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Lyu Y, Xu Q, Liu J. Exploring the medical decision-making patterns and influencing factors among the general Chinese public: a binary logistic regression analysis. BMC Public Health 2024; 24:887. [PMID: 38523310 PMCID: PMC10962172 DOI: 10.1186/s12889-024-18338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE With the ongoing evolution of the healthcare system and shifts in cultural paradigms, there is a pressing need to delve into the medical decision-making behaviors of general Chinese public and understand their underlying motivations. This research seeks to elucidate the prevailing tendencies in these decision-making processes and to empirically validate the pivotal factors that shape their choices, offering valuable insights for healthcare policymakers and institutions. METHOD A comprehensive survey was administered to 2,696 Chinese residents to examine their medical decision-making patterns. These patterns were classified into two primary categories: Unilateral Decision-making (Doctor-dominant, Family-centric, and Patient-driven subtypes) and Collaborative Decision-making (Doctor-led, Doctor-Patient, Patient-Family, and Doctor-Patient-Family subtypes). Binary logistic regression analysis was employed to empirically pinpoint the significant factors influencing these decision-making frameworks. RESULTS The study's analysis reveals distinct preferences in medical decision-making among Chinese residents. In the Collaborative Decision-making category, chosen by 70.81% of participants, the subtypes are as follows: Doctor-led (29.90%), Doctor-Patient (13.54%), Patient-Family (2.93%), and Doctor-Patient-Family (24.44%). The Unilateral Decision-making, preferred by 29.19%, includes Doctor-dominant (23.22%), Family-centric (1.74%), and Patient-driven (4.23%) models. The preference for Collaborative Decision-making is associated with higher educational levels, specific marital statuses (particularly married but childless), and choices of rural residents' basic medical insurance or occupational basic medical insurance. In contrast, Unilateral Decision-making correlates with males, individuals with religious beliefs, certain occupational roles (like civil servants), and holders of commercial or publicly funded medical insurance. CONCLUSION This study elucidates the complex interplay of socio-cultural and individual determinants shaping medical decision-making in China. The findings reveal a marked inclination towards collaborative models, closely linked to educational level, marital status, and specific insurance types, reflecting an evolving trend towards participatory healthcare. Simultaneously, the persistence of unilateral models, influenced by gender, religious beliefs, and occupational roles, highlights the heterogeneity within Chinese healthcare preferences. These insights are crucial for policymakers and healthcare practitioners, underscoring the need for adaptable, culturally attuned healthcare frameworks that cater to this diversity, thereby enhancing patient engagement and healthcare efficacy.
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Affiliation(s)
- Yuwen Lyu
- Institute of Humanities and Social Sciences, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qian Xu
- School of Health Management, Guangzhou Medical University, Guangzhou, 511436, China
| | - Junrong Liu
- Institute of Humanities and Social Sciences, Guangzhou Medical University, Guangzhou, 511436, China.
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Theys S, van Belle E, Heinen M, Malfait S, Eeckloo K, Beeckman D, Verhaeghe S, Van Hecke A. Individualised care in Flemish and Dutch hospitals: Comparing patients' and nurses' perceptions. Scand J Caring Sci 2021; 36:635-649. [PMID: 34241909 DOI: 10.1111/scs.13016] [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] [Received: 10/22/2020] [Accepted: 06/12/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patient-centred care has been recognised as vital for today's healthcare quality. This type of care puts patients at the centre, contributing to positive patient outcomes such as patient autonomy. Empirical research comparing nurses' and patients' perceptions of the support and provision of patient-centred care is limited and focuses solely on nurses and patients working and staying on surgical wards. AIMS AND OBJECTIVES Comparing patients' and nurses' perceptions of patient-centred care on different types of hospital wards, and exploring if patient empowerment, health literacy, and certain sociodemographic and context-related variables are associated with these perceptions. DESIGN Cross-sectional design. METHODS Data were collected in ten Flemish (February-June 2016) and two Dutch (December 2014-May 2015) hospitals using the Individualised Care Scale (ICS). A linear mixed model was fitted. Data from 845 patients and 569 nurses were analysed. As the ICS was used to measure the concept of patient-centred care, it is described using the term 'individualised care.' RESULTS Nurses perceived that they supported and provided individualised care more compared with patients as they scored significantly higher on the ICS compared with patients. Patients with higher empowerment scores, higher health literacy, a degree lower than bachelor, a longer hospital stay, and patients who were employed and who were admitted to Dutch hospitals scored significantly higher on some of the ICS subscales/subsections. Nurses who were older and more experienced and those working in Dutch hospitals, regional hospitals and maternity wards scored significantly higher on some of the ICS subscales/subsections. CONCLUSION Nurses perceived that they supported and provided individualised care more compared with patients. RELEVANCE TO CLINICAL PRACTICE Creating a shared understanding towards the support and provision of individualised care should be a priority as this could generate more effective nursing care that takes into account the individuality of the patient.
