ABSTRACT
Person‐centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA‐ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person‐centred wound care was identified. Most studies referred to patient‐centred rather than person‐centred approaches and applied principles such as empowerment, shared decision‐making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience‐based dimensions of care. Some studies used the term person‐centred as an unreflected keyword. Person‐centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person‐centred principles into consistent, evidence‐based clinical practice.
Keywords: empowerment, patient education, patient‐reported outcomes, person‐centred care, scoping review, shared decision‐making, wound management
Key Messages
Person‐centred care in wound management remains conceptually heterogeneous, unreflected and with interchangeable use of patient‐ and person‐centred terminology limiting theoretical clarity.
Few studies employ explicit frameworks; most integrate person‐centred elements such as empowerment, patient education and shared decision‐making without a defined theoretical foundation.
Current outcome measures focus predominantly on clinical or functional aspects, with limited assessment of relational and experience‐based dimensions of care.
Advancing person‐centred wound care requires consensus on definitions, development of validated frameworks and instruments capturing partnership, participation and patient experience.
1. Introduction
Person‐centred care (PCC) has become a cornerstone of contemporary health policy and clinical practice. The World Health Organization [1] defines people‐centred health services as an approach that consciously adopts individuals', families' and communities' perspectives as participants in and beneficiaries of trusted health systems that are organised around the comprehensive needs of people rather than individual diseases. This approach emphasises empowerment, shared decision‐making and recognition of the person within their social and life context, instead of focusing solely on disease management. Over recent decades, PCC has gained prominence as a response to the limitations of fragmented disease‐oriented care models [2, 3]. It reflects a paradigm shift from the ‘patient as object of care’ to the ‘person as partner in care’, where health systems are co‐produced through reciprocal relationships among professionals, patients and communities [1]. The concept is grounded in holistic, biopsychosocial principles and aligned with values such as respect, empathy and dignity [3, 4]. The medium‐range theory of PCC developed by McCormack and McCance [5] through years of research includes comprehensive theoretical considerations that also enable the implementation of the concept.
Despite broad consensus on its desirability, PCC remains inconsistently defined and operationalised across contexts [6, 7]. The term ‘person’ differs from ‘patient’ by emphasising the individual's life beyond illness, encompassing identity, autonomy and lived experience. As Lines et al. [7] argue, person‐centredness prioritises personal well‐being and participation in daily life, while patient‐centredness focuses more narrowly on clinical outcomes and treatment compliance.
Several frameworks have sought to structure and guide the implementation of PCC. Santana et al. [2] developed a conceptual framework distinguishing structural, process and outcome dimensions. Structural elements include promoting PCC culture, integrating patient perspectives into education and governance and ensuring supportive environments and information systems. Process dimensions involve communication, empathy, partnership and care coordination, while outcome dimensions emphasise access, satisfaction and patient‐reported outcomes. Similarly, Sturgiss et al. [3] identified nine recurring elements across 159 studies, including shared power and responsibility, therapeutic relationships, seeing the patient as a person, biopsychosocial understanding and continuity of care. These elements transcend disciplinary and national boundaries, underscoring a consistent conceptual core even when terms such as person‐centred, client‐centred or relationship‐centred are used interchangeably.
From the patient perspective, PCC is often experienced through being seen as a person, involvement in decision‐making, effective communication and meaningful relationships with professionals [4]. However, qualitative evidence suggests that PCC is frequently only partially realised; patients often report a lack of presence, time and mutual respect in care interactions. Overall, the literature indicates that PCC requires systemic commitment, spanning organisational culture, professional education and daily clinical communication, to truly embed the person's voice in care processes.
Chronic wound care presents a particularly relevant but underexplored field for the application of PCC. Chronic wounds such as diabetic foot ulcers and venous leg ulcers impose significant physical, psychosocial [8] and economic burdens on affected individuals [9]. Care is often fragmented and primarily focused on local wound healing rather than the person's overall well‐being and daily functioning [10]. The European Wound Management Association (EWMA) highlighted in its 2020 systematic review that person‐centred interventions in wound care mainly targeted patient education, leading to improvements in knowledge, satisfaction and quality of life, but found limited evidence for effects on clinical outcomes such as healing rates [11]. The authors concluded that while PCC holds promise for improving patient experience, standardised frameworks and evaluation criteria are lacking.
