Standard 1: Person-centred approach to care

A person’s experience of pain is unique and influenced by many factors including biological, psychological, social, cultural aspects, their past experiences and their diversity. Additionally, pain itself can influence (often negatively) the individual’s physical, psychological, social, cultural and spiritual health, particularly for individuals with multimorbidity and/or diversity. Understanding this multidimensional interaction is an underpinning principle to a holistic, person-centred approach to managing pain.^14,15

A person-centred approach to managing pain considers the individual as a ‘whole person’ and acknowledges their preferences, needs, values, goals and their central role in determining what matters most in their pain management journey. The intent of this standard is to ensure that education and training on pain management reinforces the significance of person-centeredness and provides opportunity for health practitioners to develop skills that promote person-centred approaches when working with the diverse range of people who experience pain. 

“A person-centred approach treats each person respectfully as an individual human being and not just as a condition to be treated. It involves seeking out and understanding what is important to the patient, their families, carers and support people, fostering trust and establishing mutual respect. It also means working together to share decisions and plan care.”^14 pS94 

“So, thinking about the patient as a whole in their social and psychological context … addressing all issues contributing to a patient’s pain experience will develop socially responsible and safe patient care around pain.” – Stakeholder consultation workshop participant 

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

A person-centred approach is a holistic way of conceptualising health. Rather than focusing on health conditions and diseases, person-centred care focuses on treating and respecting everyone as a person.^16-20 It is typified in approaches that consider the individual’s comprehensive experience of their pain, including their psychosocial, environmental, cultural and spiritual context.¹⁶ 

This is achieved through determining an individual’s preferences, needs and values,¹⁷ acknowledging and equitably catering for diversity, and actively engaging them in shared decision-making.^16-18,21,22 It includes understanding the individual’s clinical needs, including underlying diagnoses and the multitude of factors that can impact the way they experience pain. A person-centred approach is well-recognised as fundamental to high quality health care^17,23-27 and is embedded in practice frameworks,^27,28 educational outcomes^29-31 and scopes of practice for health professionals in Australia.³² 

The person-centred care approach is particularly relevant when working with a person experiencing pain. Person-centred approaches to care focus on understanding and validating the individual and their experiences, values, goals and strengths, engaging them in decision-making, and implementing individualised management and monitoring of their pain.^17,21,33 Particularly for people experiencing recurrent or chronic/persistent pain or pain associated with multimorbidity, such an approach enables the individual to play an active role in their own self-management, grow in confidence and attain a sense of control and self-determined decision making.^23,34

By promoting active engagement using a person-centred approach, individuals experiencing pain have their diverse needs met and are more likely to adhere to their pain management plan.²³ This individualised focus can empower the person to carry on with an improved quality of living.^16,19,24,33  

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

Developing and maintaining a positive and mutually trusting therapeutic alliance is critical in a person-centred approach and to the success of treatment.^19,23,25 The adoption of an appropriate communication style whereby the health practitioner practices with competence, empathy and genuineness, actively listens, meets the person’s need for information and confirms mutual understanding are all important.^{17, 25, 33,35} 

Acknowledging and addressing the emotions of the individual and their significant/relevant others, managing uncertainty, building confidence and skills and providing evidence-based pain management resources and strategies are also fundamental to a person-centred approach to pain management.^16,24,25 Interdisciplinary collaboration is also fundamental to implementing a person-centred approach that meets the diverse needs of people who experience pain.   

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

While many health practitioners support a person-centred approach in principle, their knowledge, skills and confidence in delivering person-centred pain management are identified as areas that require ongoing reinforcement through pain management education. Achieving and maintaining strong knowledge of, and competency in, person-centred care delivery can empower health practitioners to overcome barriers (for example structural, attitudinal and time) to its consistent implementation.^22,30,36

By building and supporting the skills of health practitioners, the person-centred care standard defines a standard of pain education that supports better outcomes for Australian individuals experiencing pain. 

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}