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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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de Lange S, Heyns T, Filmalter C. A concept analysis of person-centred handover practices: The meaning in emergency departments. Int Emerg Nurs 2024; 74:101446. [PMID: 38677057 DOI: 10.1016/j.ienj.2024.101446] [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] [Received: 07/29/2023] [Revised: 02/22/2024] [Accepted: 03/23/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care. AIM The aim of this concept analysis was to define the concept person centred handover practices. METHODS The eight steps for Walker and Avant's method of concept analysis. RESULTS Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption. CONCLUSIONS Results suggested that person-centred handover practices involve verbal and non- verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.
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Affiliation(s)
- Santel de Lange
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
| | - Tanya Heyns
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
| | - Celia Filmalter
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
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van den Eijnde C, Dohmen MD, Groot BC, Huijg JM, Abma TA. Moral learning through caring stories of nursing staff. Nurs Ethics 2024; 31:572-583. [PMID: 38112187 DOI: 10.1177/09697330231218345] [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: 12/21/2023]
Abstract
BACKGROUND Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff's stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. OBJECTIVE This study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. RESEARCH DESIGN In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff's perceptions of working with their caring stories and the impact on PCC. ETHICAL CONSIDERATIONS Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. FINDINGS Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. DISCUSSION Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff's narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. CONCLUSION Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC.
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Affiliation(s)
| | - Marleen Dw Dohmen
- Leyden Academy on Vitality and Ageing; Leiden University Medical Center
| | - Barbara C Groot
- Leiden University Medical Center; Vrije Universiteit Amsterdam
| | - Johanna M Huijg
- Leyden Academy on Vitality and Ageing; Leiden University Medical Center
| | - Tineke A Abma
- Leyden Academy on Vitality and Ageing; Leiden University Medical Center
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Lood Q, Carlström E, Klinga C, Barenfeld E. A collaborative endeavour to integrate leadership and person-centred ethics: a focus group study on experiences from developing and realising an educational programme to support the transition towards person-centred care. BMC Health Serv Res 2024; 24:395. [PMID: 38553717 PMCID: PMC10979622 DOI: 10.1186/s12913-024-10793-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Ensuring the transition towards person-centred care is a growing focus in health and social care systems globally. Presented as an ethical framework for health and social care professionals, such a transition requires strong leadership and organisational changes. However, there is limited guidance available on how to assist health and social care leaders in promoting person-centred practices. In response to this, the Swedish Association of Health Professionals and the University of Gothenburg Centre for Person-Centred Care collaborated to develop an educational programme on person-centred leadership targeting health and social care leaders to support the transition towards person-centred care in Sweden. The aim with this study was to explore programme management members' experiences from the development and realisation of the programme. METHODS Focus group discussions were conducted, involving 12 members of the programme management team. Data from the discussions were analysed using a structured approach with emphasis the collaborative generation of knowledge through participant interaction. RESULTS The analysis visualises the preparations and actions involved in programme development and realisation as a collaborative endeavour, aimed at integrating leadership and person-centred ethics in a joint learning process. Participants described the programme as an ongoing exploration, extending beyond its formal duration. Leadership was thoughtfully interwoven with person-centred ethics throughout the programme, encompassing both the pedagogical approach and programme curriculum, to provide leaders with tangible tools for their daily use. CONCLUSIONS According to our analysis, we conclude that a person-centred approach to both development and realisation of educational initiatives to support person-centred leadership is essential for programme enhancement and daily implementation of person-centred leadership. Our main message is that educational initiatives on the application of person-centred ethics is an ongoing and collaborative process, characterised by an exchange of ideas and collective efforts.
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Affiliation(s)
- Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, SE-40530, Gothenburg, Sweden.
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
- Centre for Ageing and Health-AgeCap, University of Gothenburg, Gothenburg, Sweden.
