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Jonnergård A, Björkman I, Forsgren E, Feldthusen C, Lundberg M, Wallengren C. Person-centred care in the context of higher education - a discourse analysis based on interviews with programme directors. BMC MEDICAL EDUCATION 2024; 24:873. [PMID: 39138437 PMCID: PMC11323549 DOI: 10.1186/s12909-024-05885-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 08/09/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND As person centred care (PCC) is being implemented globally, higher educational institutions (HEI) have begun to play a crucial part in enabling this transition. In Sweden, however, the delivery of PCC is inconsistently implemented in medicine, nursing, occupational therapy, and physiotherapy study programmes. This inconsistency is partly the result of a lack of a national strategy across HEI. Program directors are responsible for the PCC content of their programs, so their views influence how PCC is taught. Using interviews with programme directors in higher education, we aim to deepen the understanding of the preconditions needed to implement PCC by exploring discourses and identifying subject positions of how PCC is taught and learned. METHODS We performed a discourse analysis based on interviews with program directors in the above-mentioned national study programmes. A discourse can be seen as a struggle over identity. The subject position - i.e., discourses designate positions for persons to occupy as subjects - guided our analysis and identification of the subject positions of the teacher and the student in teaching and learning PCC. RESULTS This study unfolded in two main antagonistic aspects with respect to teaching and learning PCC, resulting in four subject positions for the teacher and four corresponding subject positions for the students. First, the teacher and student were given a subject position as change agents towards a more egalitarian healthcare and were assigned a subject position to cope with a practical reality they could not change. Second, the teacher and student were assigned a subject position that embodied profession-specific identities, navigating and valuing these boundaries. Simultaneously, both teachers and students assumed a subject position that required interprofessional interaction and co-creation for teaching and learning PCC. CONCLUSION This study demonstrates the discursive tension surrounding the implementation of PCC in HEI, and the findings can serve as a basis for creating future relevant and high-quality learning activities. The process of negotiating diverse and co-existing perspectives as well as building interprofessional trust when incorporating PCC into higher education is essential and requires further exploration.
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Affiliation(s)
- A Jonnergård
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - I Björkman
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Forsgren
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Feldthusen
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Lundberg
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - C Wallengren
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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McCabe G, Lavery J. Self-neglect as a significant public health issue: exploring the responsibility of the SPCDN. Br J Community Nurs 2024; 29:378-382. [PMID: 39072738 DOI: 10.12968/bjcn.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Self-neglect is a recognised form of abuse affecting individuals across the lifespan. Gaps are evident within current data to support its prevalence; thus, it is considered to be an under-researched and under-reported phenomenon. Evidence suggests that there are multiple risk factors which contribute to self-neglect and sources recognise it leads to poorer health outcomes. Specialist Community Practitioner District Nurses (SCPDNs) deliver care across a diverse demographic and continuously assess risk for individuals in complex environments leading and managing the care of individuals who self-neglect. It is therefore essential that SCPDNs are equipped with the knowledge and skills required to therapeutically assess the health needs of this patient group and lead on the coordination of care. This article aims to explore the subject of self-neglect as a public health concern and appraise the role and responsibilities of the SCPDN within community nursing practice.
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Affiliation(s)
- Georgia McCabe
- Specialist community practitioner district nursing student, Liverpool John Moores University; Community nurse, Wirral Community Foundation Trust
| | - Joanna Lavery
- Senior Lecturer Post graduate nursing, Programme Lead Advanced Clinical Practitioner Apprenticeship, Liverpool John Moores University
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Van Diepen C, Fors A, Bertilsson M, Axelsson M, Ekman I, Hensing G. How the current non-significant effects of person-centred care on nurses' outcomes could be abated by the WE-CARE roadmap enablers: A discursive paper. Nurs Open 2023; 10:2044-2052. [PMID: 36440684 PMCID: PMC10006598 DOI: 10.1002/nop2.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/30/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022] Open
Abstract
AIM To describe the non-significant results in nurses' outcomes after the implementation of person-centred care (PCC) and discuss if and how enablers of the WE-CARE roadmap for implementing PCC could abate the non-significant results. DESIGN In this paper, an innovative framework of enablers in the WE-CARE Roadmap is explained in relation to increased PCC and nurses' job satisfaction. METHOD Findings from a scoping review and published material provided how PCC and nurses' outcomes connect. The WE-CARE roadmap entails five enablers: Information technology, Quality measures, Infrastructure, Incentive systems and contracting strategies. RESULTS The WE-CARE roadmap was described and each enabler in the WE-CARE roadmap is discussed concerning PCC and the nurses' job satisfaction. Thus far, the effects of PCC on nurses' outcomes have been non-significant. The WE-CARE roadmap enablers can be implemented to ensure an increased PCC implementation and higher nurses' job satisfaction.