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Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Elise van Belle
- IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Ghent University Hospital, Ghent, Belgium
| | - Dimitri Beeckman
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden
| | - Sofie Verhaeghe
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
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Theys S, Van Hecke A, Akkermans R, Heinen M. The Dutch Individualised Care Scale for patients and nurses - a psychometric validation study. Scand J Caring Sci 2021; 35:308-318. [PMID: 32301170 PMCID: PMC7984034 DOI: 10.1111/scs.12853] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/17/2020] [Indexed: 12/03/2022]
Abstract
AIMS AND OBJECTIVES Translating and psychometrically assessing the Individualised Care Scale (ICS) for patients and nurses for the Flemish and Dutch healthcare context. BACKGROUND Individualised care interventions have positive effects on health outcomes. However, there are no valid and reliable instruments for evaluating individualised care for the Flemish and Dutch healthcare context. DESIGN Psychometric validation study. SETTING AND PARTICIPANTS In Flemish hospitals, data were collected between February and June 2016, and in Dutch hospitals, data were collected between December 2014 and May 2015. Nurses with direct patient contact and a working experience of minimum 6 months on the wards could participate. Patient inclusion criteria were being an adult, being mentally competent, having an expected hospital stay of minimum 1 day, and being able to speak and read the Dutch language. In total, 845 patients and 569 nurses were included. METHODS The ICS was translated into Dutch using a forward-backward translation process. Minimal linguistic adaptations to the Dutch ICS were made to use the scale as a Flemish equivalent. Omega, Cronbach's Alpha, mean inter-item correlations and standardised subscale correlations established the reliability and confirmatory factor analysis the construct validity of the ICS. RESULTS Internal consistency using Omega (Cronbach's Alpha) ranged from 0.83 to 0.96 (0.82-0.95) for the ICS-Nurse and from 0.88 to 0.96 (0.87-0.96) for the ICS-Patient. Fit indices of the confirmatory factor analysis indicated a good model fit, except for the root mean square error of approximation, which indicated only moderate model fit. CONCLUSION The Dutch version of the ICS showed acceptable psychometric performance, supporting its use for the Dutch and Flemish healthcare context. RELEVANCE TO CLINICAL PRACTICE Knowledge of nurses' and patients' perceptions on individualised care will aid to target areas in the Dutch and Flemish healthcare context in which work needs to be undertaken to provide individualised nursing care.
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Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health SciencesDepartment of Public Health and Primary Care – University Centre for Nursing and MidwiferyGhent UniversityGhentBelgium
| | - Ann Van Hecke
- Faculty of Medicine and Health SciencesDepartment of Public Health and Primary Care – University Centre for Nursing and MidwiferyGhent UniversityGhentBelgium
| | - Reinier Akkermans
- IQ HealthcareRadboud University Medical CentreNijmegenThe Netherlands
| | - Maud Heinen
- Nursing Science and Allied HealthcareRadboud Institute for Health SciencesIQ HealthcareRadboud University Medical CentreNijmegenThe Netherlands
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Caspar S, Davis ED, Douziech A, Scott DR. Nonpharmacological Management of Behavioral and Psychological Symptoms of Dementia: What Works, in What Circumstances, and Why? Innov Aging 2018; 2:igy001. [PMID: 30480128 PMCID: PMC6176983 DOI: 10.1093/geroni/igy001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective Behavioral and psychological symptoms of dementia (BPSD) refer to the often distressing, noncognitive symptoms of dementia. BPSD appear in up to 90% of persons with dementia and can cause serious complications. Reducing the use of antipsychotic medications to treat BPSD is an international priority. This review addresses the following questions: What nonpharmacological interventions work to manage BPSD? And, in what circumstances do they work and why? Method A realist review was conducted to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases for empirical studies that reported a formal evaluation of nonpharmacological interventions to decrease BPSD. Results Seventy-four articles met the inclusion criteria. Three mechanisms emerged as necessary for sustained effective outcomes: the caring environment, care skill development and maintenance, and individualization of care. We offer hypotheses about how different contexts account for the success, failure, or partial success of these mechanisms within the interventions. Discussion Nonpharmacological interventions for BPSD should include consideration of both the physical and the social environment, ongoing education/training and support for care providers, and individualized approaches that promote self-determination and continued opportunities for meaning and purpose for persons with dementia.
