone at home. Patient centered care has shown to improve patient outcomes and all
healthcare experts should utilize this concept while caring for patients.
Principle of autonomy and how it relates to Gwen
Often, patients are expected to make decisions regarding the type of care they wish to be
subjected to. This, according to the World Health Organization, is the background of quality or
better health outcomes (Rathert, Wyrwich, & Boren, 2012). The principle of Autonomy,
according to medicine.net is defined as the right or obligation of a patient to make decisions
without the influence of the healthcare provider which in most cases is the nurse. However, the
healthcare provider plays a critical role in the decision making process. As a nurse, patient
centered care necessitates that I should provide relevant education to Gwen that will assist the
patient in the decision making process. In so doing, the ethical principle of autonomy is in line
with the person centered care principle of information and education (Page, 2012). The nurse is
supposed to provide information to the patient of the possible consequences of certain choices or
remedies. Like in this case, Gwen is suffering from osteoporosis and the nurse has requested her
to take part in physical exercise which she has declined. In such a case, I would educate her
about the importance of physical exercise such that when she persists not to engage in physical
exercise, she is fully aware of the impending consequences (Smebye, Kirkevold, & Engedal,
2015). Furthermore, Gwen stays alone at home despite her old age. This are risk factors for falls.
In this case, I would therefore educate her on the consequences of living at home alone then let
her decide if she will go ahead and stay alone at home or she will stay at the nursing home.
According to the case study, Gwen is reluctant to participate in daily activities as
requested by the nurse to engage in physical exercise to improve her physical condition.
However, she has declined this request or directive. Gwen claims that she feels much

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comfortable sitting in the chair and watching TV. According to the principle of Autonomy, a
patient is entitled to make a decision that suits him/her. In this context, Gwen feels comfortable
sitting on the chair in her room and watching television. She doesn’t want to take part in physical
exercise. The nurse or rather healthcare expert should therefore act according to the principle of
autonomy and let her do whatever makes her comfortable (Ubel, Scherr, & Fagerlin, 2017).
However, she should only be allowed to do that if the nurse has provided information about
consequences of physical inactivity towards recovery form osteoporosis.
In as much as the ethical principle has shown to optimize care accorded to the patients, it
comes along with a lot of controversy. Some patients might make decisions that hurt them but
the nurse or healthcare expert has no obligations to object such decisions. I feel that the principle
should be reviewed in such a manner that the patients should be barred from making such
decisions. Besides, further research should be conducted to overcome such gaps in healthcare.
How the principle of autonomy applies in everyday nursing care and how it might
be compromised by nursing actions or inactions.
The principle of autonomy is applicable nearly on a daily basis in nursing care. The
nurses are the people who spend most of their time with patients and they act as a bridge between
the patients and other healthcare workers. As defined earlier, the principle of autonomy dictates
that a patient should make decisions on their own without the influence of any other person.
Often, there comes times when the patient is expected to make certain decisions (Straehle, 2016).
This normally happens when the patient is suffering from chronic conditions. Such decisions
include the preferences of certain nursing interventions. There is a patient who would feel
comfortable with drugs as the best option for therapy while another one would prefer

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physiotherapy. Whether the decision made by the patient is not correct as per the nurse, the nurse
has no otherwise but to act in accordance to the choice of the patient.
However, there are situations where nurses compromise the principle of autonomy. A
good example is if the person is not in a good mental status. Often, studies suggest that some
health problems affect the mental status of an individual. Such conditions include stress. In such
scenarios, the patient is not in a position to make sound decisions (Gillon, 2014). Therefore, it is
vital that the nurse overlook or compromises the principle of autonomy. Furthermore, it is
suggested nurses should be patient enough until the patient is a stable state of mind to make any
meaningful decision.
The principle of autonomy can be compromised if the patient is a minor. Different
constitutions or rather countries have different age groups that are considered minors and adults.
In most countries however, minors are those below 18 years old. Studies point out clearly that
minors are not in a position to make sound mind decisions. Most of the decisions are made out of
influence or panic. Therefore, if a nurse comes in contact with such a minor during the decision
making process, he/she has to overlook the same (Reilly & Jurchak, 2017). In some countries
however, parents have the sole responsibility to make decisions on behalf of the children which
again creates conflict of interest since the interest of the parents might be contrary to those of the
children in question.
Besides nurses, family members also play a role in compromising patient autonomy. In a
recent study, some patients have reported verbal threats, harassment and intimidation from both
family members and nurses to coerce patients into decisions that are contrary with their
preferences. It is therefore the duty of each stakeholder in healthcare to ensure that patient

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autonomy is upheld always since it has shown to optimize patient outcome during treatment or
care.
Conclusion
Person centered care improves patient outcome. Nurses and other healthcare workers
should therefore utilize person centered care by respecting the decision of the patient otherwise
known as autonomy. However, the nurse should ensure that the patient is the right state to make
sound mind decisions. The nurse should also provide relevant information that will guide the
patient in making the decision.

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References
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Elwyn, G., Dehlendorf, C., Epstein, R. M., Marrin, K., White, J., & Frosch, D. L. (2014).
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