Health systems strengthening through person-centred care: development of a feasible and acceptable theory-based workforce approach to improve quality.

我们想要解决的问题是什么？严重的疾病对患者和家庭都有重大影响。在低收入和中等收入国家，这些压力可能是身体上的（如疼痛及其症状）、心理上的、社会上的（包括收入、儿童学费、耻辱等额外压力）和精神上的。这可能会影响患者和家人的健康以及他们获得和保持护理的能力。卫生系统必须不仅仅解决疾病问题-它们必须更加“以人为本”。以人为本的护理意味着，卫生系统的组织方式是以满足个人需求的方式来满足他们的偏好、价值观和信仰，提供尊严和尊重。以人为本被认为是确保高质量护理服务的一种方式。通过劳动力（卫生保健工作人员）、卫生保健系统所掌握的信息（关于个人的需求和偏好）以及提供服务的方式来改善卫生保健系统，我们可以使保健更加以人为本。我们该怎么办？在这项研究中，我们想做一些重要的初步工作，为更大的研究提供信息，以提高以人为本。我们将利用我们在英国，津巴布韦和乌干达的伙伴关系，从面临严重疾病的患者和家庭的角度，以及非常重要的是，从负责提供服务的人（卫生保健专业人员）的角度，找出以人为本的最佳护理。我们将利用这些新信息与卫生保健团队合作，制定一项患者和工作人员都能接受的战略，并将其作为加强卫生系统的范例在这些国家付诸实施。我们还将研究衡量以人为本的最佳方法，以便在进行更大规模的研究时，我们有一个准确的方法来了解我们是否实现了目标。产出是什么？世界卫生组织制定了一项战略，以改善以人为本的全民保健-这项研究将从非洲的角度提供一种切实可行的方法。我们还将提供一种适应性的方法，从患者和家庭的角度来衡量护理体验。我们提出的战略将以患者、家属和卫生专业人员的意见为主导--使其更有可能取得成功。我们正在与社区卫生组织和政府合作，确保我们能够通过更强大的卫生系统实现更好的护理。

What is the problem we want to address? Serious illness has major effects on both the patient and family. In low and middle income countries these can be physical (such as pain and their symptoms) psychological, social (with additional stressors on income, children's school fees, stigma) and spiritual. This can affect both the wellbeing of the patient and family and their ability to access and stay in care. Health systems must address more than just the disease- they must become more "person centred". Person-centred care means that the health system is organised to meet the needs of the individual in ways that respond to their preferences, values and beliefs, offering dignity and respect. Being person-centred is seen to be a way to ensure that care services are high quality. By improving the health system through the workforce (the health care staff) the information it holds (on the individual's needs and preferences) and the way things are delivered, we can make care more person-centred. What will we do? In this study, we want to do some of the important initial work to inform a larger study to improve person-centredness. We will use our partnership across the UK, Zimbabwe and Uganda to find out what best person-centred care looks like from the view of patients and families facing serious illness, and very importantly from those who would be responsible for delivering (health care professionals). We will use this new information to work with health care teams to develop a strategy that is acceptable to patients and staff that can be put into practice in these countries as examples of health systems strengthening. We will also look at the best way to measure person centredness, so that when we conduct a larger study we have an accurate way to knowing if we have achieved our goals. What will be the outputs?The World Health Organisation has a strategy to improve person-centredness of care for all- this study will provide a practical way to deliver this from an African perspective. We will also deliver an adapted way to measure the experience of care from the patient & family perspective. Our proposed strategy will be led by the views of patients, families and health professionals- making it more likely to achieve success. We are working with health organisations in the community and with Governments to make sure that we can achieve better care through stronger health systems.