A five-year systematic approach to person-centred hearing care in China shows how implementation, reflection and learning deepen understanding of the person.
Person-centred care (PCC) has become increasingly important in healthcare, including audiology. Although its principles are widely recognised, implementing them consistently in clinical practice remains challenging. Over the past five years, colleagues in China and internationally have worked together to develop person-centred hearing care (PCHC) systematically.
Through implementation, reflection and continuous learning, the programme evolved from introducing PCC concepts and tools to developing a deeper understanding of the person at the centre of care. This article shares that journey, key learnings and the practical framework that emerged.
Five-year PCHC journey in China
PCC has evolved over 70 years through contributions from psychology, healthcare and the social sciences. Carl Rogers’ person-centred approach, George Engel’s biopsychosocial model, and work by the World Health Organization and the Picker Institute all contributed to an understanding that healthcare should focus on the person rather than the disease [1–2]. Within audiology, the Ida Institute played a pioneering role for 15 years before closing in 2024. These developments laid the foundation for our programme.
The programme developed in two stages. The first stage (2020–2023), the Ida China PCC Project, focused on introducing and localising the six PCC elements and Ida tools, establishing a strong foundation in China. The second stage (2023 onwards) focused on developing PCC more systematically. Beyond knowledge, skills and tools, we explored the essence of PCC, leading to the PCC Capability-Competence Framework.
An international group of 12 key opinion leaders drove the programme through monthly meetings and collaboration. In 2025, we established the PCC Alliance with support from The Person-Centred Care Hearing Research Centre (PCCHRC). The programme brings together hearing care professionals, universities, researchers, industry partners, professional associations, and people with hearing loss and their families. Its mission is to transform hearing care towards a person-centred service model that restores humanity to professional relationships, empowers both professionals and people with hearing loss, and improves outcomes, satisfaction and wellbeing. Three strategies guided the programme: synthesising multidisciplinary insights, developing an implementation framework and integrating it into clinical practice with continuous evaluation.
Figure 1: Programme eight-step implementation pathway.
From vision to practice
The programme followed an eight-step implementation pathway, progressing from introducing concepts to developing guidelines and standards (Figure 1). Early work focused on adapting PCC concepts and Ida tools for the Chinese context. As the programme expanded, educational resources were produced, research findings were published and national training programmes were introduced.
Figure 2: Programme timeline and key milestones.
Several milestones marked this journey (Figure 2). An important milestone was the Chinese translation of Counseling-Infused Audiologic Care from Drs Clark and English [3]. The title is adapted as Person-Centred Hearing Counseling and Care. The book provides a systematic guide to PCC knowledge, skills, procedures and tools for both university education and clinical practice. In 2024, person-centred principles were incorporated into China’s national standard for hearing-aid fitting.
Implementation has focused on four major areas: awareness, education, research and clinical practice, with remarkable results. The programme has engaged approximately 3000 hearing care professionals, 2000 university students across 12 universities, and more than 500 hearing centres. Thousands have participated in webinars, seminars and conference presentations. More than 20 papers have been published, two dedicated PCC journal issues produced and a PCC mobile application developed to support clinical practice. PCC principles are now being applied across a broad range of hearing services, including hearing-aid fitting, cochlear implant programmes, rehabilitation and tinnitus management in both public hospitals and private hearing centres.
Outcome and impact
Clinical experience suggests that PCC strengthens trust between professionals and people with hearing loss, improves adherence and satisfaction, and enhances experiences for both clinicians and patients. Improved satisfaction is typically observed within one to three months, the PCC fitting model is typically established within three months and overall effectiveness is observed in the hearing centre within three to six months.
Hearing care professionals attend the PCC seminar in PCCHRC 18–20 April 2026.
This programme has made a substantial impact on people with hearing loss, professionals and hearing services in China. It has gained increasing national recognition, supporting all stakeholders, and provides a sustainable model for advancing person-centred hearing care.
Key learning and development
We firstly focused on introducing PCC concepts, counselling skills and clinical tools. However, they did not explain why some professionals naturally practised person-centred care while others struggled to sustain it. This prompted us to explore more fundamental questions:
- What is a person and personhood? Who am I?
- What does person-centredness mean?
- What is PCC?
- Why is PCC important?
- How can it be practised authentically in everyday clinical practice?
