How do and could clinical guidelines support patient-centred care for women: Content analysis of guidelines
Patient-centred care (PCC) improves multiple patient and health system outcomes. However, many patients do not experience PCC, particularly women, who are faced with disparities in care and outcomes globally. The purpose of this study was to identify if and how guidelines address PCC for women (PCCW...
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| description | Patient-centred care (PCC) improves multiple patient and health system outcomes. However, many patients do not experience PCC, particularly women, who are faced with disparities in care and outcomes globally. The purpose of this study was to identify if and how guidelines address PCC for women (PCCW).
We searched MEDLINE, EMBASE, National Guideline Clearing House, and guideline developer websites for publicly-available, English-language guidelines on depression and cardiac rehabilitation, conditions with known gendered inequities. We used summary statistics to report guideline characteristics, clinical topic, mention of PCC according to McCormack's framework, and mention of women's health considerations. We appraised guideline quality with the AGREE II instrument.
A total of 27 guidelines (18 depression, 9 cardiac rehabilitation) were included. All 27 guidelines mentioned at least one PCC domain (median 3, range 1 to 6), most frequently exchanging information (20, 74.1%), making decisions (20, 74.1%), and enabling patient self-management (21, 77.8%). No guidelines fully addressed PCC: 9 (50.0%) of 18 depression guidelines and 3 (33.3%) of 9 cardiac rehabilitation guidelines addressed 4 or more PCC domains. Even when addressed, guidance was minimal and vague. Among 14 (51.9%) guidelines that mentioned women's health, most referred to social determinants of health; none offered guidance on how to support women impacted by these factors, engage women, or tailor care for women. These findings pertained even to women-specific guidelines. Reported use or type of guideline development process/system did not appear to be linked with PCCW content. Based on quality appraisal with AGREE II, guidelines were either not recommended or recommended with modifications. In particular, the stakeholder involvement AGREE II domain was least addressed, but guidelines that scored higher for stakeholder involvement also appeared to better address PCCW.
This research identified opportunities to generate guidelines that achieve PCCW. Strategies include employing a PCC framework, considering gender issues, engaging women on guideline-writing panels, and including patient-oriented tools in guidelines. Primary research is needed to establish what constitutes PCCW. |
| doi_str_mv | 10.1371/journal.pone.0224507 |
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We searched MEDLINE, EMBASE, National Guideline Clearing House, and guideline developer websites for publicly-available, English-language guidelines on depression and cardiac rehabilitation, conditions with known gendered inequities. We used summary statistics to report guideline characteristics, clinical topic, mention of PCC according to McCormack's framework, and mention of women's health considerations. We appraised guideline quality with the AGREE II instrument.
A total of 27 guidelines (18 depression, 9 cardiac rehabilitation) were included. All 27 guidelines mentioned at least one PCC domain (median 3, range 1 to 6), most frequently exchanging information (20, 74.1%), making decisions (20, 74.1%), and enabling patient self-management (21, 77.8%). No guidelines fully addressed PCC: 9 (50.0%) of 18 depression guidelines and 3 (33.3%) of 9 cardiac rehabilitation guidelines addressed 4 or more PCC domains. Even when addressed, guidance was minimal and vague. Among 14 (51.9%) guidelines that mentioned women's health, most referred to social determinants of health; none offered guidance on how to support women impacted by these factors, engage women, or tailor care for women. These findings pertained even to women-specific guidelines. Reported use or type of guideline development process/system did not appear to be linked with PCCW content. Based on quality appraisal with AGREE II, guidelines were either not recommended or recommended with modifications. In particular, the stakeholder involvement AGREE II domain was least addressed, but guidelines that scored higher for stakeholder involvement also appeared to better address PCCW.
This research identified opportunities to generate guidelines that achieve PCCW. Strategies include employing a PCC framework, considering gender issues, engaging women on guideline-writing panels, and including patient-oriented tools in guidelines. Primary research is needed to establish what constitutes PCCW.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0224507</identifier><identifier>PMID: 31703076</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Arthritis ; Asthma ; Cardiac Rehabilitation ; Cardiovascular disease ; Clinical decision making ; Clinical medicine ; Clinical practice guidelines ; Content analysis ; Decision making ; Depression - psychology ; Domains ; Empowerment ; Evidence-based medicine ; Female ; Gender ; Guidelines ; Health ; Health aspects ; Health care networks ; Health care reform ; Heart ; Humans ; Identification methods ; Medicine and Health Sciences ; Methods ; Patient-Centered Care ; Patients ; People and places ; Practice Guidelines as Topic ; Qualitative research ; Quality ; Rehabilitation ; Research and Analysis Methods ; Statistical analysis ; Sustainable development ; Web sites (World Wide Web) ; Websites ; Women ; Women's Health ; Womens health</subject><ispartof>PloS one, 2019-11, Vol.14 (11), p.e0224507-e0224507</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Gagliardi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Gagliardi et al 2019 Gagliardi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-baa44041444cc70d05c64d607c3a72c646f51d5af98ec3ba587bcb4d68ce44663</citedby><cites>FETCH-LOGICAL-c692t-baa44041444cc70d05c64d607c3a72c646f51d5af98ec3ba587bcb4d68ce44663</cites><orcidid>0000-0002-5721-809X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839851/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839851/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31703076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gagliardi, Anna R</creatorcontrib><creatorcontrib>Green, Courtney</creatorcontrib><creatorcontrib>Dunn, Sheila</creatorcontrib><creatorcontrib>Grace, Sherry L</creatorcontrib><creatorcontrib>Khanlou, Nazilla</creatorcontrib><creatorcontrib>Stewart, Donna E</creatorcontrib><title>How do and could clinical guidelines support patient-centred care for women: Content analysis of guidelines</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Patient-centred care (PCC) improves multiple patient and health system outcomes. However, many patients do not experience PCC, particularly women, who are faced with disparities in care and outcomes globally. The purpose of this study was to identify if and how guidelines address PCC for women (PCCW).