Building upon this, Panfil et al. [10] proposed within the German‐Austrian‐Swiss Wound Healing Society (WundD.A.CH) a theoretical foundation for person‐centred wound care, defining it as care that aligns with the health‐related needs, expectations and values of individuals rather than diseases. They emphasised that person‐centred wound care requires communication, shared decision‐making, empowerment and supportive organisational cultures, as well as the use of patient‐reported outcome and experience measures for evaluation. However, substantial barriers persist, including health systems oriented towards acute care, limited communication competencies and paternalistic professional attitudes [6]. Earlier contributions such as the Lindsay Leg Club Foundation Manifesto [12] also called for a paradigm shift ‘from the hole in the patient to the whole patient’, emphasising empathy, partnership, empowerment and community engagement as essential for dignified wound care.
Despite international advocacy [1, 11], person‐centred wound care remains insufficiently theorised and operationalised. Barriers include conceptual inconsistency, lack of assessment tools and inadequate interprofessional training [6]. While PCC frameworks have been successfully applied in rehabilitation [13], obstetrics [14] and women's health [15], wound management research continues to focus predominantly on clinical and material outcomes rather than relational, psychosocial or experiential dimensions. Furthermore, cultural and contextual inequities complicate implementation. Nkhoma et al. [16] emphasised that cultural adaptation and community engagement are critical for successful PCC, especially in resource‐limited settings. Without attention to patients' social contexts and lived experiences, PCC risks being reduced to rhetoric rather than meaningful practice.
Although key elements of PCC have been widely conceptualised, there is limited synthesis of how these principles have been already applied in wound care. Existing evidence suggests promising patient‐related outcomes but reveals substantial heterogeneity in frameworks, concepts and evaluation measures. Therefore, this scoping review aims to map and synthesise the existing literature on PCC in wound management in order to identify how person‐centred frameworks and concepts have been used, in which contexts they have been applied and what outcome criteria have been measured.
2. Materials and Methods
This review was conducted according to the methodological framework proposed by the Joanna Briggs Institute (JBI) for scoping reviews [17], which provides a systematic and transparent process for mapping the available evidence. Reporting adhered to the PRISMA‐ScR (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews) guidelines to ensure comprehensive and transparent documentation [18]. The review was registered in the Open Science Framework (OSF) (registration: https://doi.org/10.17605/OSF.IO/CWHS2) and designed in accordance with the JBI Manual for Evidence Synthesis [19].
2.1. Search Methods
2.1.1. Eligibility Criteria
The eligibility framework for scoping reviews was structured using the Population, Concept, Context model [17].
Population: Studies that involved adults (18 years and older) living with chronic or complex wounds, such as diabetic foot ulcers, venous or arterial leg ulcers, pressure ulcers or palliative wounds, were considered. Research including healthcare professionals, patients or informal caregivers engaged in wound management was also eligible.
Concept: The review focused on PCC within wound management, encompassing theoretical models, frameworks, principles, implementation strategies and outcomes. Studies addressing PCC interventions, conceptualizations, measurement instruments (e.g., patient‐reported outcome or experience measures) or implementation processes were included.
Context: Evidence from any healthcare setting (acute, community, home‐based or long‐term care) was considered.
Eligible sources comprised peer‐reviewed empirical studies (qualitative, quantitative and mixed methods), literature reviews, conceptual or theoretical papers and clinical guidelines. Publications were limited to English or German and included from January 2020 until March 2025 to capture developments following the EWMA review [11]. To maintain contextual comparability, studies conducted within Western healthcare contexts or applying comparable conceptual and organisational care models were included. Excluded were commentaries, editorials, studies focusing solely on technical wound care without a person‐centred dimension and commercially influenced reports.
2.1.2. Search Strategy
Search terms for wound care and person‐centred care were derived from a previous review [13], the Cochrane Wound Group and relevant clinical practice guidelines, including the S3 Guideline for Palliative Care in Patients with Incurable Cancer [20]. These terms were subsequently refined through an iterative process of testing and validation to ensure comprehensiveness and specificity.
The final search was carried out on 20 March 2025 in the following databases: PubMed/MEDLINE, Cochrane Library and Google Scholar. Although CINAHL was initially considered, it was excluded due to closed institutional access. Boolean operators (‘AND’, ‘OR’), truncation, phrase searching and proximity operators were applied to combine relevant terms such as (‘person‐centred care’ OR ‘patient‐centred care’ OR ‘people‐centred care’) AND (‘chronic wound’ OR ‘diabetic foot ulcer’ OR ‘pressure ulcer’ OR ‘leg ulcer’). The complete search string is available in Table 1.
TABLE 1.
