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. 2023 Apr 16;26(4):1391–1403. doi: 10.1111/hex.13759
For care to fit, care should be:
  • Maximally responsive to patients' unique situations (dimension 1). It should reflect each patient's personal and medical backstory, and life circumstances.
  • Maximally supportive of patient priorities (dimension 2). It places patients’ needs and wishes in the foreground, accounting for and supporting their capacity to cope, adapt and thrive. It is congruent with each patient's values and their goals for life, well‐being and healthcare. It does not do harm. It draws from research evidence and guidelines for ‘patients like this’ to flexibly form care for ‘this patient’. It knows that people vary in their valuation of life and care.
  • Minimally disruptive patient lives (dimension 3). Through conversations, it understands that care contributes to how life is lived or aimed to be lived. It understands that patients have a finite and varying capacity to prevent disruption, cope and adapt.
  • Minimally disruptive of patients' loved ones and social networks (dimension 4). It is inclusive of and flexibly supports each patient's community of care, including their loved ones. It is not bound by the healthcare setting, but instead respectfully enters the patient's life space to support the work that patients do both in and with their community to make care fit.
Making care fit:
  • Requires patients (and their loved ones) and clinicians to collaborate (for the purpose of this review, split in ‘content’ (dimension 5) and ‘manner’ (dimension 6)). They use person‐sensitive communication, tailoring both the content and the manner of their conversation to their needs, abilities and situation. This conversation is potentially supported by tools. Care is built through equal patient–clinician relationships, mutual respect, willingness to accept each other's contributions, empathy, humanity and dignity.
  • Is an ongoing and iterative process (dimension 7). People's needs, desires, capacities, capabilities and personal or medical situations may change. Care plans should therefore be flexible and continuously modified.
Although the object of making care fit is to advance the situation of patients, the consequences of caring impact positively on patients, their loved ones, clinicians, and healthcare systems (dimension 8).