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Affiliation(s)
- Cornelia Van Diepen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Inger Ekman
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ansah Ofei AM, Parima Y, Achempim-Ansong G, Barnes T. Exploring the planning practices of nurse managers in the unit: a study of nurse managers in the greater Accra region. J Health Organ Manag 2022; ahead-of-print. [PMID: 35365982 DOI: 10.1108/jhom-08-2021-0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Nurse managers' planning practices are essential to the practice of management in the unit, and the overall efficiency of the healthcare service delivery. This study aims to explore the planning practices of nurse managers in the Greater Accra Region, Ghana. DESIGN/METHODOLOGY/APPROACH A descriptive phenomenological design was employed to explore nurse managers' planning practices. In total, 15 nurse managers and 47 nurses from 19 primary and secondary hospitals of the Ghana Health Service and two specialized hospitals in the Greater Accra Region, Ghana, were involved in the study. Data were collected using semi-structured interview guides and probes. FINDINGS The findings suggested that plans were widely common to all the units of the hospitals and were considered satisfactory by nurse managers. However, most of these plans were not effectively utilized. Nurse managers had only fair knowledge about the planning process and were moderately involved and communicated ideas to colleagues in the process. Furthermore, nurse managers do not frequently share the vision neither do they even communicate expectations to achieve unit goals and objectives with subordinates. ORIGINALITY/VALUE The research emphasizes the relevance of planning in healthcare management. It highlights the management practice of planning in the context of nurse managers and accentuates the values the healthcare system derives with effective planning practices.
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Affiliation(s)
- Adelaide Maria Ansah Ofei
- Research, Education and Administration, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Yennuten Parima
- Research, Education and Administration, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Theresa Barnes
- Research, Education and Administration, College of Health Sciences, University of Ghana, Accra, Ghana
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Jobe I. Reflections of the collaborative care planning as a person-centred practice. Nurs Philos 2022; 23:e12389. [PMID: 35322917 PMCID: PMC9285900 DOI: 10.1111/nup.12389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/05/2022] [Accepted: 03/13/2022] [Indexed: 12/04/2022]
Abstract
The ageing population is increasing worldwide with an increase in chronic disorders. At the same time, person‐centred care has become a policy within both health and social care. To facilitate coordination and collaboration and integrate the older adult's perspective in the decision‐making process the collaborative care planning process with the development of a written care plan can be used. In this study, the result of an interpreted analysis of four empirical studies of the collaborative care planning as a person‐centred practice will be discussed and reflected on. A framework based on the French philosopher Paul Ricoeur's little ethics was used in the synthesis of the studies. The findings revealed two common threads: personhood and power asymmetry. Both challenges in achieving a person‐centred collaborative care planning. Ricoeur's dialogical thinking and description of a person served as an underpinning in discussing and reflecting upon the findings of the interpreted synthesis. Collaborative care planning is a complex process. However, Ricoeur's philosophy contributed to a greater understanding of the collaborative care planning as a person‐centred practice and accentuated that ethics, human values, and the older adults and care partners perspectives need to be given the same importance and considerations as the medical and social sciences perspectives for the collaborative care planning process to truly become person‐centred.