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Affiliation(s)
- Sienna Caspar
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
| | - Erin D Davis
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
| | - Aimee Douziech
- Faculty of Health Sciences-Therapeutic Recreation, University of Lethbridge, Alberta, Canada
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Caspar S, Le A, McGilton KS. The Influence of Supportive Supervisory Practices and Health Care Aides' Self-Determination on the Provision of Person-Centered Care in Long-Term Care Facilities. J Appl Gerontol 2017; 38:1564-1582. [PMID: 29284327 DOI: 10.1177/0733464817750275] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Person-centred care (PCC) is recognized as best practice in long-term care (LTC). Using a cross-sectional design, we examined the relationship between supportive supervisory practices and health care aides' (HCAs) self-determination on HCAs' perceived ability to provide PCC. A total of 131 HCAs from four LTC facilities participated in the study. There were strong, positive associations between HCAs' self-determination and their perceived ability to provide PCC, r = .59, p < .0001, and how supportive their supervisors were, r = .50, p < .0001. Mediation analysis using structural equation modeling found the direct effect of self-determination on PCC was 73% of its total effect on PCC; its indirect effect mediated through supervisory support was 27% of its total effect on PCC. Improving supportive supervisory relationships that encourage and enable HCAs' self-determination in LTC settings may be an important and effective means by which to increase the provision of PCC.
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Affiliation(s)
| | - Anne Le
- University of Calgary, Alberta, Canada
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Chappell NL, Reid RC, Gish JA. Staff-based measures of individualized care for persons with dementia in long-term care facilities. DEMENTIA 2016. [DOI: 10.1177/1471301207084372] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although individualized care for persons with dementia in long-term care institutions has become accepted as best practice, there have not been easy-to-use, multi-item reliable measures of the concept for scientific research or for administrative use. Following review of the literature, consultation with experts in the field, and direct observation within long-term care facilities, three domains of individualized care (knowing the person/resident, resident autonomy and choice, communication — staff-to-staff and staff-to-resident) were chosen as appropriate for the development of multi-item paper-and-pencil staff completion scales. These scales are presented in this article, including, where appropriate, shorter scales derived from factor analyses. The findings suggest that these domains of individualized care lend themselves to brief multi-item measures and that not all conceptual domains of individualized care co-occur in practice. Further, supplemental staff training in individualized care practice may be warranted.
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Reid RC, Chappell NL, Gish JA. Measuring family perceived involvement in individualized long-term care. DEMENTIA 2016. [DOI: 10.1177/1471301207075640] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although family involvement is considered an important aspect of care for residents with dementia in long-term care facilities, measurement is lacking. The purpose of this study is to present a multi-item reliable measurement instrument assessing family perceived involvement. Literature reviews, observations within facilities, iterative consultations with an expert panel and extensive pilot testing of items for family perceived involvement were undertaken, to establish face and content validity. Two scales were developed: family perceived involvement and family assessment of importance of their involvement in individualized care for their resident relative. Strong evidence of face and content validity, internal consistency and test-retest reliability were established for both scales. Short versions of the original scales were derived via factor analysis. These instruments provide researchers and facilities with the ability to measure both degree of family perceived involvement and the importance the family places on that involvement using a relatively brief set of statements.