Search strategy.
|
Pubmed/Medline:
|
| Cochrane | ||
|---|---|---|
| #1 | MeSH descriptor: [Foot Ulcer] explode all trees | 1716 |
| #2 | MeSH descriptor: [Diabetic Foot] explode all trees | 1612 |
| #3 | (diabet* near/3 ulcer*):ti,ab,kw | 2783 |
| #4 | (diabet* near/3 (foot or feet)):ti,ab,kw | 4071 |
| #5 | (diabet* near/3 wound*):ti,ab,kw | 733 |
| #6 | #1 or #2 or #3 or #4 or #5 | 4573 |
| #7 | MeSH descriptor: [Leg Ulcer] explode all trees | 2943 |
| #8 | (varicose next ulcer*):ti,ab,kw OR (venous near/1 ulcer*):ti,ab,kw OR (ulcus near/1 cruris):ti,ab,kw OR (varicose near/1 ulcer*):ti,ab,kw OR (ulcus near/1 cruris):ti,ab,kw | 1518 |
| #9 | #7 or #8 | 3558 |
| #10 | MeSH descriptor: [Skin Ulcer] explode all trees | 4255 |
| #11 | (pressure near/1 ulcer*):ti,ab,kw OR (pressure near/1 sore*):ti,ab,kw AND (pressure near/1 injur*):ti,ab,kw | 2139 |
| #12 | (chronic near/1 wound*):ti,ab,kw | 977 |
| #13 | (fungat* near/3 (wound* or tumor* or tumour* or lesion*)):ti,ab,kw | 23 |
| #14 | (ulcer* near/1 (tumor* or tumours*)):ti,ab,kw OR (‘malignant wound’):ti,ab,kw AND (metastases next (cutaneous or skin)):ti,ab,kw | 40 |
| #15 | #10 or #11 or #12 or #13 or #14 | 5932 |
| #16 | (decubitus next ulcer*):ti,ab,kw OR (decubitus next sore*):ti,ab,kw | 182 |
| #17 | (bed next sore*):ti,ab,kw OR (bedsore*):ti,ab,kw | 253 |
| #18 | #16 or #17 | 388 |
| #19 | (skin ulcer*):ti,ab,kw OR (foot ulcer*):ti,ab,kw | 6671 |
| #20 | (arterial ulcer*):ti,ab,kw OR (neuropathic ulcer*):ti,ab,kw | 1309 |
| #21 | ((wound* or ulcer*) near/1 (ischaemic or ischemic)):ti,ab,kw OR (bed sore* or bedsore* or pressure sore* or pressure ulcer* or decubitus ulcer*):ti,ab,kw OR (chronic near/1 (wound* or ulcer*)):ti,ab,kw | 7552 |
| #22 | #19 or #20 or #21 | 12494 |
| #23 | MeSH descriptor: [Varicose Ulcer] explode all trees | 867 |
| #24 | (chronic wound care):ti,ab,kw OR (chronic Wounds):ti,ab,kw OR (non‐healing wounds):ti,ab,kw OR (palliative wound care):ti,ab,kw | 2796 |
| #25 | #23 or #24 | 3447 |
| #26 | #6 or #9 or #15 or #18 or #22 or #25 | 16040 |
| #27 | MeSH descriptor: [Patient‐Centered Care] explode all trees | 1303 |
| #28 | MeSH descriptor: [Patient Preference] this term only | 1236 |
| #29 | (‘Patient Experience’):kw OR (‘Patients Experience’):ti,ab,kw OR (‘Patient Experiences’):ti,ab,kw OR (‘Patients Experiences’):ti,ab,kw OR (‘Patient Perspective’):ti,ab,kw | 4439 |
| #30 | (‘Patients Perspective’):ti,ab,kw OR (‘Patient Perspectives’):ti,ab,kw OR (‘Patients Perspectives’):ti,ab,kw OR (‘person centred’):ti,ab,kw OR (‘person centered’):ti,ab,kw | 2077 |
| #31 | (‘client centered’):ti,ab,kw OR (‘client centred’):ti,ab,kw OR (‘patient concordance’):ti,ab,kw OR (‘patient involvement’):ti,ab,kw | 965 |
| #32 | (‘Patient empowerment’):ti,ab,kw AND (wound*):ti,ab,kw | 3 |
| #33 | #27 or #28 or #30 or #31 or #32 | 5299 |
| #34 | #26 AND #33 | 36 |
|
Google Scholar (‘Patient centered care’ OR ‘patient centred care’) AND ((intitle:‘chronic wound*’ OR intitle:’diabetic foot’ OR intitle:‘diabetic feet’) OR (intitle:‘ulcus cruris’ OR intitle:‘ulcus’) OR (intitle:‘bedsore*’ OR intitle:‘pressure ulcer*’) OR (intitle:‘fungat* wound’ OR intitle:‘tumor* lesion’)) hier |
Additionally, reference lists of included studies and relevant reviews were hand‐searched to identify additional eligible publications.
