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Tajari M, Ashktorab T, Ebadi A, Zayeri F. Designing and psychometric evaluation of safe nursing care instrument in intensive care units. BMC Nurs 2024; 23:629. [PMID: 39256803 PMCID: PMC11384708 DOI: 10.1186/s12912-024-02322-z] [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: 07/08/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Providing safe care in a sensitive and high-risk unit such as the ICU is one of the most crucial tasks for nurses. One way to establish the criteria for safe care is by creating a instrument to assess it. Therefore, this study was conducted with the aim of designing and psychometrically evaluating an instrument for safe nursing care in the ICU. METHODS The current study employed a sequential-exploratory mixed-method approach with two qualitative and quantitative phases. Based on the results of qualitative phase and the literature review, the primary instrument was designed. In the quantitative phase, the designed instrument underwent psychometric evaluation. Face, content and construct validity were assessed. Face validity was assessed by 20 nurses, and content validity was assessed by 26 experts. In the construct validity stage, the sample size for the exploratory factor analysis (EFA) included 300 nurses, and for the confirmatory factor analysis (CFA) included 200 nurses who work full-time in the ICUs of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran. EFA sampling was conducted in three hospitals, encompassing six ICUs, while CFA sampling was carried out in two hospitals, covering four ICUs. Sampling was done using the convenience method. The reliability of the instrument was also assessed. Finally, the interpretability, feasibility, weighting, and scoring of the instrument were evaluated. RESULTS The qualitative phase identified three themes, including professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment). The primary instrument was designed with 107 items rated on a five-point Likert scale. In the quantitative phase, the psychometrics of the instrument were conducted. First, the face and content validity were assessed, and the average scale content validity index (S-CVI) was 0.94. Then, a preliminary test was conducted to assess the initial reliability (α = 0.92) and the correlation of each item with the total score. After completing these steps, the number of items in the instrument was reduced to 52. The results of the EFA explained 58% of the total variance, with 4 factors identified: professional behavior by following guidelines, comprehensive care, accurate documentation, and pressure ulcer care. At the CFA stage, the results of the calculation of indices and goodness of fit showed that the model had a good fit. The reliability of the relative stability by examining the intraclass correlation coefficient (ICC) for the whole instrument in 20 samples was 0.92 with a confidence interval of 0.97 - 0.81. To measure absolute stability and determine the responsiveness of the instrument, the standard error of measurement (SEM) was 4.39 and the minimum detectable change (MDC) was 12.13. CONCLUSION The instrument for safe nursing care in the ICU has favorable psychometric properties.
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Affiliation(s)
- Mozhdeh Tajari
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Tahereh Ashktorab
- Department of Management, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Abbas Ebadi
- Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran
| | - Farid Zayeri
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Carruthers H, Derry D, Astin F. Becoming partners in rehabilitation with patients in intensive care: physiotherapists' perspectives. Disabil Rehabil 2024; 46:4194-4204. [PMID: 37818631 DOI: 10.1080/09638288.2023.2266993] [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: 06/15/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE Person-centred care is widely accepted as being central to high quality care, but little is known about how physiotherapists implement person centred rehabilitation in Intensive Care. This study explores the self-reported experiences and interpretations of physiotherapists delivering person-centred rehabilitation in this setting. METHODS A qualitative study using Interpretative Phenomenological Analysis explored the lived experiences of physiotherapists and students who have worked in Intensive Care. Three focus groups, with four participants in each, were conducted. Data were fully transcribed, analysed and managed using NVivo software. RESULTS Participants shared similar interpretations about the principles of person-centred care. Operationalising person-centred rehabilitation during early recovery was not easily achievable. As the person's clinical condition improved, participants moved away from routine physiotherapy and their practice became more person-centred through the development of a partnership. Participants connected as humans to understand the person and respond to their needs within a culture that valued person-centred care. CONCLUSIONS Physiotherapists aspire to develop a partnership with their patients by connecting on a human level with them and addressing their biopsychosocial needs. Physiotherapists with experience of developing patient partnerships influence the culture of the Intensive Care team and are role-models to facilitate collaborative person-centred activity in others.
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Affiliation(s)
- Helen Carruthers
- School of Health and Society, University of Salford, Salford, UK
| | - David Derry
- Long-Term Ventilation Unit, Wythenshawe Hospital, Manchester Foundation NHS Trust, Manchester, UK
| | - Felicity Astin
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
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Su JJ, Bayuo J, Lin RS, Batalik L, Chen X, Abu-Odah H, Chan EA. Providing compassionate care via eHealth. Nurs Ethics 2024; 31:1079-1091. [PMID: 38243793 DOI: 10.1177/09697330231196226] [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: 01/22/2024]
Abstract
BACKGROUND eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. PURPOSE to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the COVID-19 pandemic. METHODS A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. ETHICAL CONSIDERATIONS Permission to conduct the study was obtained from the Institutional Review Board. RESULTS Participants stated that "eHealth enabled compassionate care during the pandemic" by ensuring patient care availability and accessibility. They shared experiences of "communicating compassionate care via eHealth" with suggestions of addressing patients' needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended "setting realistic mutual expectations" considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered "low eHealth literacy hinders compassion." Additionally, they recommended the need for "institutional/system-level support to foster compassionate care." CONCLUSION Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients.
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Affiliation(s)
- Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rose Sy Lin
- School of Nursing, University of Rochester, NY, USA
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Xi Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Engle Angela Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Uhm JY. Knowledge of and attitude toward diabetes care as predictors of school nurses' partnership with parents: A cross-sectional study. NURSE EDUCATION TODAY 2024; 143:106378. [PMID: 39241489 DOI: 10.1016/j.nedt.2024.106378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/20/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Collaboration between parents and school nurses is important for effective healthcare in schools. This study focuses on the competency of school nurses, which encompasses their knowledge and self-efficacy in diabetes care, and investigates how these factors, along with workload, influence healthcare partnerships in schools. However, it is unknown whether school nurses' knowledge and self-efficacy about diabetes care, as well as their workload, affect school healthcare partnerships concerning children with type 1 diabetes. AIM This study aimed to investigate the impact of school nurses' self-efficacy, knowledge, attitude, and role overload on healthcare partnerships with parents of children with type 1 diabetes in schools. DESIGN A cross-sectional, descriptive design. SETTING AND PARTICIPANTS Between December 2023 and January 2024 in South Korea, 142 elementary- and middle-school nurses participated in this study. METHODS School healthcare partnership, self-efficacy in diabetes education, knowledge of and attitude toward school healthcare for type 1 diabetes, and the role-overload scale were utilized in the analysis. Data were analyzed using multiple regression. RESULTS Knowledge of school healthcare (β = 0.34, p < .001) and attitude toward it (β = 0.29 p = .001) for type 1 diabetes, as well as the grade level of the current employing school (β = -0.15, p = .039) were predictors of school healthcare partnerships. These three variables explained 30.3 % of the total variance in school healthcare partnerships (F = 21.44, p < .001). CONCLUSIONS Knowledge of school healthcare and attitudes toward it for type 1 diabetes were identified as factors in school nurses' school healthcare partnerships. Therefore, interventions to strengthen school nurses' competencies should be developed to improve school healthcare partnerships.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan 48513, South Korea.
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Kim S, Tak SH. Experiences of Family Members With Visitation Prohibition for Critically Ill Patients. West J Nurs Res 2024:1939459241277777. [PMID: 39183724 DOI: 10.1177/01939459241277777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
BACKGROUND Visitation plays a number of positive roles for critically ill patients and their families. It reduces the physical and mental stress of intensive care unit (ICU) patients and their families and allows family members to participate in patient care. Visit prohibition during the COVID-19 pandemic has raised unprecedented challenges to patients, family members, and health care providers. OBJECTIVE This qualitative study aimed to explore the experiences of families of patients in the ICU with no-visitor policies due to COVID-19. METHODS Data collection was conducted through 8 individual in-depth semi-structured interviews conducted between October 2021 and March 2022. Data analysis was performed following the qualitative method proposed by Colaizzi. The researchers independently analyzed the data, checked the findings, derived subthemes, and categorized them into overarching themes. RESULTS Four themes emerged from the data analysis: (a) experiencing emotional distress, (b) being fearful of in-person patient contact, (c) being dissatisfied with the access control policy in the ICU, and (d) making efforts to reach the patient. CONCLUSIONS It is critical to provide support and develop interventions for families denied visitation with loved ones in ICUs. Since in-person visits are crucial for families, hospitals should establish clear and reasonable visitation guidelines, communicate effectively with families, and offer alternative methods for them to connect with loved ones in the ICU.
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Affiliation(s)
- Sunjung Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Sunghee H Tak
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Korea
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Mohammadi M, Peyrovi H, Fazeli N, Parsa Yekta Z. Empathic Care Culture in Intensive Care Unit Nurses: A Focused Ethnographic Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241240902. [PMID: 38876482 DOI: 10.1177/10497323241240902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Empathy is one of the important components in the patient-nurse relationship. The aim of the study was to explain the culture of empathic care in intensive care unit (ICU) nurses. The present focused ethnographic study was conducted in the cardiac surgery ICU in Tehran. Three methods of observation, interview, and review of existing documents were used to collect data. From data analysis, three cultural models, "Predominance of task-based care over emotion-based care," "Empathy and lack of empathy, two ends of the spectrum of the nurse-patient relationship," and "Empathy, an interactive and reciprocal process," were extracted. The results showed that empathy creates a caring environment where nurses not only understand their patients but also relate to them, and both are affected by it. Policymakers should consider removing barriers as a means of empowering nurses to provide empathic care.