We searched MEDLINE, EMBASE, National Guideline Clearing House, and guideline developer websites for publicly-available, English-language guidelines on depression and cardiac rehabilitation, conditions with known gendered inequities. We used summary statistics to report guideline characteristics, clinical topic, mention of PCC according to McCormack's framework, and mention of women's health considerations. We appraised guideline quality with the AGREE II instrument.
A total of 27 guidelines (18 depression, 9 cardiac rehabilitation) were included. All 27 guidelines mentioned at least one PCC domain (median 3, range 1 to 6), most frequently exchanging information (20, 74.1%), making decisions (20, 74.1%), and enabling patient self-management (21, 77.8%). No guidelines fully addressed PCC: 9 (50.0%) of 18 depression guidelines and 3 (33.3%) of 9 cardiac rehabilitation guidelines addressed 4 or more PCC domains. Even when addressed, guidance was minimal and vague. Among 14 (51.9%) guidelines that mentioned women's health, most referred to social determinants of health; none offered guidance on how to support women impacted by these factors, engage women, or tailor care for women. These findings pertained even to women-specific guidelines. Reported use or type of guideline development process/system did not appear to be linked with PCCW content. Based on quality appraisal with AGREE II, guidelines were either not recommended or recommended with modifications. In particular, the stakeholder involvement AGREE II domain was least addressed, but guidelines that scored higher for stakeholder involvement also appeared to better address PCCW.
This research identified opportunities to generate guidelines that achieve PCCW. Strategies include employing a PCC framework, considering gender issues, engaging women on guideline-writing panels, and including patient-oriented tools in guidelines. 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gagliardi, Anna R</au><au>Green, Courtney</au><au>Dunn, Sheila</au><au>Grace, Sherry L</au><au>Khanlou, Nazilla</au><au>Stewart, Donna E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How do and could clinical guidelines support patient-centred care for women: Content analysis of guidelines</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-11-08</date><risdate>2019</risdate><volume>14</volume><issue>11</issue><spage>e0224507</spage><epage>e0224507</epage><pages>e0224507-e0224507</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Patient-centred care (PCC) improves multiple patient and health system outcomes. However, many patients do not experience PCC, particularly women, who are faced with disparities in care and outcomes globally. The purpose of this study was to identify if and how guidelines address PCC for women (PCCW).
We searched MEDLINE, EMBASE, National Guideline Clearing House, and guideline developer websites for publicly-available, English-language guidelines on depression and cardiac rehabilitation, conditions with known gendered inequities. We used summary statistics to report guideline characteristics, clinical topic, mention of PCC according to McCormack's framework, and mention of women's health considerations. We appraised guideline quality with the AGREE II instrument.
A total of 27 guidelines (18 depression, 9 cardiac rehabilitation) were included. All 27 guidelines mentioned at least one PCC domain (median 3, range 1 to 6), most frequently exchanging information (20, 74.1%), making decisions (20, 74.1%), and enabling patient self-management (21, 77.8%). No guidelines fully addressed PCC: 9 (50.0%) of 18 depression guidelines and 3 (33.3%) of 9 cardiac rehabilitation guidelines addressed 4 or more PCC domains. Even when addressed, guidance was minimal and vague. Among 14 (51.9%) guidelines that mentioned women's health, most referred to social determinants of health; none offered guidance on how to support women impacted by these factors, engage women, or tailor care for women. These findings pertained even to women-specific guidelines. Reported use or type of guideline development process/system did not appear to be linked with PCCW content. Based on quality appraisal with AGREE II, guidelines were either not recommended or recommended with modifications. In particular, the stakeholder involvement AGREE II domain was least addressed, but guidelines that scored higher for stakeholder involvement also appeared to better address PCCW.
This research identified opportunities to generate guidelines that achieve PCCW. Strategies include employing a PCC framework, considering gender issues, engaging women on guideline-writing panels, and including patient-oriented tools in guidelines. Primary research is needed to establish what constitutes PCCW.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31703076</pmid><doi>10.1371/journal.pone.0224507</doi><tpages>e0224507</tpages><orcidid>https://orcid.org/0000-0002-5721-809X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Arthritis Asthma Cardiac Rehabilitation Cardiovascular disease Clinical decision making Clinical medicine Clinical practice guidelines Content analysis Decision making Depression - psychology Domains Empowerment Evidence-based medicine Female Gender Guidelines Health Health aspects Health care networks Health care reform Heart Humans Identification methods Medicine and Health Sciences Methods Patient-Centered Care Patients People and places Practice Guidelines as Topic Qualitative research Quality Rehabilitation Research and Analysis Methods Statistical analysis Sustainable development Web sites (World Wide Web) Websites Women Women's Health Womens health |
| title | How do and could clinical guidelines support patient-centred care for women: Content analysis of guidelines |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T03%3A28%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=How%20do%20and%20could%20clinical%20guidelines%20support%20patient-centred%20care%20for%20women:%20Content%20analysis%20of%20guidelines&rft.jtitle=PloS%20one&rft.au=Gagliardi,%20Anna%20R&rft.date=2019-11-08&rft.volume=14&rft.issue=11&rft.spage=e0224507&rft.epage=e0224507&rft.pages=e0224507-e0224507&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0224507&rft_dat=%3Cgale_plos_%3EA605227827%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2313062216&rft_id=info:pmid/31703076&rft_galeid=A605227827&rft_doaj_id=oai_doaj_org_article_f434b87904cf4e73a7bf9c71dc58471e&rfr_iscdi=true |