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Ceylan B, Eser I. Assessment of individualized nursing care in hospitalized patients in a university hospital in Turkey. J Nurs Manag 2016; 24:954-961. [DOI: 10.1111/jonm.12400] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Burcu Ceylan
- Department of Fundamentals of Nursing; Ege University Faculty of Nursing; Bornova Izmir Turkey
| | - Ismet Eser
- Department of Fundamentals of Nursing; Ege University Faculty of Nursing; Bornova Izmir Turkey
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Köberich S, Feuchtinger J, Farin E. Factors influencing hospitalized patients' perception of individualized nursing care: a cross-sectional study. BMC Nurs 2016; 15:14. [PMID: 26937220 PMCID: PMC4774135 DOI: 10.1186/s12912-016-0137-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/24/2016] [Indexed: 11/30/2022] Open
Abstract
Background Individualized care is a cornerstone of patient-centered nursing care. To foster individualized care, influencing factors should be known. The aim of this study was to identify the individual and organizational factors influencing hospitalized patients’ perception of individualized care. Methods A cross-sectional study was conducted of 606 patients from 20 wards from five hospitals across Germany. Individualized care and potential influencing factors were assessed via structured questionnaires. To identify influencing factors, we applied a hierarchical linear model with two levels. Results Self-rated health, length of ward stay, educational level and shared decision-making process about nursing care were perceived to influence individualized care. A higher rating of health and longer ward stay correlated with improved perceptions of individualized nursing care. In addition, an educational level of nine or fewer years and a perceived shared decision-making process about nursing care positively influenced the perception of nursing care as being tailored to individual needs. Conclusions Several factors influence patients’ perception of individualized care. However, only the decision-making process can be actively influenced by nurses. Therefore, nurses should be encouraged to promote shared decision-making regarding patients’ nursing care. Trial number DRKS00005174 (Date of registration: 2013/08/01).
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Affiliation(s)
- Stefan Köberich
- Institute for Quality Management and Social Medicine, Medical Center - University of Freiburg, Engelbergerstr. 21, 79106 Freiburg, Germany ; Pflegedirektion, Heart Center - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Johanna Feuchtinger
- Quality and Development in Nursing Care, Medical Center - University of Freiburg, Breisacher Str. 62, Freiburg, Germany
| | - Erik Farin
- Institute for Quality Management and Social Medicine, Medical Center - University of Freiburg, Engelbergerstr. 21, 79106 Freiburg, Germany
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Reid RC, Chappell NL. Family Involvement in Nursing Homes: Are Family Caregivers Getting What They Want? J Appl Gerontol 2015; 36:993-1015. [DOI: 10.1177/0733464815602109] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The provision of person-centered care for nursing home residents with dementia suggests the need for family caregiver involvement. In this article, we argue that optimal family involvement differs by family caregiver and therefore depends on the degree to which family caregivers consider their own involvement to be important. In this Canadian study, we compare the importance that 135 family caregivers of residents with dementia place on 20 kinds of involvement with the degree to which they perceive opportunities for involvement. Family Involvement Congruence Scores are calculated in three ways: those for whom involvement is important, those for whom involvement is not important, and an overall congruence score. Congruence scores varied by involvement type. These scores show promise for use in future research on family caregiver involvement and as tools for use by facilities as they endeavor to meet family caregiver expectations for involvement.
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Affiliation(s)
- R. Colin Reid
- University of British Columbia Okanagan, Kelowna, Canada
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Nilsson Å, Skär L, Söderberg S. Nurses' views of shortcomings in patent care encounters in one hospital in Sweden. J Clin Nurs 2015; 24:2807-14. [PMID: 26177676 DOI: 10.1111/jocn.12886] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVE To describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden. BACKGROUND Shortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being. DESIGN A qualitative design was used in the study. METHODS Three focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis. RESULTS The results are presented in two themes. The first theme, 'Disregard for the patient's unique nursing needs', describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, 'Difficulty managing obstacles', nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability. CONCLUSION The findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff. RELEVANCE TO CLINICAL PRACTICE Nurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care.