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Affiliation(s)
- Marziyeh Mohammadi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Hamid Peyrovi
- Nursing and Midwifery Care Research Center/School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Parsa Yekta
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
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Lindberg HB, Steindal SA, Kvande ME. Critical care nurses' experiences of caring for patients with iatrogenic opioid withdrawal in the intensive care unit: A qualitative study. Intensive Crit Care Nurs 2023; 78:103452. [PMID: 37178587 DOI: 10.1016/j.iccn.2023.103452] [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: 12/06/2022] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To explore critical care nurses' experiences of caring for adult patients experiencing iatrogenic opioid withdrawal in the intensive care unit. RESEARCH METHODOLOGY/DESIGN A qualitative study with an explorative and descriptive design was conducted. Data were collected through semi-structured interviews and systematic text condensation was used to analyse the data. The study was reported according to the consolidated criteria for reporting qualitative research checklist. SETTING AND PARTICIPANTS Ten critical care nurses, working at three different intensive care units in two university hospitals in Norway. FINDINGS Three categories were identified in the data analysis. "Subtle signs and symptoms of opioid withdrawal", lack of a systematic approach to opioid withdrawal, and the prerequisites for appropriate management of opioid withdrawal. Critical care nurses experienced challenges in identifying opioid withdrawal due to subtle and vague signs and symptoms, especially when not knowing their patient or when difficulties were encountered with patient communication. A systematic approach to opioid withdrawal and increased knowledge, definitive plans for weaning, as well as interdisciplinary unity and collaboration, could improve the management of opioid withdrawal. CONCLUSION Validated assessment tools, systematic strategies, and guidelines are essential for the management of opioid withdrawal in opioid naïve patients in intensive care units. The prerequisites for an appropriate management of opioid withdrawal are an accurate and effective communication among critical care nurses and other healthcare professionals involved in patient care. IMPLICATIONS FOR CLINICAL PRACTICE There is a need for a validated assessment tool, systematic strategies, and guidelines for the management of opioid withdrawal in opioid naïve patients in intensive care units. Increased emphasis needs to be placed on the process of identifying iatrogenic opioid withdrawal and improving opioid withdrawal management in the education system and clinical practice.
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Affiliation(s)
- Hedda Bekken Lindberg
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456 Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456 Oslo, Norway; Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Monica Evelyn Kvande
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456 Oslo, Norway; Department of Anaesthesiology and Surgery, University Hospital of North Norway, Tromsø, Norway.
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Hasandoost F, Mohammadi E, Khademi M, Seddighi M. Paradoxical perception of humanistic care in the intensive care unit: A qualitative study. Nurs Open 2023; 10:1492-1502. [PMID: 36177853 PMCID: PMC9912452 DOI: 10.1002/nop2.1399] [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: 01/19/2021] [Revised: 12/19/2021] [Accepted: 09/14/2022] [Indexed: 11/11/2022] Open
Abstract
AIM The aim of this study was to explore the perceptions of nurses, patients and attendants of humanistic care in the intensive care unit. DESIGN The present study was a qualitative conventional content analysis conducted in the intensive care unit in a hospital in Iran, in 2019. METHODS Data were collected using semi-structured interviews and field notes through purposive sampling with 17 nurses who worked in an adult ICU in a teaching hospital, 4 attendants and 4 alert patients, and then analysed using the Elo-Kyngäs method in 2008. RESULTS Analysis of the data led to the extraction of Four main themes as follows: (1) Insufficient understanding of nurses and patients' families of each other's roles, needs and expectations; (2) The use of personal and situational reasoning rather than ethical principles; (3) Caring stagnation; and (4) Satisfaction with care.
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Affiliation(s)
- Fateme Hasandoost
- Faculty of Medical SciencesNursing DepartmentTarbiat Modares UniversityTehranIran
| | - Eesa Mohammadi
- Faculty of Medical SciencesNursing DepartmentTarbiat Modares UniversityTehranIran
| | - Mojgan Khademi
- Social Determinants of Health Research CenterLorestan University of Medical SciencesKhoram‐AbadIran
| | - Mahyar Seddighi
- Anesthesiology and critical careQazvin University of Medical SciencesQazvinIran
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Cederwall CJ, Rose L, Naredi S, Olausson S, Ringdal M. Care practices for patients requiring mechanical ventilation more than seven days in Swedish intensive care units: A national survey. Intensive Crit Care Nurs 2023; 74:103309. [PMID: 35965149 DOI: 10.1016/j.iccn.2022.103309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To identify care practices in Swedish intensive care units specific to patients requiring mechanical ventilation for >7 days. RESEARCH METHODOLOGY We conducted a national cross-sectional survey inviting all adult Swedish ICUs (n = 79). Nurse managers were invited by email to complete a questionnaire by telephone. The questionnaire included seven domains: ventilator weaning, mobilisation, communication, nutrition, symptom assessment, psychosocial support and organisational characteristics. RESULTS We received responses from 77 units (response rate, 97%). Weaning protocols were available in 42 (55%) units, 52 (68%) used individualised weaning strategies and 50 (65%) involved physicians and nurses in collaborative decision making. In 48 units (62%), early mobilisation was prioritised using bed cycling but only 26 (34%) units had mobilisation protocols. Most of the intensive care units (74, 96%) had nutrition protocols but only 2 (3%) had dedicated dieticians. Delirium screening tools were available in 49 (64%) ICUs, 3 (4%) assessed anxiety and none assessed dyspnoea. Nineteen (25%) units employed a primary nursing model and 11 (14%) indicated person-centred care policies. Regular case conferences, including family participation, were held by 39 (51%) units. CONCLUSION We found that an individualised approach to ventilator weaning, decided by physicians and nurses in collaboration, was the predominant approach, although weaning protocols were available in some intensive care units. Most units prioritised early mobilisation, though few used protocols. Nutritional protocols were widely adopted, as few units had a dedicated dietician.
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Affiliation(s)
- Carl-Johan Cederwall
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK; Lane Fox Respiratory Unit, St Thomas' Hospital, London, UK
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Anaesthesiology and Intensive Care, 413 45 Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden
| | - Mona Ringdal
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Kungälv, Sweden
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What the Joint Commission Medication Management Titration Standards Mean to Quality Care for Complex Patients. CLIN NURSE SPEC 2023; 37:36-41. [PMID: 36508233 DOI: 10.1097/nur.0000000000000722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT The Joint Commission (TJC), the nation's largest healthcare accreditor, was founded in the 1950s. Its Standards for Medication Management (MM) of titratable medications focused on prescriptive ordering practices versus reliance on nurse clinical decision making. The use of measurable endpoints to guide nurse decision making regarding medication titration has been the standard of care since the inception of TJC. Evidence to support altering these practice patterns is lacking. Using the 6 aims for the healthcare system (safe, timely, effective, efficient, equitable, and patient-centered) from the National Academy of Medicine, formerly the Institute of Medicine, and the American Association of Critical-Care Nurses Healthy Work Environment essential standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, authentic leadership), this article examines the impact of TJC MM standards on system design in critical care environments.
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Katja L, Terhi L, Minna S, Jouko K, Riitta S. Nurse competence provides more individuality in the care of older hospitalized people. Nurs Open 2022; 10:3191-3200. [PMID: 36572665 PMCID: PMC10077381 DOI: 10.1002/nop2.1569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 07/20/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022] Open
Abstract
AIM The aim of the study was to assess Registered Nurses' perceptions of general nurse competence, patient-centred care competence, and individuality in the care of older patients and to explore their associations. DESIGN A descriptive correlative survey. METHODS Data were collected using questionnaires at one Finnish university hospital during winter 2016-2017 amongst Registered Nurses (n = 223) and analyzedd statistically using descriptive and inferential statistics (ANOVA, Pearson's correlations coefficients) and path analysis. RESULTS Registered Nurses assessed their general competence, patient-centred care competenc,e and individuality in the care of older patients at a good level. The Path model confirmed general nurse competence was a predictor of patient-centred care competence, which in turn was a predictor of individuality in the nursing care of older patients. The novelty lies in empirical confirmation of the association between nurse competence and individuality in the care. Increasing competence may enhance individuality in the care of older people and enable interventions to support care outcomes.
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Affiliation(s)
- Lahtinen Katja
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Social and Health Care, City of Helsinki, Helsinki, Finland
| | - Lemetti Terhi
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Stolt Minna
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Katajisto Jouko
- Statistics Unit, Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Suhonen Riitta
- Department of Nursing Science, University of Turku, Turku, Finland.,Welfare Services Division, Turku University Hospital and City of Turku, Turku, Finland
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Türkmen E, Kebapçı A. Opinions and experiences of healthcare professionals regarding structured virtual patient visits in ICUs: A qualitative study. J Nurs Scholarsh 2022; 54:799-807. [PMID: 35642072 DOI: 10.1111/jnu.12779] [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: 06/01/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study aimed to reveal the experiences of healthcare professionals regarding a structured Virtual Patient Visit (sVPV) program implemented in an ICU during the coronavirus disease 2019 (COVID-19) pandemic and to share the process of establishing the program. DESIGN This qualitative, exploratory study was conducted using a semi-structured, in-depth interview method. SETTING The study was conducted in a university hospital ICU in Turkey (where a sVPV program was implemented) and comprised one physician, eight nurses, and one clerk who volunteered to participate in the study. The data were evaluated with content analysis, and themes and sub-themes were determined. FINDINGS Five themes and 13 subthemes were obtained: (1) an essential program during the pandemic, (2) contributing to patient's recovery, (3) family-centered care, (4) innovativeness, and (5) sustainability. CONCLUSION The results show that the sVPV program is highly innovative and effective and contributed to positive patient outcomes and family-centered care practices during the COVID-19 pandemic. In addition, it was revealed that in order to conduct sVPVs effectively, organizational planning, such as legal processes, and the employment of experienced and competent healthcare professionals, should be well managed. CLINICAL RELEVANCE A well-designed sVPV program specific to the setting alleviates anxiety among patients and family members, increases patient motivation and healing, and decreases the workloads of healthcare professionals. It is recommended that the sVPV program, which can be easily used during not only COVID-19 pandemics but also during other crises, be adopted in all ICUs and carried out by a dedicated nurse or healthcare provider.