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
| | - Eric Carlström
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-40530, Gothenburg, Sweden
- School of Business, Campus Vestfold, University of South-Eastern Norway, Kongsberg, Norway
| | - Charlotte Klinga
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Research and Development Unit for Older Persons (FOU nu), Stockholm Health Care Services, Stockholm, Sweden
| | - Emmelie Barenfeld
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, SE-40530, Gothenburg, Sweden
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Centre for Ageing and Health-AgeCap, University of Gothenburg, Gothenburg, Sweden
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Kavuran E, Türkoğlu N, Al‐Nuqaidan H, Fawaz M. Lebanese nursing students' perceptions of barriers to the implementation of person-centered care in clinical settings: A qualitative study. Nurs Open 2024; 11:e2116. [PMID: 38429936 PMCID: PMC10907828 DOI: 10.1002/nop2.2116] [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] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
AIM This study aims to investigate how Lebanese nursing students perceive the challenges of implementing person-centered care in clinical settings. DESIGN A qualitative descriptive design was adopted for this study. METHODS At one of Lebanon's top universities, a qualitative descriptive study design was used with 18 nursing students from various academic levels. Content analysis was used to generate the results after three focus group discussions. The Consolidated Criteria for Reporting Qualitative Research were used to report this study. RESULTS The content analysis gave rise to four main themes, namely, "overload", "challenges with education", "unawareness", "establishing connection", and "lack of initiatives related to policy". The results showed a number of obstacles that Lebanese nursing students believed were in the path of providing person-centered care. These obstacles included organisational issues like time restraints and an intense workload, as well as interaction difficulties with patients and healthcare teams, and educational issues like insufficient instruction in person-centered care concepts during nursing programs.
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Affiliation(s)
- Esin Kavuran
- Faculty of Nursing, Nursing DepartmentAtaturk UniversityErzurumTurkey
| | - Nihan Türkoğlu
- Department of Public Health Nursing, Nursing FacultyAtaturk UniversityErzurumTurkey
| | | | - Mirna Fawaz
- College of Health SciencesAmerican University of the Middle EastKuwaitKuwait
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Weber C, Nørgaard B. Nurses' perspectives on patient involvement in an emergency department - An interview study. Int Emerg Nurs 2024; 72:101401. [PMID: 38198947 DOI: 10.1016/j.ienj.2023.101401] [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] [Received: 07/19/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Patient involvement in healthcare decisions is key to patient-centred care, and it is an area subject to continuous political focus. However, patient-centred care and patient involvement are challenging to implement in an emergency department (ED) setting, as EDs tend to focus on structures, processes, and outcomes. This study explored nurses' perspectives on patient involvement in an ED setting. METHOD This study applied an explorative design and conducted focus group interviews to generate data; abductive reasoning was chosen as the analytical method. Two focus groups were held in February 2021, each including six ED nurses. RESULTS Four themes were generated: notions of patient involvement, significant factors, ED culture, and management. Nurses considered patient involvement an optional add-on and, to some extent, a matter of tokenism carried forward by managers who are afraid of complaints and bad media coverage. Patient involvement in the form of providing information to patients was considered important yet less critical than life-saving and technical tasks. CONCLUSION ED nurses' perspectives on patient involvement are particularly influenced by the technical and life-saving culture in an ED. Information provision is considered patient involvement and is decided and administered by nurses.
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Affiliation(s)
- Charlotte Weber
- Næstved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Denmark.
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Solvang PK, Fougner M. Learning from clinical placement experience: how do undergraduate physiotherapy students approach person-centered practice? Physiother Theory Pract 2023; 39:2609-2624. [PMID: 35708964 DOI: 10.1080/09593985.2022.2089609] [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] [Received: 10/15/2021] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION It is now widely accepted in physiotherapy and in other health professions, that involving patients in the design, planning and implementation of services is best practice. Little is, however, known about how physiotherapy students perceive their professional development in applying person-centered practice. OBJECTIVE To analyze how undergraduate physiotherapy students experience the process of learning to work in a person-centered way in clinical practice. METHOD Five focus-group interviews of final-year physiotherapy students. RESULTS It is important that students communicate in ways that accommodate the sociocultural characteristics of their patients. Students, where they experience that mutual understanding is not possible to achieve, tend to resort to the biomedical model and take on an expert instructor role that is met with acceptance from the patients. Some practice contexts were also found to strongly promote person-centered practice, others tightly restricting it. CONCLUSION In the educational setting, attention should be paid to the practice learning context, to the improvement of the ability of students to grasp the lived world of patients, and to activate their own identities and experiences as a relational tool in practicing person-centered care.
