Patient-centered Care in Maternity Services: A Critical Appraisal and Synthesis of the Literature

Background
Patient-centered care (PCC) has been recognized as a marker of quality in health service delivery. In policy documents, PCC is often used interchangeably with other models of care. There is a wide literature about PCC, but there is a lack of evidence about which model is the most appropriate for maternity services specifically.

Aim
We sought to identify and critically appraise the literature to identify which definition of PCC is most relevant for maternity services.

Methods
The four-step approach used to identify definitions of PCC was to 1) search electronic databases using key terms (1995–2011), 2) cross-reference key papers, 3) search of specific journals, and 4) search the grey literature. Four papers and two books met our inclusion criteria.

Analysis
A four-criteria critical appraisal tool developed for the review was used to appraise the papers and books.

Main Results
From the six identified definitions, the Shaller's definition met the majority of the four criteria outlined and seems to be the most relevant to maternity services because it includes physiologic conditions as well as pathology, psychological aspects, a nonmedical approach to care, the greater involvement of family and friends, and strategies to implement PCC.

Conclusion
This review highlights Shaller's definitions of PCC as the one that would be the most inclusive of all women using maternity services. Future research should concentrate on evaluating programs that support PCC in maternity services, and testing/validating this model of care.