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Affiliation(s)
- Emine Türkmen
- Nursing Department, Istinye University Faculty of Health Sciences, Istanbul, Turkey
| | - Ayda Kebapçı
- Koç University School of Nursing, Istanbul, Turkey
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Person-centred care among intensive care unit nurses: A cross-sectional study. Intensive Crit Care Nurs 2022; 73:103293. [PMID: 35871960 DOI: 10.1016/j.iccn.2022.103293] [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: 03/02/2022] [Revised: 05/02/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Practising person-centred care is crucial for nurses in the intensive care unit, as patients have high physical and psychological care needs. We aimed to identify the predictors of person-centred care among nurses working in intensive care settings. METHODS In this cross-sectional study, 188 intensive care unit nurses at four tertiary hospitals in two cities of South Korea were included. They completed self-reported questionnaires on emotional intelligence, compassion satisfaction, secondary traumatic stress, burnout, and person-centred care. Emotional intelligence was measured using the Korean version of the Wong and Law's emotional intelligence scale. Compassion satisfaction, secondary traumatic stress, and burnout were measured by the Professional Quality of Life questionnaire (version 5). Person-centred care was measured using the person-centred critical care nursing scale. RESULTS Multiple regression identified compassion satisfaction (β = 0.49, p <.001) as the most powerful predictor of person-centred care, followed by emotional intelligence (β = 0.21, p =.004) and intensive care unit career length (β = 0.17, p =.021). These three variables accounted for 31.0 % of the variance in person-centred care. CONCLUSIONS This study highlights the importance of career length, emotional intelligence, and compassion satisfaction in the promotion of person-centred care among intensive care unit nurses. Nursing management should contemplate specific measures to reduce turnover among experienced intensive care unit nurses and to enhance the factors that promote person-centred care, such as compassion satisfaction and emotional intelligence.
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Sturgiss EA, Peart A, Richard L, Ball L, Hunik L, Chai TL, Lau S, Vadasz D, Russell G, Stewart M. Who is at the centre of what? A scoping review of the conceptualisation of 'centredness' in healthcare. BMJ Open 2022; 12:e059400. [PMID: 35501096 PMCID: PMC9062794 DOI: 10.1136/bmjopen-2021-059400] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We aimed to identify the core elements of centredness in healthcare literature. Our overall research question is: How has centredness been represented within the health literature published between 1990 and 2019? METHODS A scoping review across five databases (Medline (Ovid), PsycINFO, CINAHL, Embase (Ovid) and Scopus; August 2019) to identify all peer-reviewed literature published since 1990 that focused on the concept of centredness in any healthcare discipline or setting. Screening occurred in duplicate by a multidisciplinary, multinational team. The team met regularly to iteratively develop and refine a coding template that was used in analysis and discuss the interpretations of centredness reported in the literature. RESULTS A total of 23 006 title and abstracts, and 499 full-text articles were screened. A total of 159 articles were included in the review. Most articles were from the USA, and nursing was the disciplinary perspective most represented. We identified nine elements of centredness: Sharing power; Sharing responsibility; Therapeutic relationship/bond/alliance; Patient as a person; Biopsychosocial; Provider as a person; Co-ordinated care; Access; Continuity of care. There was little variation in the concept of centredness no matter the preceding word (eg, patient-/person-/client-), healthcare setting or disciplinary lens. Improving health outcomes was the most common justification for pursuing centredness as a concept, and respect was the predominant driving value of the research efforts. The patient perspective was rarely included in the papers (15% of papers). CONCLUSIONS Centredness is consistently conceptualised, regardless of the preceding word, disciplinary lens or nation of origin. Further research should focus on centring the patient perspective and prioritise research that considers more diverse cultural perspectives.
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Affiliation(s)
- Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Annette Peart
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lauralie Richard
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Lauren Ball
- Menzies Health Institute Queensland, Griffith University,School of Public Health, Southport, Queensland, Australia
| | - Liesbeth Hunik
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tze Lin Chai
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Steven Lau
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | - Grant Russell
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Moira Stewart
- Department of Family Medicine, Centre for Studies in Family Medicine, Western University, London, Ontario, Canada
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15
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Ryan T. Facilitators of person and relationship-centred care in nursing. Nurs Open 2022; 9:892-899. [PMID: 34590790 PMCID: PMC8859070 DOI: 10.1002/nop2.1083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/26/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS To provide an expert overview on the current state of evidence as it relates to person and relationship-centred care. DESIGN Review and commentary. METHODS The paper was prepared in order to contribute to a Consensus Development Project. It is based upon a scoping review with additional theoretical material used to supplement the narrative. The content is limited to that person and relationship-centred literature as it relates to nursing practice and policy. RESULTS There is compelling evidence in favour of nurses pursuing person and relationship-centred policies and practices. Organizational and individual factors contribute to the successful implementation of person and relationship-centred care. These include conditions that enable nurses to provide high-quality care (resources, clinical supervision and security) and include training and development, a biographical approach to care and those care environments centred on innovation and person-centred care processes.
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Affiliation(s)
- Tony Ryan
- Division of Nursing & Midwifery, Health Sciences SchollFaculty of Medicine Dentistry & HealthUniversity of SheffieldSheffieldUK
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16
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Jang SJ, Kim EH, Lee H. Moral sensitivity and person-centered care among mental health nurses in South Korea: A cross-sectional study. J Nurs Manag 2022; 30:2227-2235. [PMID: 35119156 DOI: 10.1111/jonm.13554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022]
Abstract
AIM To identify the predictors of mental health nurses' person-centered care, including moral sensitivity. BACKGROUND Person-centered care meets patients' ethical needs by protecting their autonomy and dignity, and respecting their choices; it is essential to enhance patient outcomes. Therefore, it is important to identify the predictors of the practice of advocating patients' rights and dignity, and providing person-centered care among mental health nurses to foster competency and ensure the highest quality of care. METHODS This cross-sectional study included 220 mental health nurses in South Korea. It measured their general and work-related characteristics, moral sensitivity, and person-centered care. Multiple regression analysis was conducted to identify the person-centered care predictors. RESULTS The most potent person-centered care predictor was moral sensitivity (β=.35, p<.001). Other predictors included prior biomedical ethics education (β=.15, p=.013) and marital status (β=.14, p=.025). The regression model had 28.0% explanatory power. CONCLUSIONS Mental health nurses' moral sensitivity must be increased to improve their person-centered care. IMPLICATIONS FOR NURSING MANAGEMENT Nurses should receive continuous education to remain aware of and maintain a high level of moral sensitivity and be encouraged to continue the person-centered practice. Organizational and policy support is needed to promote the practice of person-centered care in the workplace.
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Affiliation(s)
- Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Eun Hye Kim
- Dawongongdongche, Mental Rehabilitation Facilities, Daejeon, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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17
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Kang J, Lee M, Cho YS, Jeong JH, Choi SA, Hong J. The relationship between person-centred care and the intensive care unit experience of critically ill patients: A multicentre cross-sectional survey. Aust Crit Care 2021; 35:623-629. [PMID: 34844837 DOI: 10.1016/j.aucc.2021.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/30/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Person-centred care has the potential to improve the patient experience in the intensive care unit (ICU). However, the relationship between person-centred care perceived by critically ill patients and their ICU experience has yet to be determined. OBJECTIVES The aim of this study was to investigate the relationship between person-centred care and the ICU experience of critically ill patients. METHODS This study was a multicentre, cross-sectional survey involving 19 ICUs of four university hospitals in Busan, Korea. The survey was conducted from June 2019 to July 2020, and 787 patients who had been admitted to the ICU for more than 24 hours participated. We measured person-centred care using the Person-Centered Critical Care Nursing perceived by Patient Questionnaire. Participants' ICU experience was measured by the Korean version of the Intensive Care Experience Questionnaire that consists of four subscales. We analysed the relationship between person-centred care and each area of the ICU experience using multivariate linear regression. RESULTS Person-centred care was associated with 'awareness of surroundings' (β = 0.29, p < .001), 'frightening experiences' (β = -0.31, p < .001), and 'satisfaction with care' (β = 0.54, p < .001). However, there was no significant association between person-centred care and 'recall of experience'. CONCLUSIONS We observed that person-centred care was positively related to most of the ICU experiences of critically ill patients except for recall of experience. Further studies on developing person-centred nursing interventions are needed.