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Affiliation(s)
- Per Koren Solvang
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Marit Fougner
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Mannethodi K, Hassan N, Kunjavara J, Pitiquen EE, Joy G, Al-Lenjawi B. Research Self-Efficacy and Research-Related Behavior Among Nurses in Qatar: A Cross-Sectional Study. FLORENCE NIGHTINGALE JOURNAL OF NURSING 2023; 31:138-144. [PMID: 37847012 PMCID: PMC10724818 DOI: 10.5152/fnjn.2023.23002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/13/2023] [Indexed: 10/18/2023]
Abstract
AIM Research self-efficacy helps predict the individual interest and confidence in conducting research. The study was conducted to identify the research self-efficacy among nurses working in a group of tertiary hospitals and their research-related behavior. METHOD The study design was descriptive cross-sectional and conducted among nurses at Hamad Medical Corporation, Qatar Convenient sampling was done and 500 is the sample size. Data were collected through an online survey during 2 months in 2019 by using a validated "Nursing Research Self-Efficacy Scale" questionnaire. The scale includes 38 items under five domains, and the response was collected on a Likert scale from 1 to 5. The authors of the scale suggested excellent reliability score for the subscales, ranging from .94 to .97 and the existence of subscales was supported by exploratory and confirmatory factor analysis. RESULTS A completed survey was collected from 780 nurses. The mean self-efficacy score was 2.92 ± 0.97. The mean score for the subscale of obtaining science-based knowledge resources was the highest (3.24 ± 1.03) and the lowest for critically read and evaluate qualitative research literature (2.63 ± 1.12). Nurses with higher educational qualifications and those who enrolled in any educational program further to their nursing education have statistically significantly high research self-efficacy. CONCLUSION The overall research self-efficacy of working nurses is moderate. However, nurses' confidence in the ability to perform critiquing research and understand the concept and methodology in research is minimal. Introduction of nurse-tailored research training, which covers fundamental aspects of research to an advanced level, will help make them more confident in research.
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Affiliation(s)
| | - Nesiya Hassan
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha, Qatar
| | - Jibin Kunjavara
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha, Qatar
| | | | - George Joy
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha, Qatar
| | - Badriya Al-Lenjawi
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha, Qatar
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Dellenborg L, Enstedt D. Balancing hope at the end of life organisational conditions for spiritual care in palliative homecare in Sweden. Soc Sci Med 2023; 331:116078. [PMID: 37450987 DOI: 10.1016/j.socscimed.2023.116078] [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: 12/23/2022] [Revised: 05/15/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
The aim of this article is to examine how norms and values related to culture, religion, and spirituality were experienced and expressed by healthcare professionals caring for patients at the end of life in Advanced Care at Home (ACH) in Sweden, with a focus on how organisational aspects enabled or hindered spiritual care. Founded on participant observation with physicians and exploratory short-term fieldwork conducted between June and December 2019, findings show that physicians experienced communication problems relating to both religion and culture, yet were skilled in balancing hope and existential needs, medically and practically. However, all healthcare encompassed a secular bias complicating abilities to "read" religious and spiritual needs, reflecting a general lack of religious literacy among healthcare providers. ACH physicians and the palliative care team were facilitated by several organisational and structural conditions necessary for person-centred and spiritual care, including the non-hierarchical and interprofessional composition of care teams, continuity of care, space for physicians' reflection, and engagement in dialogue with patients and their relatives. Furthermore, the 6S palliative care ideology was promoted within the team, as was a creative outlook in supporting patients and their relatives' hope at the end of life. Nevertheless, interest varied. Some physicians were more skilled in dialogue, creativity and including the patient in medical decisions. Others were less focused on the person and maintained a strong emphasis on medicine, practicalities, and biomedical testing. Further, structural and organisational hindrances to person-centred and spiritual care were illuminated, including a lack of routines surrounding protecting the patient's needs in transitions from hospital to ACH. Even though the organisation of care in ACH provided conditions for person-centredness, the lack of religious literacy caused further hindrances to spiritual care. We conclude that, without religious literacy, and the ability to holistically meet patients' spiritual needs, care cannot be truly person-centred.