2.1.3. Study Selection
The search results were imported into EndNote X20 [21] to identify and remove duplicate records. Following de‐duplication, two reviewers (E.‐M.P. and F.S.) independently screened the titles and abstracts of all retrieved studies, after which full texts were assessed for eligibility according to the predefined inclusion criteria. Any disagreements were resolved through discussion, and if consensus could not be reached, a third reviewer (S.P.) provided the final decision. The entire study selection process was documented using a PRISMA‐ScR flow diagram to ensure transparency and reproducibility [18] (Figure 1).
FIGURE 1.
Prisma flowchart.
2.1.4. Data Extraction
Data were charted independently by two reviewers using a standardised and piloted data extraction form. The following information was recorded for each included study: bibliographic details, year, country, study design, type of wound, setting, frameworks and concepts and outcomes. Extraction was supported by the Elicit AI‐assisted tools, with all entries verified manually for accuracy and completeness.
Consistent with the purpose of a scoping review, methodological quality assessment of individual studies was not undertaken [17].
2.1.5. Data Synthesis
Extracted data were synthesised descriptively. Results were grouped by study type and thematically organised into conceptual domains: [1] frameworks and theoretical underpinnings of person‐centred wound care, [2] used concepts and [3] measured outcomes. A narrative synthesis summarised the findings. Tables were developed to illustrate study characteristics and the relevant content about person‐centredness. As the review was based exclusively on publicly available sources, ethical approval was not required.
3. Results
3.1. Selection of Sources of Evidence
The database search yielded a total of 319 records. After removal of duplicates, titles and abstracts were screened independently by two reviewers. Following full‐text assessment, 14 publications met the inclusion criteria and were included in the final analysis. Reasons for exclusion during screening were most commonly due to conceptual misapplication of the term, for instance when ‘person‐centred’ was used primarily to describe outcome measurement, device evaluation or service satisfaction, without incorporating relational or participatory elements.
Studies focusing solely on patient experience were excluded because they did not address key elements of person‐centred care, such as relational or participatory processes. The selection process is summarised in the PRISMA‐ScR flowchart (Figure 1).
3.2. Characteristics of the Included Sources
The included publications were published between 2020 and 2024 and originated primarily from Europe (n = 6) and North America (n = 4), with additional contributions from Australia, India and two international collaborations. The study designs comprised four observational studies [22, 23, 24, 25], four systematic or narrative reviews [26, 27, 28, 29], three qualitative investigations [30, 31, 32], one Delphi consensus study [33], one conceptual framework paper [34] and one concept development [35]. Settings varied widely and included community wound care, acute hospital services and podiatric practice (see Table 2).
TABLE 2.
Overview of included studies.
| Author, year |
Country in which the study was conducted/ paper was published |
Study design/person‐centred element/aim or research question | Type of wound/setting | Definition of person‐centredness | Relevant content |
|---|---|---|---|---|---|
| Bianchi et al. (2020) | UK | Framework/adherence with therapy, empowerment, self‐management | Venous and mixed leg ulcer/community wound care | No definition, legitimation through costs and suffering | Goal is to improve the outcomes of patients with venous and mixed leg ulcers. Person‐centredness focuses primarily on adherence to treatment, empowerment of patients and their families and appropriate self‐management. To this end, the authors conceptualise ‘dialogues’ with patients, their families and other healthcare professionals. |
| Callender et al. (2021) | USA | Narrative review/adherence | General wounds/without specific setting | No definition, focus on adherence | Improving patient adherence through patient‐centred training; description of theoretical models for behaviour change and communication concepts. |
| Chatterjee et al. (2024) | India | Observational study/patient‐centred assessment/evaluation of the assessment Blue Index (BI) as a single index | General wounds/community wound care | No definition, term patient‐centred only appears in the title | The Assessment BI uses ten parameters to measure objective clinical criteria such as blood glucose and blood pressure, as well as subjective criteria such as adherence to diet, exercise or smoking habits, as well as diabetes‐related complications. It can be used for patient education, monitoring, as an aid to clinical decision‐making and as motivation for people with diabetes. |
| Clemett et al. (2024) | UK | Systematic review/shared decision‐making/exploration of the effectiveness of interventions to enhance patient participation in shared decision‐making | General wounds/without specific setting | Definitions according to McCormack and McCance [5] and Gethin et al. [11] | Eight included studies; patients respond well to shared decision‐making interventions. Interventions varied widely, generally multi‐level and included information ranging from individual to group training, motivational interviewing and the collection and response of questions. There were few theory‐based interventions. |
| Deery et al. (2022) | USA | Observational study/patient reported outcome/what factors are associated with success from a patient's perspective? | DFU/community wound care | No definition | The 131 patients included rated clinical success lower than the physicians. This was due to their preference for wound healing and ambulation over vascular patency. |