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Affiliation(s)
- Jiyeon Kang
- College of Nursing, Dong-A University, 32, Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea
| | - Minju Lee
- Department of Nursing, Youngsan University, 288, Junam-ro, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Young Shin Cho
- Department of Nursing, Youngsan University, 288, Junam-ro, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Jin-Heon Jeong
- Department of Intensive Care Medicine & Neurology, Dong-A University Hospital, Dong-A University College of Medicine, 26, Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea
| | - Sol A Choi
- Medical Intensive Care Unit, Inje University Busan Paik Hospital, 75, Bokji-ro, Busanjin-gu, Busan, Republic of Korea
| | - Jiwon Hong
- College of Nursing, Dong-A University, 32, Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea.
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18
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Andersson M, Nordin A, Engström Å. Critical care nurses' experiences of working during the first phase of the COVID-19 pandemic - Applying the Person-centred Practice Framework. Intensive Crit Care Nurs 2021; 69:103179. [PMID: 34895797 PMCID: PMC8595352 DOI: 10.1016/j.iccn.2021.103179] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/24/2021] [Accepted: 10/31/2021] [Indexed: 11/19/2022]
Abstract
AIM The aim of the study was to deductively study person-centred care, based on critical care nurses' experiences during the first phase of the CoViD-19 pandemic. DESIGN The study used a qualitative design. METHOD Data collection was conducted as individual interviews and was analysed with qualitative content analysis with a deductive approach. PARTICIPANTS Six critical care nurses working in a special CoViD-19 intensive care unit during the first phase of the pandemic participated. FINDINGS The findings are presented within the four domains of person-centred practice: the prerequisites, the care environment, person-centred processes and person-centred outcomes. While the ambition and knowledge about how to work in accordance with person-centred practice were high, there were several obstacles to perform it. CONCLUSION We need to prepare ahead of time so that nurses have optimal organisational prerequisites to be able to work in accordance with person-centred practice, also during pandemics and other crisis, which means to be able to give nursing care in accordance with the ill person's needs and resources.
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Affiliation(s)
- Maria Andersson
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden
| | - Anna Nordin
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden; Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden
| | - Åsa Engström
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden.
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19
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King E, Gustafson O, Judge T, Vollam S. Multidisciplinary team perception of games-based therapy in critical care: A service evaluation. Nurs Crit Care 2021. [PMID: 34783137 DOI: 10.1111/nicc.12731] [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: 06/23/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND As survivorship following critical illness improves, there is greater focus on maximizing recovery. As well as physical effects, critical illness often results in cognitive impairments such as delirium, anxiety, or disorientation. In other populations, such as delirium, non-pharmacological approaches to manage these conditions are preferred, including re-orientation and ensuring personal care needs are met. Cognitive rehabilitation is also well documented for patients with neuropsychological deficits. Treatments include memory aids, compensation strategies, and functional execution. In other hospital populations, games and activities have been utilized to optimize patient engagement, stimulation, and aid recovery, but it is considered an emerging therapy in intensive care. AIMS This service evaluation aimed to gather multidisciplinary team members' perceptions of the use of games based therapy (GBT) in critical care, including patient engagement and acceptability in clinical practice. STUDY DESIGN A UK-based single-centre qualitative service evaluation. METHODS Purposive sampling was used to identify interviewees within an adult intensive care who had experience of using a recently implemented GBT intervention. Qualitative data were collected through semi-structured interviews, which were recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS Eight staff members across the multidisciplinary team were interviewed. One overarching theme of humanizing health care was identified, with three sub-themes of enhancing recovery, non-physical components of care, and bespoke tailoring. In addition, further recommendations for development of the service were summarized. CONCLUSION GBT was well received by staff in clinical practice. It was described as a supportive adjunct to traditional care and rehabilitation, enhancing staff-patient relationships. While it was recognized it may not suit all patients, GBT has the potential to enhance cognitive and physical recovery.
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Affiliation(s)
- Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Tom Judge
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sarah Vollam
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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20
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Suhonen R, Lahtinen K, Stolt M, Pasanen M, Lemetti T. Validation of the Patient-Centred Care Competency Scale Instrument for Finnish Nurses. J Pers Med 2021; 11:jpm11060583. [PMID: 34205569 PMCID: PMC8235000 DOI: 10.3390/jpm11060583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 12/30/2022] Open
Abstract
Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses' self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach's alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach's alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker-Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses' self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses' patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument.
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Affiliation(s)
- Riitta Suhonen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (K.L.); (M.S.); (M.P.); (T.L.)
- Turku University Hospital, 20014 Turku, Finland
- City of Turku, Welfare Division, 20014 Turku, Finland
- Correspondence: ; Tel.: +358-50-435-0662
| | - Katja Lahtinen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (K.L.); (M.S.); (M.P.); (T.L.)
- City of Helsinki, Department of Social and Health Care, 00099 Helsinki, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (K.L.); (M.S.); (M.P.); (T.L.)
| | - Miko Pasanen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (K.L.); (M.S.); (M.P.); (T.L.)
| | - Terhi Lemetti
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (K.L.); (M.S.); (M.P.); (T.L.)
- University Hospital, 00029 Helsinki, Finland
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21
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The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis. Int J Nurs Stud 2021; 120:103973. [PMID: 34102372 DOI: 10.1016/j.ijnurstu.2021.103973] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Compassion fatigue is a consequence of chronic work-related stress exposure among healthcare providers. Nursing is a high-risk, stressful profession which increases nurses' vulnerability to compassion fatigue symptoms compared to other healthcare workers. Compassion fatigue has serious consequences for nursing staff, patients and healthcare organizations. Though several studies on the prevalence of compassion fatigue among nurses have been published, the reported data vary considerably across studies; and few meta-analysis have examined the prevalence of compassion satisfaction and compassion fatigue among nurses with large sample sizes. OBJECTIVES To systematically assess the prevalence of compassion satisfaction and compassion fatigue among nurses, and to evaluate the effect of different geographical regions, years and departments on the prevalence of compassion fatigue. DESIGN Systematic review and meta-analysis DATA SOURCES: The Cochrane Library, PubMed, EMbase, Web of Science, CINAHL, PsyclNFO, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched in the systematic review. The time frame for the searches included all literature before January 31st, 2020. REVIEW METHODS The reviewers independently completed study selection, quality assessments, data extraction and analysis of all included literature. The mean scores and standard deviations of the three subscales of the Professional Quality of Life (ProQOL) scale were pooled using random effects meta-analysis in Stata 16.0 software package. Finally, subgroup analyses were conducted to explore the sources of between-study heterogeneity. RESULTS A total of 79 studies were included in the systematic review and meta-analysis, consisting of 28,509 nurses worldwide from 11 countries. In our studies, the pooled mean scores of compassion satisfaction, burnout and secondary traumatic stress were 33.12 (95% CI: 32.22-34.03), 26.64 (95% CI: 26.01-27.27) and 25.24 (95% CI: 24.69-25.79), respectively. In addition, the Asian region had the lowest levels of compassion satisfaction but the highest levels of compassion fatigue symptoms, while the Americas and Europe had the lowest levels of compassion fatigue but highest compassion satisfaction. Levels of compassionate fatigue in nurses increased gradually from 2010 to 2019, reaching the highest level in 2019; and nurses from ICU had the highest levels of compassion fatigue symptoms among all nurses. CONCLUSION The levels of compassion satisfaction and compassion fatigue among nurses are moderate. Nurses from the Asian region and in ICUs suffer from severe compassion fatigue symptoms, and the prevalence of compassion fatigue has increased over time. These findings may provide hospital administrators with the theoretical basis for the management and treatment of compassion fatigue. REGISTRATION NUMBER PROSPERO [CRD42020164327].
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22
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Chang AK, Yoon H, Jang JH. Predictors of posttraumatic growth of intensive care unit nurses in Korea. Jpn J Nurs Sci 2021; 18:e12427. [PMID: 33977673 DOI: 10.1111/jjns.12427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/29/2021] [Accepted: 04/04/2021] [Indexed: 11/26/2022]
Abstract
AIM Nurses working in intensive care units are repeatedly exposed to trauma (e.g., verbal or physical abuse by confused patients, and unexpected death). However, after experiencing traumatic events, not all intensive care unit nurses develop psychopathological issues, including posttraumatic stress disorder. Therefore, this study aims to examine the level of posttraumatic growth and psychosocial factors such as posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion to predict posttraumatic growth in Korean intensive care unit nurses. METHODS A total of 156 intensive care unit nurses participated in this cross-sectional survey. Posttraumatic growth, posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion were measured using validated self-report scales, and data were analyzed by descriptive statistics. RESULT Posttraumatic growth was found to be comparatively low in intensive care unit nurses, while multiple regression showed that positive self-compassion was the most significant predictor for posttraumatic growth, followed by wisdom, age, and deliberate rumination. All together four variables explained 30% of the variance in posttraumatic growth. CONCLUSION Findings from this study suggest that intensive care unit nurses' posttraumatic growth may be enhanced by increasing positive self-compassion, wisdom, and deliberate rumination. Therefore, a paradigm shift focusing on possible positive pathways, such as development of mental health programs to improve posttraumatic growth for intensive care unit nurses is required rather than focusing on management of posttraumatic stress disorder. The results of this study could provide theoretical guidance to seek more effective and integrated intervention strategies for intensive care unit nurses.
