![]() ![]() ![]() Health was subsequently conceptualized as “the ability to adapt and to self-manage” at the two-day conference. Recognizing the limitations of the WHO’s health definition, a multidisciplinary group of international healthcare experts attending a two-day conference in the Netherlands explicated a new vision of health that acknowledges its dynamic nature and underscores the individual’s ability to adapt to changing health states. For health systems to plan and deliver services tailored to the unique needs of individuals, a person- and goal-centred definition of health is needed. For the purposes of this study, being person-centred is defined as an approach to health and healthcare that seeks to promote dignity and respect, information sharing, participation in decision making and collaboration with healthcare stakeholders in the development, implementation and evaluation of healthcare delivery. ![]() For individuals managing chronic health conditions, the WHO’s definition does not provide a person-centred goal on which their health needs could be assessed. At present, however, the definition’s focus on completeness appears incongruous with current epidemiological realities related to chronic disease. Promulgated at the founding of the WHO in 1948, its decision to include mental and social dimensions as integral components to healthy functioning, thus broadening the lens through which health was viewed, was at the time considered pioneering. The World Health Organization’s (WHO) definition of health as a state of complete physical, and social wellbeing, and not merely the absence of disease, is one of the most commonly referenced definitions. How we define health has significant ramifications for care delivery across different settings. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of ‘Meaningfulness’ and ‘Participation’ in person-centred home and community care. Conclusionįindings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Of these, two elements and nine of the 11 descriptors reached consensus. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Ten elements were identified to have no pillar of best fit. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. In Stage 1, 189 of 201 elements reached consensus in domain mapping. The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or “No pillar of best fit”. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. The panel consisted of researchers, health care providers, older adults and caregivers. MethodsĪ modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). This study sought to identify opportunities for more person-centred care planning at the point of care in home care, using the MPH tool as a framework to link comprehensive assessment and dialogue-based goal-setting. The PPH was subsequently converted to the My Positive Health (MPH) spider web visualization tool. Researchers in the Netherlands proposed the Pillars for Positive Health (PPH) as a broadly encompassing health definition to support more realistic and meaningful care planning for people living with chronic disease and other life-long health conditions. ![]()
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