Caring in patient-focused care: the relationship of patients' perceptions of holistic nurse caring to their levels of anxiety

Simple mastectomy under hypnosis: A case study approach

There is a clear inverse relationship between preoperative anxiety and effective anaesthesia and recovery. Studies have shown that perioperative anxiety can be detrimental to the efficacy of recovery. In order to mitigate the perioperative anaesthetic risk to the patient, perioperative care must be inclusive of psychological as well as physiological elements. Therefore, when planning and implementing care for the surgical patient alternative interventions, such as hypnosis, should be considered when presented with difficult patient factors, such as crippling anxiety. This article takes on a case study approach to critically analyse and appraise the holistic care of a patient undergoing a simple mastectomy with hypnosis as the primary anaesthesia.

Development of a Quantitative Measure of Holistic Nursing Care

Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition.

Hearing what older consumers say about participation in their care

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.

Caring Behaviors Among Nurses

Caring behaviors have been shown to financially benefit business in general and the health care industry in particular. Nursing presence is a concept representative of caring behaviors within the nursing profession. This article suggests a means through which nursing presence might be identified and taught. Patients may, as a result. increasingly view their assigned nurses as caring in attitude and behavior.

Nursing presence, patient satisfaction, and the bottom line

Hospital planners rely on a number of motivational models to increase patient satisfaction. Missing is the user friendly model oriented to nursing presence. Absent is the approach which taps into that contribution particular nurses might make to increase patient satisfaction and enhance the bottom line. This paper remedies this circumstance by the introduction of the Nursing Presence Grid model. The model is based upon a review of the literature conducted in the manner of Polit and Hungler (1995) and appearing since 1983. Nursing presence is defined. The Nursing Presence Grid matches the various dimensions of nursing presence with various courses of action thought to attain nursing presence. An explanation of how the model might be applied is presented.

Pain at first dressing change after toenail avulsion 2: findings and discussion of the data analysis

A qualitative study was carried out on patients' and nurses' perceptions of pain following toenail avulsion. In part two of her award-winning paper, Brenda King discusses the patients' and nurses' responses to questions on expectations and pain.

Creating patient-focused, family-centered, maternal-child and pediatric healthcare

Healthcare's economic challenges, corporate mergers, and technological innovations marked the last decade of the 20th century. Both consumers and providers of maternity care faced dramatic changes in reimbursement, which threatened the quality and scope of care provided to childbearing women, children, and families. For nurses in some institutions, this meant decreases in the number of RNs caring for patients and challenges to meet patients' needs with the focus on a black bottom line, fiscal profitability rather than on the patient. New York's Mount Sinai Hospital adopted a philosophy of patient-focused care. This article describes the 5-year journey to redesign a traditional, provider-focused obstetric and pediatric program, into a new patient-focused, family-centered maternal-child healthcare center. The process, opportunities, challenges, and outcomes of this ongoing work demonstrate that a scholarly, data-driven, patient-focused process can result in improved quality, and increased patient and staff satisfaction, while decreasing costs.

Oncology patients' and oncology nurses' perceptions of nurse caring behaviours

Previous research on patients' and nurses' perceptions of nurse caring behaviours has documented significant differences in the ranking of important behaviours. However, these samples have included a variety of medical-surgical patients and nurses and different types of institutional settings, all of which may have affected the results. The present study sought to determine if patients and nurses from one subspecialty area and one institution would have more concordant perceptions of caring. Forty-four oncology patients and 49 oncology nurses completed the Respondents Perceptions of Caring Behaviour Scale (RPCBS). Results showed that overall mean patient rankings were highly correlated with mean nurse rankings (Spearman's correlations coefficient 0.94, P<0.0001). The Wilcoxon two-sample rank sum test was used to test the difference in rank of the 20 items between the patients and nurses. There was a significant difference in rank in only six of the 20 items. These data suggest that oncology patients and nurses have more concordant perceptions of caring than previously investigated groups. Implications for practice and further research are discussed.