1
|
Shaban M, Mohammed HH, Gomaa Mohamed Amer F, Shaban MM, Abdel-Aziz HR, Ibrahim AM. Exploring the nurse-patient relationship in caring for the health priorities of older adults: qualitative study. BMC Nurs 2024; 23:480. [PMID: 39010101 PMCID: PMC11247866 DOI: 10.1186/s12912-024-02099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Person-centered care (PCC) is critical in addressing the diverse health priorities of older adults. Nurses play a pivotal role in implementing PCC, yet the nuances of the nurse-patient relationship in outpatient settings remain underexplored. This study aimed to gain insights into nurses' experiences, challenges, and strategies in caring for older adults through the lens of PCC. METHODS A qualitative descriptive design was employed, involving semi-structured interviews with 12 registered nurses from outpatient clinics serving older adults. Thematic analysis was conducted following the principles of trustworthiness and credibility. RESULTS Five main themes emerged: (1)Understanding and Implementing Person-Centered Care (PCC) (2) Experiences in Older Adult Care, highlighting the significance of trust-building, adapting care approaches, interdisciplinary collaboration, and emotional rewards; (3) Challenges in Care Delivery, including resource constraints, navigating family dynamics, keeping up with medical advances, and emotional strain; (4) Impact on Care Quality, encompassing consistency in care, patient satisfaction, professional development, and ethical considerations; and (5) Coping Strategies, such as peer support, work-life balance, reflective practice, and resilience building. CONCLUSIONS The study underscores the complexities and rewards of the nurse-patient relationship in caring for older adults in outpatient settings. Nurses face formidable challenges but employ various coping strategies to maintain high-quality, person-centered care. Findings have implications for nursing practice, education, policy, and future research, emphasizing the need for supportive environments, continuous professional development, and recognition of the critical role nurses play in addressing the health priorities of the aging population.
Collapse
Affiliation(s)
| | | | | | | | - Hassanat Ramadan Abdel-Aziz
- Department of Nursing, College of Applied Medical Sciences in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Gerontological Nursing Department, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| |
Collapse
|
2
|
Caston S, Greenfield B, Piemonte N, Jensen G. Turning toward suffering: Rethinking the patient- clinician relationship in physical therapy practice. Physiother Theory Pract 2023:1-11. [PMID: 37916508 DOI: 10.1080/09593985.2023.2272844] [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: 04/28/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
In this professional theoretical article, the authors argue that patient care should be centered on connection and that authentically turning toward suffering necessitates an approach to care that transcends medicine's traditional focus on cure and physical restoration and differentiates between pathology and disability. The meaning of illness and suffering for those who have experienced life-changing injuries or illness is explored. Strategies for approaching the lifeworld of these individuals are discussed using the concepts of phenomenology and embodiment, rooted in the work of philosophers from the phenomenological tradition. The authors also propose an approach to patient care offering a case-based example based on postmodernist concepts that elevate connection, relationship, and interdependency above the traditional focus of restoring normality and physical independence for individuals with disabilities. Traditional assumptions about quality of life, illness, and disability are called into question by focusing on the fluidity of being and disability identity, which serves to destabilize static, binary conceptions of individuals as either healthy or ill, disabled, or able-bodied. A postmodern lens invites healthcare practitioners to envision themselves as part of an assemblage that may promote a more expansive view of the relationship between patient and healthcare practitioner.
Collapse
Affiliation(s)
- Sarah Caston
- Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Bruce Greenfield
- Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicole Piemonte
- Department of Medical Humanities, Creighton University School of Medicine, Phoenix, AZ, USA
- Department of Physical Therapy, Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA
| | - Gail Jensen
- Department of Physical Therapy, Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA
| |
Collapse
|
3
|
Cook CE, Pergolotti M, Garcia AN, Hopwood D. Creation and Validation of the Select Medical Patient Reported Experience Measure for Physical and Occupational Therapy Outpatient Clinics. Arch Phys Med Rehabil 2023; 104:1767-1774. [PMID: 37150428 DOI: 10.1016/j.apmr.2023.04.016] [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: 01/23/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE This study describes the creation and examination of the internal consistency, content validity, construct/structural validity, and criterion/concurrent validity of the Select Medical Patient Reported Experience Measure (SM-PREM). DESIGN Observational study design. SETTING 1054 Outpatient physical and occupational therapy locations in North America. PARTICIPANTS The study included 89,205 patients with various musculoskeletal disorders (N=89,205). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Content validity was described, and internal consistency, construct/structural validity (factor analysis), and criterion/concurrent validity were analyzed, with concurrent validity compared against patient reported outcomes (PROM), the Net Promoter Scale, and the Orebro Musculoskeletal Screening Questionnaire-12. RESULTS Exploratory and confirmatory factor analysis of the SM-PREM yielded 3 dimensions, each with a very strong internal consistency (>.850). The SM-PREM yielded statistically significant results in all areas, with values that reflected minimal to fair association with PROMs. CONCLUSION The SM-PREM appears to capture a unique construct compared to PROMs. The 11-item tool has 3 definitive dimensions and exhibits strong internal consistency. The tool may be useful in examining patient experience in patients with musculoskeletal injuries seen by physical and occupational therapists.