| Egan et al. (2021) | UK | Observational study/patient‐centred support/exploration of the practice and understanding of podiatrists towards patient‐centred support versus prescriptive instruction in consultations | DFU/allgemein Podologen | No definition, refer to Pelzang [36] | A survey of 78 podiatrists. Most respondents agreed that they provide patient‐centred training. They identified barriers to this as insufficient personal skills and self‐confidence, patients' unwillingness to engage in self‐management and the need for institutional change and support. The authors conclude that contradictory responses indicate a lack of understanding of behaviour change techniques. |
| Gould et al. (2020) | USA | Observational study/PREM/what are clinicians' perception and people with wounds regarding clinically meaningful endpoints for wound care? | General wounds/without specific setting | No definition | A survey of 438 patients and caregivers. The most important quality of life outcomes were increased independence, reduced social isolation and pain. Narrative answers from patients with wounds highlighted the inability to perform activities of daily living and pain as major factors that impacted their daily lives. |
| Hackert et al. (2024) | Germany | Concept development/empowerment/development of the concept of degrees of freedom | General wounds/without specific setting | Patient centred in the form of a secondary source as a quote: Latimer et al. [37] | They identify five dimensions of empowerment: informed consent and shared decision‐making, adherence to self‐care, responsibility and control, a general call for empowerment and ‘degrees of freedom’. By this, they define the ability of patients to initiate everyday wound care tasks and tailor them to their wishes. Since a concept for ‘degrees of freedom’ is lacking, the authors developed this in a further step. They believe that patient control could be facilitated by utilising degrees of freedom. |
| Highton et al. (2024) | UK | Systematic review/PROM/summarisation of the literature presenting PROMs or patient experience outcomes and highlight areas that are potentially impacted by patient ethnicity | DFU/without specific setting | No definition | Inclusion of 23 qualitative and quantitative studies; diabetes‐related foot conditions have a largely negative impact on various life dimensions, with some differences regarding views on disease causes and footwear habits. |
| Nano et al. (2020) | International | Delphi panel/PROM/selection of a core list of standard outcomes for diabetes to be routinely applied internationally, including patient reported outcomes | DFU/without specific setting | No definition, term person‐centred only appears in the title | 25 international experts and patient representatives; the following three instruments were recommended for regular follow‐up assessments: the WHO Well‐Being Index for psychological well‐being; the depression module of the Patient Health Questionnaire for depression; and the Problem Areas in Diabetes scale for diabetes distress. |
| Ong et al. (2024) | Australia | Qualitative study/shared‐decision‐making/perspectives of individuals, healthcare professionals and experts regarding decision‐making for people with DFU who were considering non‐urgent amputation | DFU/acute setting | No definition, reference to person‐centred factors such as emotional state, psychological well‐being and support networks | 26 persons were surveyed about their decisions about amputation. Key aspects included considering their own needs and expectations regarding their quality of life and lifestyle. Key aspects included the available evidence for amputation; trust, respect and the right time for discussions; adapting decisions to individual circumstances and reaching a turning point in decisions for the future. |
| Romero‐Collado et al. (2022) | Spain | Systematic review/PROM/psychometric properties of standard instruments for assessing quality of life | DFU/without specific setting | No definition, term patient‐centred once mentioned as legitimation for PROMs | Available PROMs to measure QoL have limited evidence for their measurement properties. There is no fully suitable PROM. Wound‐QoL is the most feasible PROM. |
| Squitieri et al. (2020) | International | Qualitative study/PREM/understanding patient experiences and health care processes that impact quality of care | General wounds/without specific setting | No definition; hint: PREMs have potential to improve patient‐centredness | Interviews with 60 patients from four different industrialised countries with various wounds were conducted. The authors identified five domains: care coordination, receipt of care, information provision, patient‐physician interaction and treatment implementation, which were described in detail in 21 subdomains. |
| Zamani et al. (2021) | USA | Qualitative study/PREM/prioritisation of patient‐centred outcomes | DFU/acute setting | No definition: hint: patient‐centred outcomes reflect functional status and efficiency of care | Group interviews with patients with DFS, their relatives and a healthcare professional. Prioritised were the prevention of amputations and the maintenance or improvement of health‐related quality of life. |
Abbreviations: DFU: diabetic foot ulcer; PREM: patient‐reported experience measures; PROM: patient‐reported outcome measure.
3.3. Terminology Person‐Centredness
Terminological consistency was limited. Only a minority of studies explicitly used the term PCC [31, 33, 34], whereas most referred to adjacent concepts such as patient‐centred care, person‐reported outcomes or shared decision‐making [22, 23, 24, 25, 26, 27, 28, 29, 30, 32, 35]. In several publications, the concept appeared as a general guiding principle rather than a systematically applied theoretical construct.