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Affiliation(s)
- Åsa Nilsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Lisa Skär
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Siv Söderberg
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Köberich S, Suhonen R, Feuchtinger J, Farin E. The German version of the Individualized Care Scale - assessing validity and reliability. Patient Prefer Adherence 2015; 9:483-94. [PMID: 25848227 PMCID: PMC4376256 DOI: 10.2147/ppa.s77486] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM To assess validity and reliability of the German version of the Individualized Care Scale (ICS). BACKGROUND Individualized nursing care plays a pivotal role in establishing patient-centered care. To assess individualized nursing care and to compare it in different settings and countries, valid and reliable instruments are needed. No psychometric-tested instrument for comparing individualized nursing care with other countries is available in Germany. DESIGN Cross-sectional study. METHODS Data were collected between September 2013 and June 2014 from 606 patients in 20 wards in five hospitals across Germany. Unidimensionality of the ICS scales ICSA (patients' views on how individuality is supported through nursing interventions) and ICSB (patients' perceptions of individualized nursing care) was analyzed by confirmatory factor analysis. Internal consistency was assessed by calculating Cronbach's alpha. The Smoliner Scale (patients' perceptions of the decision-making process in nursing care) and results from participating hospitals' assessment of the nursing care delivery systems were used to assess known-groups validity and concurrent validity. RESULTS Fit indices of confirmatory factor analysis indicate unidimensionality of the ICSA (Comparative Fit Index: 0.92; Tucker-Lewis Index: 0.902; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05) and the ICSB (Comparative Fit Index: 0.91; Tucker-Lewis Index: 0.89; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05). Internal consistency using Cronbach's alpha was 0.95 (95% confidence interval: 0.94-0.95) for ICSA and 0.93 (95% confidence interval: 0.92-0.94) for the ICSB. Concurrent validity was established by a significant relationship between the Smoliner Scale and ICSA (r=0.66; P<0.01) and ICSB (r=0.72; P<0.01). Known-groups validity was approved by ICSA/ICSB score differences related to nursing care delivery systems and patients' perceptions of decision-making style. CONCLUSION The German version of the ICS is deemed a valid and reliable instrument for use in practice and research with hospitalized patients.
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Affiliation(s)
- Stefan Köberich
- Institute for Quality Management and Social Medicine, Medical Center – University of Freiburg, Freiburg, Germany
- Pflegedirektion, Heart Center – University of Freiburg, Freiburg, Germany
- Correspondence: Stefan Köberich, Institute for Quality Management and Social Medicine, Medical Center – University of Freiburg, Engelbergerstr 21, 79106 Freiburg, Germany, Tel +49 761 270 73590, Fax +49 761 270 73310, Email
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Johanna Feuchtinger
- Quality and Development in Nursing Care, Medical Center – University of Freiburg, Freiburg, Germany
| | - Erik Farin
- Institute for Quality Management and Social Medicine, Medical Center – University of Freiburg, Freiburg, Germany
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Köberich S, Farin E. A systematic review of instruments measuring patients′ perceptions of patient-centred nursing care. Nurs Inq 2014; 22:106-20. [DOI: 10.1111/nin.12078] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 12/20/2022]
Affiliation(s)
| | - Erik Farin
- Medical Center - University of Freiburg; Freiburg Germany
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Seyyed Rasooli A, Zamanzadeh V, Rahmani A, Shahbazpoor M. Patients' Point of View about Nurses' Support of Individualized Nursing Care in Training Hospitals Affiliated with Tabriz University of Medical Sciences. J Caring Sci 2013; 2:203-9. [PMID: 25276728 DOI: 10.5681/jcs.2013.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/15/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Individualized nursing care is the key element in quality of nursing care. In fact, it changes all standardized nursing procedures and activities. In addition, it tailored nursing activities with unique peculiarity of each patient. Focusing on patient during care process is one main reason for supporting individualized care. Individual differences among patients in terms of their health, illness and needs which emphasize on providing individualized care. This research aimed to demonstrate patients' point of view about nurses' support of individualized care. METHODS A descriptive study conducted with participation of 400 being discharged patients from internal and surgical units in teaching hospitals of Tabriz University of Medical Sciences. Proportional stratified random sampling method was used. Data was collected by interviewing with patients using Suhonen Individualized Care Scale, after assessing its content validity and reliability with Chronbach's alpha method. Data analysis were done by using SPSS ver. 13. RESULTS The mean of patients' point of view about nurses' support of individualized care was 2.60 (1.14). The results showed the mean of support for clinical situation 2.61 (1.27), support for personal life situation 2.36 (1.28), and support for decisional control over care 2.77 (1.17). Comparing aspects of support showed that support for decisional control over care was the highest and the lowest was support for personal life situation. CONCLUSION According to results of the study and comparison with other researches in other countries, it is recommended that nursing care planners pay more attention to the aspects of nursing support based on individuals.
