Caring for families of the terminally ill in Malaysia from palliative care nurses’ perspectives

The function of patient-centered care in mitigating the effect of nursing shortage on the outcomes of care

BACKGROUND

The shortage of nursing staff is a national and international issue. Inadequate number of hospital nurse staff leads to poor health care services. Yet the effects of patient-centeredness between the relationships of nursing shortage on the quality of care (QC) and patient safety (PS) have not been explored. The aim of this study was to examine the mediating effects of patient-centeredness on the relationship of nursing shortage on the QC and PS in the Medical and Surgical Wards, in Malaysian private hospitals.

METHOD

A descriptive, cross-sectional study was carried out on 12 private hospitals. Data was gathered, through a self- administered questionnaire, from 652 nurses, with a 61.8% response rate. Stratified simple random sampling was used to allow all nurses to participate in the study. Hayes PROCESS macro-regression analyses were conducted to explore the mediating effects of patient-centeredness on the relationships of hospital nurse staffing on the QC and PS.

RESULTS

Patient-centeredness mediated the relationships of hospital nurse staffing on both the QC (F = 52.73 and P = 0.000) and PS (F = 31.56 and P = 0.000).

CONCLUSION

Patient-centeredness helps to mitigate the negative associations of nursing shortage on the outcomes of care. The study provides a guide for hospital managers, leaders, decision-makers, risk managers, and policymakers to maintain adequate staffing level and instill the culture of patient-centeredness in order to deliver high quality and safer care.

Palliative care in Thailand

In Thailand, several barriers exist that prevent people with life-limiting illnesses from accessing good-quality palliative care, namely: lack of palliative care providers; lack of training and education for the palliative care workforce; and issues with availability and distribution of opioids. Without palliative care, people suffer needlessly during the last months of their life. This paper gives an analysis of these issues and provides recommendations for clinical practice, research and health policy that may help to alleviate these issues.