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Affiliation(s)
- Lisen Dellenborg
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Göteborg, Sweden.
| | - Daniel Enstedt
- Department of Literature, History of Ideas and Religion, University of Gothenburg, Box 200, 40530, Göteborg, Sweden.
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Martín-Sanz MB, Salazar-de-la-Guerra RM, Cuenca-Zaldivar JN, Salcedo-Perez-Juana M, Garcia-Bravo C, Palacios-Ceña D. Person-centred care in individuals with stroke: a qualitative study using in-depth interviews. Ann Med 2022; 54:2167-2180. [PMID: 35930376 PMCID: PMC9359161 DOI: 10.1080/07853890.2022.2105393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Person-centred care (PCC) has considerable effects on the clinical practice of health professionals. The purpose of this study was to describe the perspectives and perceived barriers and enablers of individuals with stroke regarding the PCC model in stroke rehabilitation. METHODS A qualitative exploratory study was conducted based on an interpretive framework. Participants were recruited using non-probabilistic purposeful sampling and a snowball-technique strategy. The inclusion criteria consisted of: (a) individuals > 18 years, (b) diagnosed with moderate or severe stroke according to the National Institutes of Health Stroke Scale and (c) in the post-acute or chronic stage of the disease. In total, 31 individuals with stroke were included. In-depth interviews and researchers' field notes were used to collect the data. A thematic analysis was performed. Also, credibility, transferability, dependability and confirmability techniques were followed to establish trustworthiness of the data. RESULTS Thirty-one individuals with stroke (11 women) were included. Three main themes were identified: (a) The person behind the "patient" label, recognizing the person beyond their illness and valuing their identity and individual characteristics, (b) The person at the centre of care, considering themselves as an active agent in their own care and respecting their preferences and expectations for their care process and (c) Training for PCC, providing health professionals with tools to achieve professional skills for the implementation and development of the PCC model. CONCLUSIONS AND SIGNIFICANCE This paper describes relevant aspects that health professionals should consider when providing PCC in the context of the rehabilitation of individuals with stroke. Key messagesThe individuals' perspective regarding person-centred care (PCC) has considerable effects on the clinical practice of health professionals.Individuals with stroke describe how there is a person behind the "patient" label, with identity, needs and desire to participate in decision making.Training in the PCC model helps healthcare professionals identify the needs of individuals with stroke during rehabilitation.
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Affiliation(s)
- María Belén Martín-Sanz
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Juan Nicolas Cuenca-Zaldivar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - María Salcedo-Perez-Juana
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Cristina Garcia-Bravo
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability of Universidad Rey Juan Carlos (TO + IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
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Roos C, Alam M, Swall A, Boström AM, Hammar LM. Factors associated with older persons' perceptions of dignity and well-being over a three-year period. A retrospective national study in residential care facilities. BMC Geriatr 2022; 22:515. [PMID: 35739497 PMCID: PMC9219142 DOI: 10.1186/s12877-022-03205-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dignity and well-being are central concepts in the care of older people, 65 years and older, worldwide. The person-centred practice framework identifies dignity and well-being as person-centred outcomes. Older persons living in residential care facilities, residents, have described that they sometimes lack a sense of dignity and well-being, and there is a need to understand which modifiable factors to target to improve this. The aim of this study was to examine the associations between perceptions of dignity and well-being and the independent variables of the attitudes of staff, the indoor-outdoor-mealtime environments, and individual factors for residents over a three-year period. METHODS A national retrospective longitudinal mixed cohort study was conducted in all residential care facilities within 290 municipalities in Sweden. All residents aged 65 years and older in 2016, 2017 and 2018 were invited to responded to a survey; including questions regarding self-rated health and mobility, the attitudes of staff, the indoor-outdoor-mealtime environments, safety, and social activities. Data regarding age, sex and diagnosed dementia/prescribed medication for dementia were collected from two national databases. Descriptive statistics and ordinal logistic regression models were used to analyse the data. RESULTS A total of 13 763 (2016), 13 251 (2017) and 12 620 (2018) residents answered the survey. Most of them (69%) were women and the median age was 88 years. The odds for satisfaction with dignity did not differ over the three-year period, but the odds for satisfaction with well-being decreased over time. Residents who rated their health as good, who were not diagnosed with dementia/had no prescribed medication for dementia, who had not experienced disrespectful attitudes of staff and who found the indoor-outdoor-mealtime environments to be pleasant had higher odds of being satisfied with aspects of dignity and well-being over the three-year period. CONCLUSIONS The person-centred practice framework, which targets the attitudes of staff and the care environment, can be used as a theoretical framework when designing improvement strategies to promote dignity and well-being. Registered nurses, due to their core competencies, focusing on person-centred care and quality improvement work, should be given an active role as facilitators in such improvement strategies.