These questions gradually shifted our focus from implementation to understanding the essence of PCC.
Understanding the essence of the person and PCC
We explored these questions through the lens of medicine, psychology, philosophy and spirituality, drawing on Carl Rogers, Virginia Satir, Eckhart Tolle, Byron Katie and Buddhist philosophy [4–5]. Medical and behavioural perspectives describe what a person does, whereas psychological, philosophical and spiritual perspectives explore what that person thinks and feels, helping explain why that person acts in that way at that moment. Looking beyond observable behaviour reveals the deeper aspects of the person and the experiences that shape them. Together, these perspectives suggest that every person has inherent dignity, the ability to grow and develop self-awareness, and a unique way of understanding themselves and the world around them.
Although suffering may arise through thoughts, emotions, life experiences, beliefs, ego or attachment, these do not define the person. A person is more than a disease, diagnosis or social role, and cannot be reduced to their symptoms, emotional state or perceptions at any given moment. At the centre lies the authentic self (‘Who I am’), surrounded by the person, personhood and our shared humanity. Person-centred care therefore recognises each individual as unique, with their own inherent worth and potential for growth, rather than simply representing a model of healthcare delivery.
PCC begins with presence, mindfulness, empathy and compassion. It is not only about what professionals do, but also how they understand themselves and relate to the person before them. The essence of PCC lies in understanding the person and cultivating a person-centred way of being for everyone involved.
PCC Capability–Competency Framework
This understanding inspired us to recognise that professional development progresses from doing to being, shifting from acquiring competences to developing professional capability, including presence, compassion and authentic relationships. Effective person-centred care extends beyond observable knowledge and skills. Carl Rogers’ person-centred approach is grounded not only in professional competence but also in a way of being characterised by three attitudes: empathy, congruence and unconditional positive regard.
Figure 3: PCC Capability–Competency Development Model.
Adapted from the iceberg concept, we developed the PCC Capability–Competency Development Model (Figure 3), comprising seven layers. Visible layers include knowledge, skills, procedures and tools, while the deeper layers comprise principles, attitudes and presence. These deeper qualities shape how professionals think, relate and respond in clinical practice, providing the foundation for consistent person-centred practice. In this model, professional capability builds on professional competence by integrating knowledge, skills, principles, attitudes, presence and authentic relationships. It represents a new mindset of PCC.
Figure 4: PCC Capability–Competency Framework.
Building on this model, we developed the PCC Capability Competency Framework (Figure 4), which brings together the essence of PCC, its competences, tools and standards within a practical structure for education, implementation and quality improvement. The framework links the underlying foundations of PCC – including its philosophy, principles and way of being – with the capabilities and competences required in practice, from knowledge and skills to methods, clinical tools, digital technologies, AI and quality standards. PCC therefore begins with understanding the person, including the clinician self, and then infusing this understanding into practice through the PCC Capability–Competency Development Model and Framework.
The way forward
Our next step is to further evaluate and implement the PCC Capability–Competency Development Model and Framework on broader scale. Over the past five years, I have visited many hospitals, universities and hearing centres across China, connecting with people in person. Every conversation contributed to our learning. Recently, in Beijing, I met a 25-year-old girl with profound hearing loss. After years of unsatisfactory hearing care, she told me: “True hearing care starts when professionals forget my audiogram and truly see me as a person.” She is now training to become a teacher for people with hearing loss and is determined to follow the PCC pathway. Her words capture the central learning from this programme.
We hope the PCC Capability–Competency Framework will help hearing care professionals integrate scientific excellence with humanity so that every person involved is understood, respected and empowered.
References
1. Rogers CR. On Becoming a Person. Boston, USA; Houghton Mifflin; 1961.
2. Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196(4286):129–36.
3. Clark JG, English KM. Counseling-Infused Audiologic Care – 2nd ed. New York, USA; Thieme; 2019.
4. Satir V, Banmen J, Gerber J, Gomori M. The Satir Model: Family Therapy and Beyond. Palo Alto, USA; Science and Behavior Books; 1991.
5. Tolle E. The Power of Now. Novato, USA; New World Library; 1997.
Acknowledgement: I would like to express my gratitude for the great support from Ida Institute, Drs John Greer Clark and Kristina M English, the PCC Alliance members, hearing care professionals, people with hearing loss and their families during last five years.