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Affiliation(s)
- Ae Kyung Chang
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Hyejin Yoon
- Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ji Hyun Jang
- Graduate School, Kyung Hee University, Seoul, South Korea
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23
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Aghaei MH, Vanaki Z, Mohammadi E. Inducing a sense of worthiness in patients: the basis of patient-centered palliative care for cancer patients in Iran. BMC Palliat Care 2021; 20:38. [PMID: 33653323 PMCID: PMC7927376 DOI: 10.1186/s12904-021-00732-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patient-centered care is one of the main components in providing palliative care for cancer patients. This issue has been the subject of numerous studies and practices in nursing for many years. Few studies, however, have explored the perception of nurses about patient-centered treatments. This study aimed at exploring the perception of care-providers about offering patient-centered care to cancer patients. METHOD For attaining that aim, 18 care-providers were purposefully selected for an interview which allowed the researchers to explore the enriched experiences of these participants about offering patient-centered palliative care to cancer patients. After transcribing the recorded data, analysis was carried out based on Graneheim and Lundman's method of content analysis. The research was qualitative in nature and conducted in 2019 in Iran. RESULTS From content analysis, 3 main categories; considering patient's spirituality, maintaining patient's dignity during care, and reducing patient's suffering, were found. The essence of these categories reflect on the care-providers' consideration and effort in "inducing a sense of worthiness" in patients by providing patient-centered care. These categories also reflect on the perspective of care-providers about nurse- patient relationship for providing high qualified palliative care. CONCLUSION For providing patient-centered care inducing a sense of worthiness in patients, is the most fundamental component in providing palliative care to cancer patients. Therefore, by considering the structures and settings where the care is to be provided in the healthcare system, it is possible to direct the necessary educational, research, and administrative programs related to inducing a sense of worthiness in patients towards providing a more effective palliative care.
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Affiliation(s)
| | - Zohreh Vanaki
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Eesa Mohammadi
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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24
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Yoo HJ, Shim J. The Effect of a Multifaceted Family Participation Program in an Adult Cardiovascular Surgery ICU. Crit Care Med 2021; 49:38-48. [PMID: 33177359 DOI: 10.1097/ccm.0000000000004694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To develop and implement a patient- and family-centered care program for patients in a cardiovascular surgery ICU. DESIGN Prospective, pre- and postintervention evaluations were conducted. SETTING The cardiovascular surgery ICU was located in a tertiary hospital. PARTICIPANTS Participants included 56 family members of patients in cardiovascular surgery ICU between May and July 2019. INTERVENTIONS Providing personalized treatment plans for patients by: 1) providing an ICU diary, 2) communicating with the medical staff, 3) providing personal care using ICU visitation kit, and 4) guiding bedside range of motion exercises. The experimental group received a guided ICU diary and education program from a nurse, including the application of a family participation visitation program. Family members were provided with customized information from the ICU diary and communicated with the medical staff for approximately 10 minutes. Family members were instructed on how to perform personal care using an "ICU visitation kit" during visitation hours when permitted to participate in bedside activities for approximately 10-minute intervals. MEASUREMENTS AND MAIN RESULTS Scores for satisfaction with the provided care and information increased significantly for the experimental group compared with the control group (t = 8.62; p < 0.001). Anxiety levels decreased significantly after intervention in both groups (t = -7.05; p < 0.001 and t = -12.94; p < 0.001) with a significant association observed between group and time point (F = 20.50; p < 0.001). However, no significant change was observed in satisfaction with decision-making following intervention in either group, and no significant association was noted between groups and time points for this variable (F = 0.24; p = 0.626). CONCLUSIONS This set of implemented family participation processes significantly improved satisfaction and reduced anxiety in family members of critically ill patients.
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Affiliation(s)
- Hye Jin Yoo
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - JaeLan Shim
- Department of Nursing Gyeongju, Dongguk University, College of Medicine, Seoul, South Korea
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25
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Loveday C, Lord H, Ellwood L, Bonnici K, Decker V, Fernandez R. Teamwork and social cohesion are key: Nurses' perceptions and experiences of working in a new decentralised intensive care unit. Aust Crit Care 2020; 34:263-268. [PMID: 32943307 DOI: 10.1016/j.aucc.2020.07.009] [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: 12/16/2019] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Decentralised nursing stations (DCNs) have gained popularity in new hospital designs owing to their positive impact on patient safety. However, the impact on the nurses' working environment and on continuity and quality of patient care is limited. OBJECTIVES The objective of this study was to describe nurses' perceptions and experiences of the working environment and of patient care in a decentralised intensive care unit (ICU). METHODS Twelve months after the establishment of the new decentralised ICU in a tertiary teaching hospital in Sydney, Australia, a prospective cross-sectional survey of registered nurses working in the unit was undertaken. Nurses' perceptions and experiences of the working environment and patient care were evaluated using a 56-item questionnaire comprising nine domains and optional open-ended comments. Quantitative data were analysed using SPSS, version 25. Qualitative data were used to enhance the quantitative data. RESULTS A total of 128 nurses responded to the questionnaire. The mean scores for overall job satisfaction, nursing teamwork, social cohesion, continuity of patient care, and quality of patient care were 3.02 (±0.91), 2.78 (±1.05), 2.68 (1.02), 2.60 (±1.01), and 3.48 (±0.88), respectively, for a maximum obtainable score of 5. Overall mean scores for teamwork, social cohesion, and continuity of patient care were explained by nurses to be a direct result of the physical layout of the new DCN ICU. Nurses believed this influenced their ability to interact with other staff and impacted teamwork and social cohesion and in turn reflected in their current job satisfaction. CONCLUSIONS Implementation of a new model of nursing care, whereby staff members are rostered together in a pod for a period of time, along with team-building exercises, is recommended to improve the social cohesion and teamwork within the DCN ICU. Further research on nurses' experiences within a DCN ICU is required to produce robust evidence and generalisability.
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Affiliation(s)
- Clare Loveday
- Intensive Care Services, St George Hospital, South Eastern Sydney Local Health District, Australia.
| | - Heidi Lord
- Centre for Research in Nursing and Health, St George Hospital, South Eastern Sydney Local Health District, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, St George Hospital, South Eastern Sydney Local Health District, Australia.
| | - Kim Bonnici
- Intensive Care Services, St George Hospital, South Eastern Sydney Local Health District, Australia.
| | - Virginia Decker
- Intensive Care Services, St George Hospital, South Eastern Sydney Local Health District, Australia.
| | - Ritin Fernandez
- Centre for Research in Nursing and Health, St George Hospital, South Eastern Sydney Local Health District, Australia; School of Nursing, University of Wollongong, Australia.
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Jakimowicz S, Perry L, Lewis J. Bowen Family Systems Theory: Mapping a framework to support critical care nurses' well-being and care quality. Nurs Philos 2020; 22:e12320. [PMID: 32835447 DOI: 10.1111/nup.12320] [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: 12/13/2019] [Revised: 05/16/2020] [Accepted: 07/04/2020] [Indexed: 11/29/2022]
Abstract
Intensive care nursing is prone to episodic anxiety linked to patients' immediate needs for treatment. Balancing biomedical interventions with compassionate patient-centred nursing can be particularly anxiety provoking. These patterns of anxiety may impact compassion and patient-centred nursing. The aim of this paper is to discuss the application of Bowen Family Systems Theory to intensive care nursing, mapping a framework to support critical care nurses' well-being and, consequently, the quality of care they provide. This article is founded on research, theoretical papers and texts focused on Bowen Family Systems Theory (BFST), and findings from a constructivist study on patient-centred nursing and compassion in the intensive care unit. The goal of Bowen Family Systems Theory is to empower individuals, decreasing blame and reactivity. Bowen Family Systems Theory can be applied to the sometimes intimate relationships that develop in this environment, aiding understanding of nurses' experience of compassion satisfaction and fatigue. Where organizational factors and management styles fall short in supporting critical care nurses to meet expectations, BFST can offer a perspective on the processes that occur within the intensive care unit, impacting nurse well-being and quality of care. This paper makes plain the importance of understanding the anxiety that occurs within the intensive care unit as a system, so that individuals, such as critical care nurses, can be supported appropriately to ensure nurse well-being and quality care.
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Affiliation(s)
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Joanne Lewis
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Hylén M, Akerman E, Idvall E, Alm-Roijer C. Patients´ experiences of pain in the intensive care - The delicate balance of control. J Adv Nurs 2020; 76:2660-2669. [PMID: 32808692 DOI: 10.1111/jan.14503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 01/10/2023]
Abstract
AIM To explore the patients´ experiences of pain when being cared for in the intensive care. DESIGN An exploratory, qualitative design was chosen. METHOD Interviews were performed with patients (October 2015-March 2017) within a week of post-intensive care (N = 16). Thematic analysis was used as method for analysis. RESULTS The findings generated two themes - a lack of control and to struggle for control. Pain was described as overwhelming, both in body and mind and generating the experience of a lack of control, with feelings of incapacitation, isolation, and having their needs unmet. Feeling in control of the pain and thus in control of the situation was experienced as a constant struggle. Well-planned care, finding ways to handle the pain and good communication were all helpful in this struggle. CONCLUSION The participants recalled their experience of pain in the ICU and control seems to be crucial for how pain is experienced. They experienced a lack of control due to not only the pain but also the treatment, which can be avoided by the nurse continuously evaluating and individualising the care. Balanced care, meeting the patients' needs and good communication helps the patient feel more in control when experiencing pain. IMPACT The experience of pain is dependent on control for the intensive care patient. The nurse may help them gain control and thereby handle the experience of pain through including the patient, striving for better communication and implementing individualised care that continuously assesses and treats pain.