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Affiliation(s)
- Charlotte Roos
- School of Health and Welfare, Dalarna University, Falun, Sweden.
| | - Moudud Alam
- School of Information and Engineering, Dalarna University, Falun, Sweden
| | - Anna Swall
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Theme Inflammation and Ageing, Unit Nursing Ageing, Karolinska University Hospital, Huddinge, Sweden.,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Lena Marmstål Hammar
- School of Health and Welfare, Dalarna University, Falun, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Taleghani F, Farzi S, Yazdannik A, Esfahani MS. The shadow of paternalism on patient-centeredness in oncology nursing care: A barrier of health-care promotion. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:126. [PMID: 35677286 PMCID: PMC9170218 DOI: 10.4103/jehp.jehp_793_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/30/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patient-centered care (PCC) is a key component of high-quality care. Given the different effects of cancer on patients, patient-centeredness is very important in oncology nursing care. The aim of this study was to explore nurses' perceptions of the patient-centered in oncology nursing care. MATERIALS AND METHODS This descriptive qualitative study was conducted in 2018-2020, Iran. Data collection methods included observation and semi-structured interviews. Patient, family, and nurse behaviors were observed (total: 318 h). In addition, interviews were conducted with nurses and nursing managers (12 interviews). Data analysis was performed using Graneheim and Lundman's approach. RESULTS Data analysis resulted in the emergence of four themes: "Organizational structure as a barrier to the PCC," "Lack of institutionalization of PCC in nurses," "Understanding and paying attention to the patient as PCC," and "Situational PCC." The final theme of this study is "PCC in the shadow of paternalism." CONCLUSIONS The paternalism approach in the context of oncology nursing care has made the realization of PCC difficult. The first step to promote PCC is increasing nurses' awareness of the impact of paternalism on patient-centeredness. Providing patient-centered oncology nursing care requires changing attitudes, values, and behaviors at individual, professional, and organizational levels.
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Affiliation(s)
- Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saba Farzi
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Yazdannik
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi Esfahani
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Lydahl D, Britten N, Wolf A, Naldemirci Ö, Lloyd H, Heckemann B. Exploring documentation in Person-centred care: A content analysis of care plans. Int J Older People Nurs 2022; 17:e12461. [PMID: 35393772 PMCID: PMC9540033 DOI: 10.1111/opn.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 02/28/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Person-centred care is a growing imperative in healthcare, but the documentation of person-centred care is challenging. According to the Gothenburg Framework of Person-centred Care, care should be documented in continuously revised care plans and based on patients' personally formulated goals and resources to secure a continuous partnership. OBJECTIVES This study aimed to examine care plans produced within a randomised controlled trial that tested a person-centred care intervention in older people with acute coronary syndrome. Nurses with training in the theory and practice of person-centred care had written the care plans. METHODS We conducted a secondary analysis of care plans developed in a randomised controlled trial for assessing person-centred care in patients with acute coronary syndrome (Myocardial Infarct [MI] or unstable angina pectoris). The study sample included 84 patients, with three care plans for each patient from inpatient (T1), outpatient (T2) and primary care (T3), that is, a total of 252 care plans. We conducted a descriptive quantitative content analysis of the care plans to examine the reported patients' life-world and medical/health resources and goals. RESULTS The analysis illustrates the differences and overlaps between life-world and medical/health goals and resources. The documented goals and resources change over time: life-world goals and resources decreased with time as medical/health goals and resources documentation increased. CONCLUSIONS This paper illustrates that in the setting of a randomised controlled trial, nurses with training in person-centred care recorded fewer life-world and more medical/health goals over time. Placing life-world goals at the top of the goal hierarchy enables alignment with medical/health goals. Further research should explore whether the goals and resources documented in care plans accurately reflect patients' wishes as they transition along the care chain. TRIAL REGISTRATION Swedish registry, Researchweb.org, ID NR 65 791.