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Affiliation(s)
- Alehe Seyyed Rasooli
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Shahbazpoor
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Laitinen H, Kaunonen M, Åstedt-Kurki P. When time matters: The reality of patient care in acute care settings. Int J Nurs Pract 2011; 17:388-95. [DOI: 10.1111/j.1440-172x.2011.01945.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Andersson L, Burman M, Skär L. Experiences of caretime during hospitalization in a medical ward: older patients’ perspective. Scand J Caring Sci 2011; 25:646-52. [DOI: 10.1111/j.1471-6712.2011.00874.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hudon C, Fortin M, Haggerty JL, Lambert M, Poitras ME. Measuring patients' perceptions of patient-centered care: a systematic review of tools for family medicine. Ann Fam Med 2011; 9:155-64. [PMID: 21403143 PMCID: PMC3056864 DOI: 10.1370/afm.1226] [Citation(s) in RCA: 218] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 09/24/2010] [Accepted: 10/26/2010] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Patient-centered care is widely acknowledged as a core value in family medicine. In this systematic review, we aimed to identify and compare instruments, subscales, or items assessing patients' perceptions of patient-centered care in family medicine. METHODS We conducted a systematic literature review using the MEDLINE, Embase, and Cochrane databases covering 1980 through April 2009, with a specific search strategy for each database. The search strategy was supplemented with searching by hand and expert suggestions. We looked for articles meeting all of the following criteria: (1) describing self-administered instruments measuring patient perceptions of patient-centered care; (2) reporting quantitative or psychometric results of development or validation; (3) being relevant to an ambulatory family medicine context. The quality of each article retained was assessed using a modified version of the Standards for Reporting of Diagnostic Accuracy. Instrument' items were mapped to dimensions of a patient-centered care conceptual framework. RESULTS Of the 3,045 articles identified, 90 were examined in detail, and 26, covering 13 instruments, met our inclusion criteria. Two instruments (5 articles) were dedicated to patient-centered care: the Patient Perception of Patient-Centeredness and the Consultation Care Measure, and 11 instruments (21 articles) included relevant subscales or items. CONCLUSIONS The 2 instruments dedicated to patient-centered care address key dimensions but are visit-based, limiting their applicability for the study of care processes over time, such as chronic illness management. Relevant items from the 11 other instruments provide partial coverage of the concept, but these instruments were not designed to provide a specific assessment of patient-centered care.
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Affiliation(s)
- Catherine Hudon
- Département de Médecine de Famille, Université de Sherbrooke, Québec, Canada.
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O'Rourke N, Chappell NL, Caspar S. Measurement and Analysis of Individualized Care Inventory Responses Comparing Long-Term Care Nurses and Care Aides. THE GERONTOLOGIST 2009; 49:839-46. [DOI: 10.1093/geront/gnp053] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.
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Affiliation(s)
- Wendy Penney
- School of Nursing, Deakin University, Geelong, Victoria, Australia
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Suhonen R, Välimäki M, Leino-Kilpi H. Individualized care, quality of life and satisfaction with nursing care. J Adv Nurs 2005; 50:283-92. [PMID: 15811107 DOI: 10.1111/j.1365-2648.2005.03391.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS This paper reports a study of the maintenance of individualized care from surgical patients' point of view and examines associations between individualized care, patient satisfaction with nursing care, and health-related quality of life. Rationale. There is preliminary evidence that individualized care is effective from patients' point of view, and is associated with improved patient outcomes, such as patient satisfaction and quality of life. However, individualized care has mainly been studied from the vantage-point of nurses' experiences. METHODS In this cross-sectional, descriptive, correlational study the data were collected with surgical adult patients (n = 279, response rate 93%) in surgical wards in Finland using self-administered questionnaires including the Individualized Care Scales, Patient-Satisfaction Scale, and Finnish versions of the Nottingham Health Profile and EuroQol 5D. Associations between individualized care, satisfaction with care and health-related quality of life were examined. Cronbach's alpha values and item analysis were used to evaluate the psychometric properties of the instruments, especially the Individualized Care Scales. RESULTS The more often patients felt they received support for individuality through specific nursing interventions, the higher the individuality of care received. Secondly, the more individualized patients regarded their care, the higher the level of reported patient satisfaction with nursing care. However, the correlation between individualized care and health-related quality of life was fairly low, albeit statistically significant. CONCLUSION Individualized care may produce positive outcomes, such as patient satisfaction. Further research is needed to explore individualized care in relation to health-related quality of life.
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Affiliation(s)
- Riitta Suhonen
- Quality and Development Manager, Health Care District of Forssa, Forssa, Finland.