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Affiliation(s)
- Mia Hylén
- Department of Care Science, Faculty of Health and Society, Malmo University, Malmo, Sweden.,Department of Intensive and Perioperative Care, Skane University Hospital, Malmo, Sweden
| | - Eva Akerman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,General Intensive Care Unit, Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Ewa Idvall
- Department of Care Science, Faculty of Health and Society, Malmo University, Malmo, Sweden
| | - Carin Alm-Roijer
- Department of Care Science, Faculty of Health and Society, Malmo University, Malmo, Sweden
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Yoo HJ, Shim J. Effects of a person-centred care intervention in an intensive care unit: Using mixed methods to examine nurses' perspectives. J Nurs Manag 2020; 28:1295-1304. [PMID: 32589762 DOI: 10.1111/jonm.13081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Abstract
AIM We identified nurses' experiences and changes in person- and family-centred care (PFCC) after applying a family-visiting programme in an intensive care unit (ICU). BACKGROUND Critical care provision is shifting to include communication among patients, families and health care providers. METHODS We used mixed methodology and a group pre- and post-test design. In 2019, 30 ICU nurses completed an 8-week programme, including keeping a diary and completing fundamental care activities. A survey of PFCC nursing performance was completed pre- and post-programme, and 15 nurses were interviewed post-programme. Performance differences were examined through paired t tests; qualitative data were analysed by thematic analysis. RESULTS The pre- and post-scores were 3.06 ± 0.34 and 4.00 ± 0.29, respectively (t = 17.38, p =.000), and five main themes and 13 subtopics were revealed. Most nurses 'discovered the importance of nursing through a truthful relationship with ICU patients' families'. CONCLUSION For effective PFCC, changes in nurses' perceptions and hospital organisation are required, such as improving the ICU working environment, assigning suitable health care personnel to provide care and implementing open-visit programmes. IMPLICATIONS FOR NURSING MANAGEMENT Hospital policymakers and nurse managers should take care to provide staff support and high-quality patient care to realize effective PFCC.
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Affiliation(s)
- Hye Jin Yoo
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - JaeLan Shim
- Department of Nursing, College of Medicine, Dongguk University, Gyeongju, South Korea
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Alhalal E, Alrashidi LM, Alanazi AN. Predictors of patient-centered care provision among nurses in acute care setting. J Nurs Manag 2020; 28:1400-1409. [PMID: 32667691 DOI: 10.1111/jonm.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
AIM The study was conducted to assess the predictors of patient-centred care provision among nurses working in an acute care setting. We hypothesized that higher structural empowerment and compassion satisfaction and lower burnout would predict the provision of patient-centred care. BACKGROUND Patient-centred care is a crucial aspect of quality health care and the heart of nursing care. Although previous studies have highlighted some determinants of patient-centred care provision among nurses, there remains a gap in understanding the factors that predict the provision of patient-centred care. METHODS A cross-sectional predictive design was used. Through random sampling, 255 nurses were recruited from five hospitals providing acute care services in Saudi Arabia. RESULTS Multiple linear regression revealed that compassion satisfaction (β = 0.260 [95% CI: 0.201-0.645]), burnout (β = -0.266 [95% CI: -0.998 to -0.403]) and structural empowerment (β = 0.273 [95% CI: 0.462-1.427]) jointly explained significant variance (27.5%) in the provision of patient-centred care by nurses. CONCLUSIONS The study findings reveal that lower burnout, higher compassion satisfaction and structural empowerment increase nurses' provision of patient-centred care. IMPLICATIONS FOR NURSING MANAGEMENT Leadership and managerial strategies that not only address compassion satisfaction and burnout but also empower nurses are crucial for the provision of patient-centred care by nurses.
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Affiliation(s)
- Eman Alhalal
- Nursing College, King Saud University, Riyadh, Saudi Arabia
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Byrne AL, Baldwin A, Harvey C. Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One 2020; 15:e0229923. [PMID: 32155182 PMCID: PMC7064187 DOI: 10.1371/journal.pone.0229923] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/18/2020] [Indexed: 11/19/2022] Open
Abstract
AIM The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. METHOD/DATA SOURCES An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. REVIEW METHODS The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. RESULTS While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. CONCLUSION The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.
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Affiliation(s)
- Amy-Louise Byrne
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Adele Baldwin
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Clare Harvey
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
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Stavropoulou A, Rovithis M, Sigala E, Pantou S, Koukouli S. Greek nurses' perceptions on empathy and empathic care in the Intensive Care Unit. Intensive Crit Care Nurs 2020; 58:102814. [PMID: 32089417 DOI: 10.1016/j.iccn.2020.102814] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Empathy is a fundamental component of nursing practice impacting positively on the therapeutic process. Understanding the concepts of empathy and empathic care in the context of Intensive Care Units is essential for providing better care in high challenging environments. However, research on empathy in the ICU is scarce and mostly quantitative. OBJECTIVES To explore how ICU nurses perceive the concepts of empathy and empathic care. DESIGN AND SETTING A descriptive qualitative research design was applied using an inductive content analysis approach. Semi-structured interviews were conducted with nineteen ICU nurses in two hospitals in Greece. FINDINGS Data analysis revealed three main themes namely: "To become one of them", "Empathic Care" and "Integration of empathic care in practice". Findings corroborated the affective, cognitive and behavioral components of empathy. Nurses underlined that understaffing, increased workload and professional burnout impeded empathic care. CONCLUSION Empathy and empathic care in the ICU were perceived as closely related to patients' outcomes and quality care. Empathic care was arduous due to organisational issues. Despite that, ICU nurses appeared to promote empathic care in practice and sought ways to enhance it.
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Affiliation(s)
| | - Michael Rovithis
- Department of Nursing & Quality of Life Lab, Hellenic Mediterranean University, Heraklion, Greece
| | | | | | - Sofia Koukouli
- Department of Social Work & Quality of Life Lab, Hellenic Mediterranean University, Heraklion, Greece.
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Jang MS, Kim S. [Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study]. J Korean Acad Nurs 2020; 49:423-436. [PMID: 31477672 DOI: 10.4040/jkan.2019.49.4.423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/10/2019] [Accepted: 05/21/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. METHODS Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. CONCLUSION The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
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Affiliation(s)
| | - Sungjae Kim
- College of Nursing·The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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Danielis M, Palese A, Terzoni S, Destrebecq ALL. What nursing sensitive outcomes have been studied to-date among patients cared for in intensive care units? Findings from a scoping review. Int J Nurs Stud 2019; 102:103491. [PMID: 31862529 DOI: 10.1016/j.ijnurstu.2019.103491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/18/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although many studies have considered mortality and adverse effects as outcomes sensitive to nursing practice, it seems that other outcomes of nursing care in intensive care units have been explored less commonly. OBJECTIVES To describe the state-of-science in research in the field of nursing sensitive outcomes in intensive care units and to synthesize outcomes that have been documented to date as being influenced by nursing care. DESIGN A scoping review study based on the framework proposed by Arksey and O'Malley, further refined by the Levac and Joanna Briggs Institute was performed in 2019. DATA SOURCES The Medline, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and Google Scholar electronic databases were searched. In addition, the reference list of included articles was screened. REVIEW METHODS Two researchers independently identified publications on the basis of the following criteria: (a) articles that reported nursing sensitive outcomes on critically-ill adult patients admitted to the intensive care unit, (b) as primary and secondary studies, (c) written in English, and (d) without any time frame limitation. RESULTS Of the 4,231 records, 112 fully met the inclusion criteria and were included. Publications were mainly authored in the US and Canada (n = 44, 39.2%), and the majority (n = 62, 55.3%) had an observational design. A total of 233 nursing sensitive outcomes emerged, categorized in 35 outcomes, with, on average, two per study included. The most often measured outcomes were pressure ulcers (20 studies) and ventilator-associated pneumonias (19 studies); the less studied outcomes were quality of life, secretion clearance, patient-ventilator dysynchrony, and post-extubation dysphagia. When categorizing outcomes, the ones concerning safety (n = 77, 33.1%) were represented the most, followed by those concerning the clinical (n = 72, 30.9%), functional (n = 70, 30.0%), and perceptual (n = 14, 6.0%) domains. The interdependent outcomes linked to multi-professional interventions (e.g., ventilator-associated pneumonias) were the most frequently studied nursing sensitive outcomes (n = 20, 57.1%), while independent outcomes resulting from autonomous interventions performed by nurses were less often studied (n = 8, 22.9%). CONCLUSIONS From a clinical point of view, a large heterogeneity of outcomes influenced by nursing care emerged. However, identified outcomes have been studied with different approaches and metrics, so that future efforts will need to establish homogeneous conceptual and operative definitions. Moreover, increasing efforts in establishing perceptual outcomes, or those close to the fundamentals of nursing care, are suggested in order to better depict the contribution of critical care nurses in the field.