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Affiliation(s)
- Doris Lydahl
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Nicky Britten
- University of Exeter Medical School, Exeter, UK.,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Axel Wolf
- Centre for Person-Centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Anaesthetics, Surgery and Intensive Care, Sahlgrenska University Hospital, Östra, Gothenburg, Sweden.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Helen Lloyd
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Birgit Heckemann
- Centre for Person-Centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Anaesthetics, Surgery and Intensive Care, Sahlgrenska University Hospital, Östra, Gothenburg, Sweden
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14
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Heckemann B, Chaaya M, Jakobsson Ung E, Olsson DS, Jakobsson S. Finding the Person in Electronic Health Records. A Mixed-Methods Analysis of Person-Centered Content and Language. HEALTH COMMUNICATION 2022; 37:418-424. [PMID: 33213210 DOI: 10.1080/10410236.2020.1846275] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The co-creation and sharing of documentation of person-centered care is important, but challenging in clinical practice. Online access to health records is considered essential to increase patient participation and empowerment in person-centered care provision. The aims of this study were (1) to identify the extent of person-centered content in medical inpatient records and discharge letters; (2) to describe the characteristics of the language and rhetoric used in discharge letters. This was a concurrent, mixed-methods study involving a deductive, quantitative analysis of person-centered content in 69 Patient Accessible Electronic Health Records from patients with pituitary tumors, and an iterative, qualitative language analysis of a nested sample of 57 discharge letters. Both the content and language of inpatient records were mostly patient-centered. Records were concerned with the documentation of symptoms and medical and care interventions. There was little person-centered documentation of patients' preferences, wishes and needs, and shared decision-making. In the discharge letters, written for the patients, some physicians had attempted to write in a person-centered way, using plain language and a narrative. However, most wrote in a style that was reflective of their discourse community, using abbreviations and medical terms. Established norms for documentation in healthcare are a barrier to person-centered documentation. Patients' needs and preferences about documentation should be explored to increase understanding of how person-centered documentation can be achieved in clinical practice.
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Affiliation(s)
- Birgit Heckemann
- Institute of Health and Care Sciences, Sahlgrenska Academy, Centre for Person-Centered Care, University of Gothenburg
| | - Maryam Chaaya
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, Centre for Person-Centered Care, University of Gothenburg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg
| | - Daniel S Olsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg
- Department of Endocrinology, Sahlgrenska University Hospital
| | - Sofie Jakobsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg
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15
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Jobe I, Engström A, Lindberg B. Exploration of how to make the collaborative planning process work - a grounded theory study. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1896426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Ingela Jobe
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Asa Engström
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Lindberg
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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16
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Sy A, Moglia B, Aragunde G, Derossi P. Emergency care under the magnifying glass: a review of ethnographic studies in the scientific literature on hospital emergency services. CAD SAUDE PUBLICA 2021; 37:e00026120. [PMID: 33503159 DOI: 10.1590/0102-311x00026120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022] Open
Abstract
The article presents a review of ethnographic studies in the scientific literature on hospital emergency services, with the objective of systematizing the studies and their principal findings, referring to the health-disease-healthcare process in hospital emergency services from an ethnographic perspective. An integrative literature review was performed of studies published in Argentine and international indexed journals and in the following electronic databases: PubMed, VHL, Scopus, Redalyc, and SciELO. The corpus of the analysis consisted of a total of 69 articles, which were submitted to content analysis, having identified the following analytical dimensions: quality of care, communication and bonds, subjectivity, application of information technologies, methodological reflection, patients' experiences and practices, decision-making, and violence. The results allowed identifying a process that differs from guidelines and protocols, in which healthcare workers' subjective aspects, communication and interpersonal relations, and working conditions shape, orient, and condition the treatment and care provided in the hospital. The article thus highlights the approach to subjective aspects in health studies, to understand not only health workers' perspectives and experiences but also the persistent barriers to providing better quality of care, complexifying a problem ignored by a large share of the analyses.