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Abstract
RATIONALE, AIMS AND OBJECTIVES In this study we describe the development of the Individualized Care Scale (ICS) and evaluate its validity, psychometric properties and feasibility. The ICS was designed to measure patients' views on how individuality is supported through specific nursing interventions (ICA) and how they perceive individuality in their own care (ICB) during hospitalization. METHOD Three different data sets were collected among patients being discharged from hospital (n1 = 203, n2 = 279, n3 = 454). This bipartite 38-item ICS promises to be a brief, timely, easy to administer and useful self-completion measure for evaluating clinical nursing practice from the patient's point of view. RESULTS The findings supported the internal consistency reliability of the ICS (alpha 0.94 for ICA and ICB 0.93) and the three subscales (alphas 0.85-0.90). Item analysis supported the item construction of each scale. Content validity was furthered by a critical literature review and four expert analyses. Principal component analysis (Promax with Kaiser normalization) among earlier factor analyses supported construct validity by generating a three-factor solution which accounted for 65% of the variance in the ICA and 61% in the ICB. Pearson's correlation coefficients were at least 0.88 between the subscales and the total domain ICA or ICB. CONCLUSIONS The ICS has demonstrated promise as a tool for measuring patients' evaluations of their hospital experience and individuality in care.
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Affiliation(s)
- Riitta Suhonen
- Quality and Development Manager, Health Care District of Forssa, Forssa, Finland.
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Abstract
BACKGROUND Patient satisfaction and patient satisfaction with nursing care data are routinely collected as an indicator of the quality of services delivered. Despite the widespread collection and reporting of these data, the theoretical basis of patient satisfaction and patient satisfaction with nursing care remains unclear. Without a clear theoretical base, interpretation of patient satisfaction findings is hampered and the entire line of patient satisfaction research is of questionable validity. It has been suggested that, to understand patient satisfaction, patient perceptions of their care must first be understood. AIM The aim of this study was to discover patients' perceptions of the nursing care they receive in the hospital setting. METHOD Grounded theory method was used in this study of eight medical-surgical patients recently discharged from an academic medical centre in the south-eastern United States of America (USA). Participants were interviewed and the verbatim transcripts analysed using the constant comparative method. FINDINGS Four categories of patient perceptions of their nursing care emerged from the data. 'Seeing the individual patient' captures the unique nature of the nursing care experience for each patient. 'Explaining' represents the informal explanations given by nursing staff as they provide care. 'Responding' refers to both the character and timeliness of nursing staff's responses to patient requests or symptoms. 'Watching over' represents the surveillance activities of nursing staff. CONCLUSIONS The categories identified in this study may be used in efforts to further develop a formal theory of patient satisfaction with nursing care. These categories should also be tested with patients possessing a wider range of characteristics, to assess the transferability of the findings.
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Affiliation(s)
- Lee A Schmidt
- Assistant Professor, School of Nursing, University of Miami, Coral Gables, Florida 33143, USA.
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Takemura Y, Kanda K. How Japanese nurses provide care: a practice based on continuously knowing the patient. J Adv Nurs 2003; 42:252-9. [PMID: 12680969 DOI: 10.1046/j.1365-2648.2003.02614.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM Criticisms of the nursing process as a problem-solving approach have emerged recently. This study aimed to identify and describe a way of nursing based on the clinical practice of selected nurses in Japan. METHODS Data were collected using semi-structured interviews and observations at one 300-bed Japanese hospital in 1999. The purposive sample consisted of 24 female nurses. Data analysis occurred simultaneously with data collection, and questioning and constant comparison were used for data analysis. Codes were clustered into categories and relationships among these were identified. In the final stage of the analysis, two group interviews with participants were carried out to enhance credibility. FINDINGS This study identified a Japanese way of nursing intended to help patients explore and realize meanings and values of their experiences with illness. When nurses first contacted a patient, they quickly formed a patient image, but altered it each time they obtained new patient information. A patient image consisted of the patient's subjective world (the patient's perspective) and the holistic patient (nurses' perspectives of the patient). The nurses sometimes pursued strategies to know the patient's subjective world. The target, direction, conditions and ways of nursing care were decided based on continuously knowing the patient. The nurses related their knowledge and thoughts to the patient, and by talking with the patient promoted the patient's consideration and participation, and empowered the patient. Nurses continued attending to patients even when they could not provide specific nursing interventions. CONCLUSIONS Knowing the patient was found to be especially important in determining nursing care. The model described in this study does not contradict the nursing process as a systematic approach to problem-solving. Rather, it has some alternatives that might be useful in providing individual care in Japan.
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Affiliation(s)
- Yukie Takemura
- Department of Nursing Administration, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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