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Affiliation(s)
- Ingela Jobe
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Andersson M, Nordin A, Engström Å. Critical care nurses' experiences of working during the first phase of the COVID-19 pandemic - Applying the Person-centred Practice Framework. Intensive Crit Care Nurs 2021; 69:103179. [PMID: 34895797 PMCID: PMC8595352 DOI: 10.1016/j.iccn.2021.103179] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/24/2021] [Accepted: 10/31/2021] [Indexed: 11/19/2022]
Abstract
AIM The aim of the study was to deductively study person-centred care, based on critical care nurses' experiences during the first phase of the CoViD-19 pandemic. DESIGN The study used a qualitative design. METHOD Data collection was conducted as individual interviews and was analysed with qualitative content analysis with a deductive approach. PARTICIPANTS Six critical care nurses working in a special CoViD-19 intensive care unit during the first phase of the pandemic participated. FINDINGS The findings are presented within the four domains of person-centred practice: the prerequisites, the care environment, person-centred processes and person-centred outcomes. While the ambition and knowledge about how to work in accordance with person-centred practice were high, there were several obstacles to perform it. CONCLUSION We need to prepare ahead of time so that nurses have optimal organisational prerequisites to be able to work in accordance with person-centred practice, also during pandemics and other crisis, which means to be able to give nursing care in accordance with the ill person's needs and resources.
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Affiliation(s)
- Maria Andersson
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden
| | - Anna Nordin
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden; Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden
| | - Åsa Engström
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden.
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Curnow E, Tyagi V, Salisbury L, Stuart K, Melville-Jóhannesson B, Nicol K, McCormack B, Dewing J, Magowan R, Sagan O, Bulley C. Person-Centered Healthcare Practice in a Pandemic Context: An Exploration of People's Experience of Seeking Healthcare Support. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:726210. [PMID: 36188789 PMCID: PMC9397956 DOI: 10.3389/fresc.2021.726210] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/09/2021] [Indexed: 01/19/2023]
Abstract
Background: The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered "lens." Methods: Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences. Results: There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving. Discussion: People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.
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Affiliation(s)
- Eleanor Curnow
- Division of Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom,*Correspondence: Eleanor Curnow
| | - Vaibhav Tyagi
- Division of Nursing and Paramedic Science, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Lisa Salisbury
- Division of Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Kim Stuart
- Research and Knowledge Exchange Development Unit, Queen Margaret University, Edinburgh, United Kingdom
| | | | - Kath Nicol
- Division of Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Brendan McCormack
- Division of Nursing and Paramedic Science, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Jan Dewing
- Division of Nursing and Paramedic Science, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Ruth Magowan
- Division of Nursing and Paramedic Science, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Olivia Sagan
- Division of Psychology, Sociology and Education, School of Arts, Social Sciences and Management, Queen Margaret University, Edinburgh, United Kingdom
| | - Cathy Bulley
- Division of Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
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Jobe I, Lindberg B, Engström Å. Health and social care professionals' experiences of collaborative planning-Applying the person-centred practice framework. Nurs Open 2020; 7:2019-2028. [PMID: 33072387 PMCID: PMC7544839 DOI: 10.1002/nop2.597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/09/2020] [Accepted: 07/23/2020] [Indexed: 11/25/2022] Open
Abstract
Aim To explore how person‐centred practice framework can be applied to professionals participating in collaborative planning. Design An explorative, deductive approach. Method Eleven professionals from health care and social care participated in the study. A deductive content analysis was performed using a framework for person‐centred practice for the analysis. Results Practicing person‐centred care and collaborative planning is a complex process that needs to take into account system factors on both the macro‐ and the microlevel. Everyone working within the system needs to apply the same approach. Using a framework analysis offered new insights into how person‐centred care is expressed in practice during collaborative planning between the patient, and healthcare and social care professionals.
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Affiliation(s)
- Ingela Jobe
- Division of NursingDepartment of Health ScienceLuleå University of TechnologyLuleåSweden
| | - Birgitta Lindberg
- Division of NursingDepartment of Health ScienceLuleå University of TechnologyLuleåSweden
| | - Åsa Engström
- Division of NursingDepartment of Health ScienceLuleå University of TechnologyLuleåSweden
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