The person-centered hypothesis framework: advancing clinical reasoning in musculoskeletal pain management

Review written by Dr Sandy Hilton info

Key Points

  1. The biopsychosocial and mechanism-based models do not adequately address the complexities of patient presentations.
All key points available for members only
Start free trial Icon
Or log in here

BACKGROUND AND OBJECTIVE

The authors differentiate between Person-centered care (PCC) and Patient-centered care. Patient-centered care is defined as a focus on the goal of returning the patient to a functional life, and PCC as focused on the goal of returning the person to a meaningful life (1). They present this paper as a “masterclass” to outline a hypo-deductive framework that blends the biopsychosocial model (BSP) and mechanisms-based models to emphasize clinical reasoning grounded in PCC.

The authors point out that many clinicians continue to focus on specific tissue-based diagnoses despite the emphasis on adopting the BPS model (2). Addressing the challenges of moving away from tissue-based models includes emphasis on reflective practice for clinical reasoning. This is a dynamic and real-time adaptation during the care visit, referred to as “in-action” in this paper.

The authors propose a person-centered hypothesis (PCH) as a pragmatic framework to allow a clinician to identify in real time the multiple pertinent components of a person’s clinical picture beyond a biomedical diagnosis.

Person centered care is focused on the goal of returning the person to a meaningful life, whereas patient centered care focuses on returning the patient to a functional life.
bulb
The authors of this paper propose a more systematic and in-depth approach based on four steps to address pertinent components of clinical presentation.

PERSON-CENTERED HYPOTHESIS (PCH)

The PCH contains four parts detailed here:

Start free trial Icon
to unlock full access to this review and 1181 more
Or log in here
Trustpilot