The legitimacy of person‐centred care was addressed inconsistently. Several publications used the term without explicit theoretical grounding, often equating it with humanistic or non‐somatic orientations such as empowerment, quality‐of‐life assessment or educational emphasis [22, 38]. In other sources, person‐centredness appeared mainly as a descriptive label without a defined conceptual basis [23, 24]. Overall, the extent and manner of use of the term varied substantially across studies.
3.4. Frameworks and Concepts
Only one explicit model of person‐centred wound care was identified. Bianchi et al. [34] proposed the 3D Framework (‘Discover, Discuss, Decide’), developed for nurses caring for individuals with venous or mixed aetiology leg ulcers. The framework promotes structured dialogues with patients and caregivers to identify expectations, goals and the personal meaning of illness. It integrates shared goal setting, empowerment and education to enhance adherence and self‐management and highlights the importance of aligning treatment plans with individual preferences and social contexts.
Other studies incorporated person‐centred elements more implicitly, addressing person‐centred principles indirectly by embedding them within broader clinical, educational or decision‐making contexts. In a systematic review of shared decision‐making interventions in wound management, patient acceptance of participatory approaches was generally high, although the theoretical foundations of these interventions were inconsistent across studies [27]. The role of shared decision‐making was also examined in non‐emergency amputation decisions among individuals with diabetic foot syndrome, where empathy, trust, timing of communication and respect for patients' circumstances were identified as essential to the quality of clinical decisions [31]. Educational strategies also reflected person‐centred elements. A training framework for wound care professionals integrated behavioural and motivational theories, including the Health Belief Model, Theory of Planned Behaviour and Social Cognitive Theory, to strengthen patient engagement, with particular emphasis on motivational interviewing and structured communication techniques designed to enhance self‐efficacy and adherence [26].
Themes of empowerment and self‐management were present across multiple studies. Reports from podiatric practice indicated that clinicians often perceived their care as patient‐centred but demonstrated variable understanding and limited skills in applying behaviour‐change communication to support self‐management among people with diabetic foot conditions [24]. The multidimensional nature of empowerment was further explored through qualitative analysis, which identified five interrelated dimensions: education and joint decision‐making, adherence to self‐care, assumption of responsibility, empowerment discourse and autonomy in wound‐related tasks, highlighting the diversity of conceptual approaches to patient involvement [35].
3.5. Person‐Centred Outcomes and Instruments
Measurement of person‐centred outcomes was reported in 12 of 14 included publications, with six studies employing or evaluating structured measurement instruments. Most tools were patient‐reported outcome measures (PROMs) or patient‐reported experience measures (PREMs) that varied in conceptual focus, psychometric testing and application within wound care contexts.
PROMs addressing health‐related quality of life were frequently used to capture the subjective impact of wounds and their treatment. In a psychometric review of ten instruments designed for people with diabetic foot ulcers, including the Wound‐QoL, Diabetic Foot Ulcer Scale—Short Form (DFS‐SF) and Cardiff Wound Impact Schedule (CWIS), the Wound‐QoL demonstrated the most satisfactory content validity and clinical feasibility [29]. Extending beyond single instruments, an international Delphi consensus involving 288 experts from 57 countries identified a standardised set of person‐centred outcome measures for diabetes care [33]. The panel recommended the WHO‐5 Well‐Being Index for psychological well‐being, the PHQ‐9 Depression Module for depressive symptoms and the Problem Areas in Diabetes (PAID) scale for diabetes‐related distress as core PROMs suitable for routine outcome monitoring in populations with chronic wounds. Complementing these consensus efforts, the Blue Index (BI) was developed and validated in a hospital‐based cohort of individuals with diabetic foot ulcers [22]. The BI combined clinical indicators, such as blood glucose and blood pressure, with behavioural variables including adherence to dietary recommendations and physical activity to evaluate patient engagement in self‐management. A systematic review examining PROMs used in diabetes‐related foot conditions further showed that most available instruments lacked cross‐cultural validation and were seldom tested in ethnically diverse populations [28].
While outcome measures predominated, three studies specifically addressed PREMs to assess perceptions of care processes [23, 30, 32]. The Wound‐Q was developed as a wound‐specific PREM based on interviews with 60 patients from several countries and comprises five domains: coordination and continuity of care, accessibility, information provision, patient–provider relationship and treatment experience, organised into 21 subdomains [32]. In a large international survey of 438 patients and caregivers, participants identified independence, pain reduction and diminished social isolation as the most meaningful indicators of treatment success [25]. Similar attention to patient priorities was observed in an analysis comparing clinical and patient perspectives following lower‐extremity revascularization for diabetic foot disease; patients valued wound healing and mobility, whereas clinicians emphasised vessel patency [23]. Parallel findings were reported in interviews with patients, relatives and clinicians, where amputation prevention and preservation of quality of life emerged as the predominant goals of care for individuals with diabetic foot ulcers [30]. These studies collectively illustrated that experience‐based data were primarily used to identify dimensions of care valued by patients rather than to evaluate structured interventions.
