Illustration: a person thinks about his strengths

Personal Strengths during Consultation

Project period

2013 - 2016


Patient-Centred Outcomes Research Institute, National Institute of Health, USA


Original abstract

Most current approaches to patient care are focused on patients’ symptoms, limitations and weaknesses. This approach can guide medical treatment, but does not unleash the transformative power of people’s positive personal strengths that can help patients to live a fulfilling life despite having multiple chronic illnesses. A growing body of literature from the fields of positive psychology and bio-behavioral research points to the potential of bringing patient-identified personal strengths (PIPS) into illness management to achieve better patient-centered outcomes.

Our team has conducted groundbreaking work in developing and evaluating symptom-focused computer-supported Interactive Tailored Patient Assessment Tools (ITPAT) and in engaging patients and clinician stakeholders in participatory group model building to compare the effectiveness of alternate therapeutic approaches. In addition, we have developed a highly participatory practice-based research network (PBRN) of safety net practices serving disadvantaged patient populations.

We propose that focusing care on patient strengths can result in enhanced health behaviors and better patient-centered outcomes by motivating positive change and engaging patients in ways that the usual deficit-based model of care cannot. Therefore, we aim to:

1.   Identify patient-identified personal strengths relevant to chronic illness management.

2.   Develop a strength-focused computer-supported Interactive Tailored Patient Assessment Tool.

3.   Engage patients, caregivers and primary care clinicians in identifying mechanisms by which leveraging patient-identified personal strengths (PIPS) in different ways might affect processes and patient-centered outcomes of care.

4.   Simulate the effect of alternate approaches to leveraging PIPS in practice on patient-oriented outcomes and provider resources compared to usual deficit/illness-focused care.

These aims will be accomplished through a collaboration between patients with multiple chronic conditions, low SES and racial and ethnic minorities; care givers, clinicians and transdisciplinary researchers.  We will :

  • Engage patients and caregivers from the PBRN network in Appreciative Inquiry focus groups to identify PIPS. 
  • Working interactively with these focus groups to use the identified PIPS to develop a computer-supported Interactive Tailored Patient Assessment Tool (ITPAT). 
  • Using the Patient Strengths ITPAT in qualitative system dynamics group model building sessions to identify mechanisms by which assessments of patient strengths in primary care encounters can affect the processes and outcomes of care. 
  • Using the identified mechanisms to build simulation models that compare usual deficit/illness-focused care to care that is informed by patient-identified personal strengths.

This research will generate a useful new tool, simulation models, and knowledge that can be used to make health care more effective in producing patient-centered outcomes. 


  • Kurt C. Stange, MD, PhD

    Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, OH, United States

  • Shirley M. Moore, RN, PhD, FAAN

    Frances Payne Bolton School of Nursing Case Western Reserve University, Cleveland, OH, USA

  • Jon Kristinsson

    Senter for sykelig overvekt, Oslo University Hospital

  • Audun Stubhaug

    Avdeling for smertebehandling, Oslo University Hospital

  • Ingvil Berger

    Enhet for lungerehabilitering, Oslo University Hospital

  • Johan Stanghelle

    Sunnaas Hospital, Ambulatory Care Clinic (Aker)

  • Per Magnus Mæhle

    Samhandlingsarena Aker, Oslo University Hospital