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Affiliation(s)
- Anahi Sy
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Brenda Moglia
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Gisele Aragunde
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
| | - Paula Derossi
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
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van Diepen C, Fors A, Ekman I, Hensing G. Association between person-centred care and healthcare providers' job satisfaction and work-related health: a scoping review. BMJ Open 2020; 10:e042658. [PMID: 33293327 PMCID: PMC7722824 DOI: 10.1136/bmjopen-2020-042658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This scoping review aimed to explore and describe the research on associations between person-centred care (PCC) and healthcare provider outcomes, for example, job satisfaction and work-related health. DESIGN Scoping review. ELIGIBILITY CRITERIA Studies were included if they were empirical studies that analysed associations between PCC measurement tools and healthcare providers outcomes. SEARCH STRATEGY Searches in PubMed, CINAHL, Psychinfo and SCOPUS databases were conducted to identify relevant studies published between 2001 and 2019. Two authors independently screened studies for inclusion. RESULTS Eighteen studies fulfilled the inclusion criteria. Twelve studies were cross-sectional, four quasi-experimental, one longitudinal and one randomised controlled trial. The studies were carried out in Sweden, The Netherlands, the USA, Australia, Norway and Germany in residential care, nursing homes, safety net clinics, a hospital and community care. The healthcare provider outcomes consisted of job satisfaction, burnout, stress of conscience, psychosocial work environment, job strain and intent to leave. The cross-sectional studies found significant associations, whereas the longitudinal studies revealed no significant effects of PCC on healthcare provider outcomes over time. CONCLUSION Most studies established a positive association between PCC and healthcare provider outcomes. However, due to the methodological variation, a robust conclusion could not be generated. Further research is required to establish the viability of implementing PCC for the improvement of job satisfaction and work-related health outcomes through rigorous and consistent research.
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Affiliation(s)
- Cornelia van Diepen
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Te M, Blackstock F, Liamputtong P, Chipchase L. New graduate physiotherapists' perceptions and experiences working with people from culturally and linguistically diverse communities in Australia: a qualitative study. Physiother Theory Pract 2020; 38:782-793. [PMID: 32729348 DOI: 10.1080/09593985.2020.1799459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Upon entering the workforce, physiotherapists are required to provide safe and effective care toward people from culturally and linguistically diverse (CALD) communities. Objective: To explore new graduate physiotherapists' perceptions and experiences when working with people from CALD communities in Australia. METHODS A phenomenological framework guided this qualitative study. Seventeen new graduate physiotherapists who had experience working with people from CALD communities were interviewed. Interviews were audio-recorded, transcribed verbatim, and then thematically analyzed. RESULTS New graduate physiotherapists felt challenged when they encountered people from CALD communities. Although they had good intentions, their healthcare approach was limited. Their perceived approach to care was unidirectional and anchored in a western healthcare framework, and they used superficial strategies for cultural adaptation. Perceptions that people from CALD communities were passive recipients to healthcare also underpinned their practices. While participants described pockets of patient-centered care, their perceived healthcare approach lacked appropriate consideration and integration of their patients' cultural perspective. CONCLUSION New graduate physiotherapists may need support with effectively integrating different cultural perspectives into their care and adapting their practices and interventions for people from CALD communities. Education and training at entry-level and after graduation should address these learning needs. However, there is limited research on how to culturally adapt physiotherapy practices and interventions that impact patient engagement outcomes. Thus, research is needed to understand how current evidence-based interventions can be culturally adapted to integrate patients' cultural perspectives into care.