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Affiliation(s)
- Matteo Danielis
- Department of Clinical Sciences and Community Health, University of Milan, Via Vanzetti 5, 20133 Milan, Italy; School of Nursing, Department of Medical Sciences, University of Udine, Udine, Italy.
| | - Alvisa Palese
- School of Nursing, Department of Medical Sciences, University of Udine, Udine, Italy
| | - Stefano Terzoni
- School of Nursing, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
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Lukmanulhakim L, Afriyani A, Haryani A. Caring Efficacy and Nurse Caring Behavior in Taking Care of Critical Patients. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i1.9664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Critical patients have different needs compared to patients in other general inpatient wards, so they need extra treatments from a nurse. Nurse caring behavior gived through an approach in which nurses work by improving their concern to patients. However, it is influenced by caring efficacy in which a nurse is confident to express his or her caring to patients. The aims of this study were to identify the correlation between caring efficacy with nurse caring behavior in taking care of critical patients at dr. Dradjat Prawiranegara Serang Hospital in Banten ProvinceMethods: This is a quantitative study with employed a correlation study. The sample size comprised 66 Nurses of ER, ICU and HCU with total sampling technique. The instruments used are CES (Caring Efficacy Scale) to measure caring efficacy and CBA (Caring Behavior Assessment) to measure nurse caring behavior. Descriptive analysis using mean, standard deviation, percentage and frequency distribution. Meanwhile, inferential analysis used Pearson's Correlation.Results: The univariate analysis results showed the mean ± DS score of caring behavior is 87.6 ± 10.12. Meanwhile, the mean ± DS score of caring efficacy is 86.23 ± 8.74. Further, inferential analysis revealed a significant (p < 0.000) and moderate correlations (r = 0.448) between caring efficacy and nurse caring behavior.Conclusion: Higher of nurse's caring efficacy were followed by higher of nurse's caring behavior in taking care of critical patients. Findings can be used by academic as a prospective nurse and health professionals, to implement a concept of caring efficacy to improve caring behavior. Further research can be a focus on the nursing interventions based on nurses caring behavior to strengthen and increase in taking care of critical patients.
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Crilly G, Dowling M, Delaunois I, Flavin M, Biesty L. Critical care nurses' experiences of providing care for adults in a highly technological environment: A qualitative evidence synthesis. J Clin Nurs 2019; 28:4250-4263. [PMID: 31429996 DOI: 10.1111/jocn.15043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 07/30/2019] [Accepted: 08/03/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To synthesise the available body of qualitative evidence relating to nurses' perceptions and experiences of care provision in adult critical care environments. METHODS The study adhered to ENTREQ (Confidence in Evidence of Reviews of Qualitative Research) guidelines. See Appendix S1. A systematic search of the literature in nine databases was undertaken: CINAHL, Web of Science, MEDLINE, EMBASE, PsycINFO, Campbell Collaboration, ProQuest A & I, DART and Lenus. Blind screening to select relevant studies was undertaken, and each selected study was assessed for quality using the Critical Appraisal Skills Programme framework. Guided by Thomas and Harden's three-stage approach to thematic analysis, line-by-line coding of participants' verbatim accounts and the researchers' interpretations in the selected studies' findings was undertaken and then organised into higher order analytical themes. Confidence in the findings was reviewed using GRADE-CERQual. RESULTS Twelve studies reported in thirteen papers, including 122 nurses, were selected in the final sample for synthesis. Three analytical themes were identified: (a) sometimes machines get all the attention, (b) with experience the patient becomes the focus and (c) technology can't save everybody. CONCLUSIONS Providing care for adult patients in a highly technological environment is challenging particularly for novice nurses, who face the potential of technology drawing all their attention. Experienced critical care nurses learn to keep technology in abeyance and deliver person-centred care within the bounds of a technological environment. RELEVANCE TO CLINICAL PRACTICE The review supports Locsin's theory of technological competence and highlights that providing care in critical care requires nurses to actively balance attention for the person while managing machines. Experienced nurses achieve this balance and can offer support to novice nurses. Critical care nurse orientation programmes should be underpinned by a holistic approach which addresses the dualism of technology and care.
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Affiliation(s)
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | | | | | - Linda Biesty
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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Affiliation(s)
- Natalie Pattison
- Senior Clinical Nursing Research Fellow/Trust lead for Patient Public Involvement in Research
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- Dovehouse DB3 Fulham Road SW36JJ, CCOT offices, Downs Rd, London SM25PT, UK
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Development and Validation of a Person-Centered Perioperative Nursing Scale. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:221-227. [DOI: 10.1016/j.anr.2019.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 11/16/2022] Open
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Connelly C, Jarvie L, Daniel M, Monachello E, Quasim T, Dunn L, McPeake J. Understanding what matters to patients in critical care: An exploratory evaluation. Nurs Crit Care 2019; 25:214-220. [PMID: 31304999 DOI: 10.1111/nicc.12461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/14/2019] [Accepted: 06/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The delivery of person-centred care is a key priority for managers, policy makers, and clinicians in health care. The delivery person-centred care in critical care is challenging because of competing demands. AIMS AND OBJECTIVES The aim of this quality improvement project was to understand what mattered to patients on a daily basis within the critical care environment. It aimed to understand personal goals and what patients needed to improve their experience. This paper reports on the outputs from this quality improvement project. DESIGN AND DATA ANALYSIS During each daily ward round, patients were asked "what matters to you today?" Outputs from this were entered into the Daily Goals Sheet, which is utilized for every patient in our critical care unit or in the nursing notes. Using Framework Analysis, prevalent themes were extracted from the patient statements documented. RESULTS A total of 196 unique patients were included in this analysis alongside 592 patient statements. Four broad themes were generated: medical outcomes and information, the critical care environment, personal care, and family and caregivers. CONCLUSION The analysis of the data from this quality improvement project has demonstrated that, by asking a simple question within the context of a ward round, care can be enhanced and personalized and long-term outcomes potentially improved. More research is required to understand what the optimal methods are of implementing these requests. RELEVANCE TO CLINICAL PRACTICE Two main recommendations from practice emerged from this quality improvement project: asking patients "what matters to you?" on a daily basis may help support the humanization of the critical care environment, and visiting and access by families must be discussed with patients to ensure this is appropriate for their needs.
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Affiliation(s)
- Christine Connelly
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Lyndsey Jarvie
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Malcolm Daniel
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Emma Monachello
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Tara Quasim
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK.,School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Lelia Dunn
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Joanne McPeake
- Critical Care, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK.,School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Kang J, Lim YM. The Relationship between the Work Environment and Person-centered Critical Care Nursing for Intensive Care Nurses. ACTA ACUST UNITED AC 2019. [DOI: 10.34250/jkccn.2019.12.2.73] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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To assess patients pain in intensive care: developing and testing the Swedish version of the Behavioural Pain Scale. Intensive Crit Care Nurs 2019; 52:28-34. [PMID: 30826170 DOI: 10.1016/j.iccn.2019.01.003] [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: 05/04/2018] [Revised: 11/12/2018] [Accepted: 01/08/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The Behavioural Pain Scale has previously been translated into Swedish and psychometrically tested. One of the domains- 'compliance with ventilation'- did not show equally as good psychometric proprieties as the other domains, which led to the question whether a development of that domain would be beneficial. This study aimed to develop the domain of 'breathing pattern' in the Swedish version of the Behavioural Pain Scale and then test the instrument for discriminant validity, inter-rater reliability and criterion validity. METHOD The domain 'breathing pattern' was developed and included when the Swedish version of the Behavioural Pain Scale was psychometrically tested in 360 paired assessments. RESULTS The instrument showed discriminant validity through a significant positive change on the scale before and during turning and inter-rater reliability with an absence of significant disagreement on the scale between the paired assessments. The developed domain had a better result in discriminant validity than the original domain. The instrument also showed higher sensitivity in discriminating pain compared to assessment without an instrument. CONCLUSION The Swedish version of the Behavioural Pain Scale, with a developed domain for 'breathing pattern' showed to be a reliable instrument for pain assessment in the adult intensive-care patient.
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Håkansson Eklund J, Holmström IK, Kumlin T, Kaminsky E, Skoglund K, Höglander J, Sundler AJ, Condén E, Summer Meranius M. "Same same or different?" A review of reviews of person-centered and patient-centered care. PATIENT EDUCATION AND COUNSELING 2019; 102:3-11. [PMID: 30201221 DOI: 10.1016/j.pec.2018.08.029] [Citation(s) in RCA: 377] [Impact Index Per Article: 75.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts. METHODS A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis. RESULTS The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life. CONCLUSIONS While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals. PRACTICE IMPLICATIONS Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.
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Affiliation(s)
- Jakob Håkansson Eklund
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden.
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Tomas Kumlin
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden
| | - Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden
| | - Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, SE-50190, Borås, Sweden
| | - Emelie Condén
- Centre for Clinical Research, Västmanland Hospital, Uppsala University, Sweden
| | - Martina Summer Meranius
- School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123, Sweden
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Kang J, Cho YS, Jeong YJ, Kim SG, Yun S, Shim M. [Development and Validation of a Measurement to Assess Person-centered Critical Care Nursing]. J Korean Acad Nurs 2018; 48:323-334. [PMID: 29968688 DOI: 10.4040/jkan.2018.48.3.323] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. METHODS A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. RESULTS EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p<.001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84. CONCLUSION The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.
