Effect of a Whole-Person Model of Care on Patient Experience in Patients With Complex Chronic Illness in Late Life.
Nathan D Shippee, Tetyana P Shippee, Patrick D Mobley and 2 others
PMID 28133973WHAT IT FOUND
Patients with serious chronic illness who received a whole-person care model with lay care guides reported slightly better patient experience at 6 months than those receiving usual care.
The improvement was modest and driven by overall care satisfaction rather than specific communication or goal-setting domains.
Key findings
01The LifeCourse intervention resulted in a 1.96-point improvement in patient experience scores at 6 months compared to usual care.
02While the total experience score improved significantly, individual domains (care team, communication, goals) all trended positively but did not reach statistical significance.
03The intervention involved lay care guides providing monthly hour-long visits to support navigation and whole-person needs, distinct from clinical treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Non-random allocation based on geography introduces potential selection bias and confounding by site. The study used a newly developed and unvalidated measure for patient experience. Attrition was significant, with the final sample (212) much smaller than the initial eligible pool (556), raising concerns about bias. The effect size was small (1.96 points), and individual domain improvements were not statistically significant. The study did not assess cost, sustainability, or long-term outcomes beyond 6 months.
Declared interests
The authors declared no potential conflicts of interest. The research was supported by the Robina Foundation.
The easy way to misread this
Do not interpret the significant total score as proof that specific components like communication or goal-setting improved significantly, as those individual domains did not reach statistical significance. The benefit was a modest overall shift in experience, not a targeted improvement in clinical interactions.