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Affiliation(s)
- Maxine Te
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | | | - Pranee Liamputtong
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Lucy Chipchase
- School of Health Sciences, Western Sydney University, Penrith, Australia
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19
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Milton J, Chaboyer W, Åberg ND, Erichsen Andersson A, Oxelmark L. Safety attitudes and working climate after organizational change in a major emergency department in Sweden. Int Emerg Nurs 2020; 53:100830. [PMID: 32029416 DOI: 10.1016/j.ienj.2020.100830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/11/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Medically complex patients present challenges to the health care system, particularly in the emergency department (ED) setting. Specifically, teamwork is thought to affect staff safety climate, which in turn impacts patient safety. AIM This study aimed to evaluate the effect of organizational changes to interprofessional team assessment processes on staff perception of teamwork and safety attitudes in the ED. METHODS This prospective observational study used cross-sectional design and measured ED staff perception of patient safety related domains at two time-points (before and after an organizational intervention), using the Safety Attitude Questionnaire. RESULTS Statistically significant changes were seen among the overall sample (n = 112 at time point one and n = 121 at time point two) for the safety climate, working conditions, and stress recognition domains. Nurses and doctors showed different baseline attitudes and different responses to the intervention between the two time points. CONCLUSION The results reflect improved positive attitudes overall though there were differences in responses between the nursing and medical professions. The findings highlight opportunities to improve attitudes among ED team members through defined organizational change and learning from one another. Organizational change can affect staff perceptions of the safety climate and interprofessional teamwork, which may improve the ED working environment.
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Affiliation(s)
- Jenny Milton
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, School of Nursing, Griffith University, Gold Coast, Australia.
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine, Gothenburg, Sweden.
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopedic Surgery, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden.
| | - Lena Oxelmark
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine, Gothenburg, Sweden.
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20
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Jakobsson S, Ringström G, Andersson E, Eliasson B, Johannsson G, Simrén M, Jakobsson Ung E. Patient safety before and after implementing person-centred inpatient care - A quasi-experimental study. J Clin Nurs 2019; 29:602-612. [PMID: 31769572 DOI: 10.1111/jocn.15120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 01/02/2023]
Abstract
AIMS AND OBJECTIVES To evaluate aspects of patient safety before and after a person-centred (PC) inpatient care intervention. BACKGROUND Transitioning from disease-centred to person-centred care requires great effort but can improve patient safety. DESIGN A quasi-experimental study with data collection preceding and 12 months after a PC inpatient care intervention. METHODS The study consecutively recruited adult patients (2014, n = 263; 2015/2016, n = 221) admitted to an inpatient care unit. The patients reported experiences of care at discharge and their perceived pain at admission and discharge. Medical records were reviewed to gather data on medications, planned care and clinical observations. The study is reported according to TREND guidelines. RESULTS At discharge, patients receiving PC inpatient care reported competent medical-technical care. Patients receiving PC inpatient care reported more effective pain relief. Updated prescribed medications at the ward were maintained, and patients were made aware of planned medical care to higher extent during PC inpatient care. The assessment of pulse and body temperature was maintained, but fewer elective care patients had their blood pressure taken during PC inpatient care. Weight assessment was not prioritised during usual or PC inpatient care. CONCLUSIONS Patients receiving PC inpatient care reported that they were given the best possible care and had less pain at discharge. The PC inpatient care included improved documentation and communication of planned medical care to the patients. Vital signs were more frequently recorded for patients admitted for acute care than patients admitted for elective care. PC inpatient care had no effect on frequency of weight measurements. RELEVANCE TO CLINICAL PRACTICE PC inpatient care seems beneficial for the patients. Aspects of patient safety such as prescribed medications were maintained, and PC inpatient care seems to enhance the continuity of care. Inpatient clinical observations need further evaluation as healthcare transitions from disease-centred to person-centred care.
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Affiliation(s)
- Sofie Jakobsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Gisela Ringström
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Andersson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Björn Eliasson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gudmundur Johannsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Simrén
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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