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Affiliation(s)
- Jiyeon Kang
- Department of Nursing, Dong-A University, Busan, Korea
| | - Young Shin Cho
- Surgical Intensive Care Unit, Kosin University Gospel Hospital, Busan, Korea.
| | | | - Soo Gyeong Kim
- Surgical Intensive Care Unit, Kosin University Gospel Hospital, Busan, Korea
| | - Seonyoung Yun
- Department of Nursing, Youngsan University, Yangsan, Korea
| | - Miyoung Shim
- Nursing Department, Seoul National University Hospital, Seoul, Korea
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The work undertaken by mechanically ventilated patients in Intensive Care: A qualitative meta-ethnography of survivors’ experiences. Int J Nurs Stud 2018; 86:60-73. [DOI: 10.1016/j.ijnurstu.2018.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 02/02/2023]
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Kvæl LAH, Debesay J, Langaas A, Bye A, Bergland A. A Concept Analysis of Patient Participation in Intermediate Care. PATIENT EDUCATION AND COUNSELING 2018; 101:1337-1350. [PMID: 29551564 DOI: 10.1016/j.pec.2018.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/01/2018] [Accepted: 03/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. METHODS Walker and Avant's model of Concept analysis [1] based on a literature review. RESULTS Patient participation in the context of IC can be defined as a dynamic process emphasizing the person as a whole, focusing on the establishment of multiple alliances that facilitate individualized information and knowledge exchange, and ensuring a reciprocal engagement in activities within flexible and interactive/dynamic organizational structures. CONCLUSION Patient participation in IC means involving patients and their relatives in holistic interdisciplinary collaborative decision-making. The results highlight the complexity of patient participation and contribute to a greater understanding of the influence of organizational structure and management. PRACTICAL IMPLICATIONS The present study may provide a practical framework for researchers, policy makers and health professionals to facilitate patient participation in IC services.
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Affiliation(s)
- Linda Aimée Hartford Kvæl
- OsloMet - Oslo Metropolitan University, Faculty of Health Sciences, Department of Physiotherapy, Oslo, Norway.
| | - Jonas Debesay
- OsloMet - Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo, Norway
| | - Anne Langaas
- OsloMet - Oslo Metropolitan University, Faculty of Health Sciences, Department of Physiotherapy, Oslo, Norway
| | - Asta Bye
- OsloMet - Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo, Norway; Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Astrid Bergland
- OsloMet - Oslo Metropolitan University, Faculty of Health Sciences, Department of Physiotherapy, Oslo, Norway
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Cederwall CJ, Olausson S, Rose L, Naredi S, Ringdal M. Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study. Intensive Crit Care Nurs 2018; 46:32-37. [PMID: 29567410 DOI: 10.1016/j.iccn.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/11/2017] [Accepted: 11/26/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. RESEARCH METHODOLOGY Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. SETTING This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. FINDINGS Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. CONCLUSION We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research.
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Affiliation(s)
- Carl-Johan Cederwall
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Sahlgrenska University Hospital, Central intensive care unit, CIVA, Gröna stråket 2, 413 45, Gothenburg, Sweden.
| | - Sepideh Olausson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden
| | - Louise Rose
- Lawrence S. Bloomberg Faculty of Nursing and Interdepartmental Division of Critical Care Medicine, University of Toronto, 155 College St, Suite 276, Toronto, ON, M5T 1P8, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Provincial Centre of Weaning Excellence/Prolonged Ventilation Weaning Centre, Michael Garron Hospital, Toronto, Canada
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care at Institute of Clinical Sciences, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - Mona Ringdal
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Sweden
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Jakimowicz S, Perry L, Lewis J. Insights on compassion and patient-centred nursing in intensive care: A constructivist grounded theory. J Clin Nurs 2018; 27:1599-1611. [PMID: 29266484 DOI: 10.1111/jocn.14231] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore patient-centred nursing, compassion satisfaction and compassion fatigue from intensive care nurses' perspectives. BACKGROUND Compassion satisfaction and compassion fatigue can influence critical care nurses' decisions to either continue or leave the profession, and could impact the compassionate patient-centred nursing care patients receive during their ICU admission. DESIGN This qualitative research design was informed by Charmaz's Grounded Theory Constructivist methodology. METHODS In-depth interviews were conducted with 21 critical care nurses of two ICUs in Australia during 2016. Interview data were analysed using grounded theory processes. RESULTS Findings reflected positive and negative impacts on critical care nurses' ability to deal compassionately with their patients. Effects on patient-centred nursing and critical care nurses' own well-being were revealed. A core category of "Expectations" emerged, explaining the tension between critical care nurses' biomedical, clinical skills and knowledge versus compassionate, patient-centred nursing care. This tension was clarified and expanded in subcategories of "Life in the Balance," "Passion and Pressure," "Understanding and Advocacy" and "Tenacity and Fragility". CONCLUSION Providing patient-centred nursing may enhance critical care nurses' experience of compassion satisfaction, in turn impacting delivery of compassionate patient-centred nursing to generate a virtuous circle. Critical care nurses who feel respected and supported by their management team and colleagues experience feelings of compassion satisfaction, leading to greater engagement and care towards their patient. RELEVANCE TO CLINICAL PRACTICE Systematically addressing critical care nurses' needs to successfully balance biomedical with compassionate nursing care may lead to greater well-being in the critical care nursing workforce and improve patient experience of intensive care.
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Affiliation(s)
| | - Lin Perry
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Joanne Lewis
- Faculty of Health, University of Technology, Sydney, NSW, Australia
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Abstract
AIM To provide guidance to educators who use the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011), in their graduate nursing curriculum BACKGROUND: While graduate nursing curricula often include a concept analysis assignment, there is a paucity of literature to assist educators in guiding students through this challenging process. DESIGN This article details one way for educators to assist graduate nursing students in learning how to undertake each step of the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). DATA SOURCE Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). RESULTS Using examples, this article walks the reader through the Walker and Avant (2011) concept analysis process and addresses those issues commonly encountered by educators during this process. CONCLUSION This article presented one way of walking students through a Walker and Avant (2011) concept analysis. Having clear information about the steps involved in developing a concept analysis will make it easier for educators to incorporate it into their graduate nursing curriculum and to effectively guide students on their journey through this process.
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Affiliation(s)
- Catharine J Schiller
- School of Nursing, University of Northern British Columbia, Prince George, Canada
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Minton C, Batten L, Huntington A. The impact of a prolonged stay in the ICU on patients' fundamental care needs. J Clin Nurs 2018; 27:2300-2310. [PMID: 29149460 DOI: 10.1111/jocn.14184] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore patients', families' and health professionals' experiences of a long-stay patient in an intensive care unit. BACKGROUND The fast-paced technologically driven intensive care unit environment, designed for a short patient stay, supports the provision of complex physiologically focused care for those with life-threatening illnesses. Long-stay patients with pronounced fundamental care needs fall outside predicted patient pathways, and nurses can find caring for these patients challenging. DESIGN AND METHODS A longitudinal, qualitative, multicase study of six cases from four New Zealand units. Case participants were patients, family members, nurses and other health professionals. Data collection methods included observation, conversations, interviews and document review. Data were analysed using thematic analysis, vignette development and trajectory mapping. RESULTS Challenges and successes of providing fundamental care for long-stay ICU patients are attributed to two interlinked factors. First, the biomedical model influences ICU nursing practices, resulting in prioritising tasks and technology for patient survival while simultaneously devaluing relational and comfort work. Fundamental psychosocial needs such as family presence, comfort, relationships and communication may be unmet. Second, the unit environment and culture have a significant impact on long-stay patients' ICU experiences and form physical and psychological barriers to families being present and involved. Some nurses negotiated these challenges to provide fundamental, patient- and family-centred care by adopting an approach of knowing the patient and these nurses reported satisfaction when seeing patients' positive responses. CONCLUSION The care environment and culture provide challenges to the provision of patient- and family-centred care for long-stay patients; however, when nurses prioritise knowing their patient these challenges can be overcome and patient and family distress reduced with the potential to improve patient outcomes. RELEVANCE TO CLINICAL PRACTICE Recognition that patients have fundamental care needs irrespective of the setting where they receive care. Intensive care environments and cultures create challenges for nurses when there is such a heavy burden of physiological needs to be met and technological tasks to be undertaken, with a focus on acuity; however, improving provision fundamental care can result in positive patient outcomes.
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Affiliation(s)
- Claire Minton
- School of Nursing, Massey University, Palmerston North, New Zealand
| | - Lesley Batten
- College of Health, Massey University, Palmerston North, New Zealand
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Bäcklund K, Persson K, Hadziabdic E. Intensive Care Nurses’ Experiences of Caring for Intubated Patients under Light Sedation: A Qualitative Study. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojn.2018.87036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Romare C, Hass U, Skär L. Healthcare professionals' views of smart glasses in intensive care: A qualitative study. Intensive Crit Care Nurs 2017; 45:66-71. [PMID: 29291922 DOI: 10.1016/j.iccn.2017.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/09/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to describe healthcare professionals' views of smart glasses before their implementation in an intensive care unit, both regarding quality of use of the glasses and to identify possible intensive care situations where the glasses could be used to increase patient safety. METHODS Data were generated through focus group interviews and analysed using thematic content analysis. FINDINGS The findings describe participants' views of smart glasses divided into three categories; Smart glasses to facilitate work at intensive care unit; Quality of use and Utilisation. Participants assumed smart glasses to cause both effect and affect in intensive care. Participants' concern for patients arose recurrently and through their concern intention to work to promote patient safety. CONCLUSION Smart glasses are suggested as a complement to existing monitoring and routines and cannot replace human presence in intensive care.
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Affiliation(s)
- Charlotte Romare
- Blekinge County Council, Intensive Care Unit, 371 81 Karlskrona, Sweden; Department of Health, Blekinge Institute of Technology, 371 79 Karlskrona, Sweden.
| | - Ursula Hass
- Padme AB, Augerumsvägen 36, 371 63 Lyckeby, Sweden
| | - Lisa Skär
- Department of Health, Blekinge Institute of Technology, 371 79 Karlskrona, Sweden
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