Beyond PROMs and PREMs, two publications described conceptual frameworks that integrated person‐centred principles into assessment processes. Within the 3D Framework, structured dialogue‐based assessments were employed to align treatment objectives with the goals articulated by patients and caregivers [34]. A complementary educational framework combined behavioural theories, the Health Belief Model and Theory of Planned Behaviour, to shape patient education and to appraise adherence and engagement in wound care [26].
4. Discussion
This scoping review examined how PCC has been conceptualised and evaluated within wound management. Although the topic has gained increasing attention in recent years, the analysis demonstrates that research remains conceptually fragmented and terminologically inconsistent. The included studies approached person‐centredness through diverse theoretical, educational and empirical lenses, yet few grounded their work in an explicit PCC framework.
A recurring methodological challenge in the review process was the lack of definitional clarity surrounding the term PCC. Across the literature, PCC was frequently used interchangeably with patient‐centred care or holistic care, with limited differentiation between these concepts. Several studies referred to person‐centredness only superficially, often to describe a general orientation towards empathy, communication or psychosocial support—without operational or theoretical grounding. This lack of conceptual precision complicated inclusion decisions and aligns with earlier observations by Constand et al. [39] and Santana et al. [2], who reported similar inconsistencies across healthcare disciplines. Unexpectedly, the term ‘person‐centred’ was used only once in the title in some publications [22, 33], without any explicit reference to it in the text. This may indicate that the concept is intuitively considered relevant, but the keyword is not used in a reflective way in the content.
The distinction between person‐centred and patient‐centred care is more than terminological; it reflects a fundamental epistemological shift in the understanding of the care relationship. As Lindsay et al. [12] articulated in their call to action for wound management, the transition from focusing on ‘the hole in the patient’ to caring for ‘the whole person’ signifies an evolution from biomedical reasoning towards relational and contextual understanding. While patient‐centred care often emphasises treatment outcomes and adherence, PCC situates the individual within their lived experience, personal values and social context [1, 7, 40, 41].
The variation in terminology also appeared to follow disciplinary lines. Within nursing and allied health research, person‐centredness was often discussed as an ethical and relational practice rooted in partnership and mutual respect [5]. In contrast, studies situated in medical or surgical contexts typically linked the concept to treatment success, adherence or quality‐of‐life outcomes [23, 30]. This disciplinary divergence mirrors findings in interprofessional care research, which shows that the interpretation and application of person‐centred principles are influenced by professional identity and organisational culture [42, 43, 44]. Such variation likely contributes to the absence of shared operational standards and measurable indicators for person‐centred wound care.
Our results also highlighted how person‐centredness is legitimised within the literature. Several studies justified their person‐centred orientation through notions of self‐management, empowerment and patient activation rather than explicit theoretical models. In chronic wound care, person‐centred approaches were often framed as responses to the psychosocial complexity of living with a chronic wound, particularly, in diabetic foot syndrome. Hansen et al. [45], for instance, illustrated that individuals living with diabetes‐related foot ulcers required individualised, communicative and family‐centred approaches that recognise the emotional and relational dimensions of illness. Similarly, Ledger et al. [46] found that adherence to pressure ulcer prevention strategies depends strongly on integrating patient lifestyles and preferences into treatment planning. These findings suggest that the legitimacy of person‐centred care in wound management often derives from its perceived relevance to daily life and practical functioning rather than from explicit theoretical justification.
Empowerment was a recurring theme across studies but varied in scope and interpretation. The concept was often equated with self‐management or individual responsibility rather than viewed as a dynamic, relational process. Hackert et al. [35] described empowerment as encompassing five dimensions: education, shared decision‐making, self‐care adherence, responsibility and degrees of freedom, indicating its conceptual breadth. However, framing empowerment primarily in terms of autonomy risks overlooking the collaborative essence of person‐centredness, which depends on partnership and dialogue between professionals and patients [5]. Similarly, holistic approaches, while common in wound management, cannot be assumed to represent person‐centred care. Holism often targets the physical, psychological and social dimensions of health but does not necessarily acknowledge the person's identity, agency and participation in care decisions [2, 15].
The 3D Framework [34] marks important steps towards operationalising person‐centred wound care. It structures clinical dialogue into ‘Discover, Discuss, and Decide’ phases. However, it remains limited to conceptual or descriptive validation. Comparable to the findings of Gethin et al. [11], the literature continues to emphasise person‐centred principles rather than empirically tested frameworks or standardised interventions.
The diversity of measurement instruments identified in this review further underscores the conceptual heterogeneity of the field. Tools such as the Wound‐QoL [8], Wound‐Q [32] and BI [22] represent valuable advances in assessing subjective experiences, yet their theoretical connection to PCC remains limited. Instruments validated for general chronic conditions, such as the WHO‐5 Well‐Being Index, PHQ‐9 and PAID scale [33], may capture related constructs but do not fully reflect the relational and participatory dimensions of person‐centredness. As Gethin et al. [11] and Panfil et al. [10] both noted, further methodological refinement is needed to ensure that measurement tools evaluate not only functional or psychosocial outcomes but also the underlying processes of engagement, partnership and mutual understanding that define person‐centred care.
In the context of wound management, these observations point to a field that is conceptually dynamic but methodologically immature. The inconsistent use of terminology, the lack of theoretically grounded interventions and the absence of validated outcome measures make it difficult to compare studies or assess the effectiveness of person‐centred approaches across clinical settings. This conceptual fragmentation reflects broader challenges in implementing person‐centred care in health systems that remain structured around biomedical efficiency rather than relational continuity. Ongoing work, such as that by Panfil et al. [10] and Gethin et al. [11], underscores the importance of establishing a shared conceptual language and empirical frameworks capable of bridging theory and practice in person‐centred wound care.
4.1. Strengths and Limitations
This scoping review represents the first structured synthesis of literature on PCC in wound management, integrating conceptual, empirical and methodological perspectives. A comprehensive and peer‐reviewed search strategy based on the JBI methodology [17, 19, 47] strengthened the rigour of the review and minimised selection bias. The inclusion of diverse study designs, ranging from qualitative inquiries to framework and instrument development, allowed for a multidimensional understanding of how person‐centred principles have been interpreted and applied in wound care. The iterative screening process, conducted independently by multiple reviewers, enhanced the transparency and reproducibility of the findings.
Nevertheless, several methodological limitations must be acknowledged. In line with the JBI approach, no formal critical appraisal of methodological quality was conducted, which restricts the ability to assess the strength of evidence or to draw conclusions regarding the effectiveness of interventions. The heterogeneity of study designs, conceptual frameworks and outcome measures further limited the potential for comparison and synthesis. Additionally, the inconsistent and overlapping terminology surrounding person‐ and patient‐centred care complicated inclusion decisions and may have led to the exclusion of relevant studies that addressed person‐centred principles implicitly rather than explicitly.
The search was limited to literature published in English and German within predominantly Western contexts, which may have excluded culturally diverse perspectives on person‐centred wound care and introduced selection bias. Furthermore, the inclusion of literature reviews among the sources increases the possibility of study duplication, although cross‐checking and data verification procedures were applied to mitigate this risk. Finally, as person‐centredness is a complex and evolving construct, some relevant publications may not have been indexed under standardised terminology and could therefore have been unintentionally overlooked despite the systematic search strategy.
5. Conclusions
PCC in wound management remains conceptually fragmented and inconsistently applied. Although the term is an unreflected keyword and principles such as partnership, empowerment and shared decision‐making are increasingly recognised, few studies operationalise these within explicit theoretical frameworks. The interchangeable use of patient‐centred and person‐centred terminology reflects disciplinary variation and hampers conceptual clarity.
Emerging frameworks, including the 3D Framework and the Chronic Wound–Related Pain Model, offer valuable direction but lack empirical validation. Current outcome measures largely emphasise clinical or functional endpoints, underscoring the need for instruments that also capture relational and experiential aspects of care. Advancing person‐centred wound management will require consensus on definitions, development of context‐specific frameworks and validated tools that reflect the multidimensional nature of care. Strengthening conceptual and methodological coherence is essential to translate person‐centred principles into consistent and measurable clinical practice.
Funding
The authors have nothing to report.
Ethics Statement
The authors have nothing to report, as this study is a scoping review based on previously published literature and did not involve human participants.
Conflicts of Interest
The authors declare no conflicts of interest.
Acknowledgements
Open access publishing facilitated by Haute Ecole Specialisee de la Suisse Occidentale, as part of the Wiley ‐ Haute Ecole Specialisee de la Suisse Occidentale agreement via the Consortium Of Swiss Academic Libraries.
Data Availability Statement
The data that support the findings of this study are openly available in Open Science Framework at https://doi.org/10.17605/OSF.IO/CWHS2.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are openly available in Open Science Framework at https://doi.org/10.17605/OSF.IO/CWHS2.