Collapse
Affiliation(s)
- Chad E Cook
- Department of Orthopedic Surgery, Duke University, Durham, NC; Department of Population Health Sciences, Duke University, Durham, NC; Duke Clinical Research Institute, Duke University, Durham, NC
| | - Mackenzi Pergolotti
- Select Medical, ReVital Cancer Rehabilitation, Mechanicsburg, PA; Department of Health Sciences, University of North Carolina, Chapel Hill, NC
| | | | - David Hopwood
- Select Medical Outpatient, Select Medical, Mechanicsburg, PA
| |
Collapse
|
4
|
Dini AP, Okabe JDS, Kalvan SZ, Simplicio C, Gasparino RC. Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension. Rev Bras Enferm 2023; 76:e20220530. [PMID: 36995824 PMCID: PMC10042477 DOI: 10.1590/0034-7167-2022-0530] [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: 09/20/2022] [Accepted: 11/11/2022] [Indexed: 03/29/2023] Open
Abstract
Objectives: to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care. Methods: methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients. Results: in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7. Conclusions: the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Collapse
Affiliation(s)
| | | | | | - Carla Simplicio
- Universidade Estadual de Campinas. Campinas, São Paulo, Brazil
| | | |
Collapse
|
5
|
Dini AP, Okabe JDS, Kalvan SZ, Simplicio C, Gasparino RC. Adaptação e validação de instrumento de classificação de paciente adulto com ênfase na dimensão familiar. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0530pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
RESUMO Objetivos: adaptar e validar um instrumento para classificação de pacientes adultos que enfatiza a rede de suporte familiar na demanda de cuidados de enfermagem. Métodos: estudo metodológico, realizado em três fases: adaptação de um instrumento considerando a realidade de pacientes adultos; validação de conteúdo com sete especialistas e avaliação das propriedades de medida (validade de construto e consistência interna) com 781 pacientes internados. Resultados: na validação de conteúdo, os indicadores alcançaram os valores estabelecidos para o Índice de Validade de Conteúdo (0,85-1,00). Na análise fatorial confirmatória, os 11 indicadores foram distribuídos em três domínios e apresentaram variância média extraída e carga fatorial superiores a 0,5. A confiabilidade composta foi superior a 0,7. Conclusões: o presente estudo adaptou e disponibilizou, com evidências de validade e confiabilidade, um instrumento para classificação de pacientes adultos que considera a rede de suporte familiar na demanda de cuidados de enfermagem.
Collapse
|
6
|
Consolo L, Castellini G, Cilluffo S, Basile I, Lusignani M. Electronic patient-reported outcomes (e-PROMs) in palliative cancer care: a scoping review. J Patient Rep Outcomes 2022; 6:102. [PMID: 36138279 PMCID: PMC9500127 DOI: 10.1186/s41687-022-00509-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In palliative oncology settings, electronic patient-reported outcome (PRO) assessment can play an important role in supporting clinical activities for clinicians and patients. This scoping review aims to map the technological innovation of electronic patient-reported outcome measures (e-PROMs) in cancer palliative care and how PRO data collected through e-PROMs can influence the monitoring and management of symptoms and enable better communication between health professionals and patients.
Methods
A scoping review study was designed according to the Arksey and O'Malley framework. Medline, Embase, Web of Science, SCOPUS, PsycINFO and CINAHL and gray literature sources were consulted. The inclusion criteria were people over 18 years old receiving palliative and/or end-of-life care using e-PROMs.
Results
Thirteen primary studies were included: nine quantitative studies, two qualitative studies, and two mixed-method studies. The recently developed software that supports e-PROMs allows patients to receive feedback on their symptoms, helps clinicians prioritize care needs and monitors patients’ conditions as their symptoms change. Electronic PRO data prompt difficult, end-of-life communication between clinicians and patients to better organize care in the last phase of life.
Conclusion
This work shows that electronic PRO data assessment provides valuable tools for patients’ well-being and the management of symptoms; only one study reported conflicting results. However, with studies lacking on how clinicians can use these tools to improve communication with patients, more research is needed.
Collapse
|
7
|
Munsey M, Juarez-Alvarado S, Wells P, Sitzer V. Maintaining person-centred care in hospitals during restrictions on family presence. Nurs Manag (Harrow) 2022; 29:17-23. [PMID: 34845881 DOI: 10.7748/nm.2021.e2011] [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] [Accepted: 09/17/2021] [Indexed: 11/09/2022]
Abstract
Providing person-centred care to hospitalised patients and their families can be challenging in the context of restrictions on visiting, such as those widely implemented in healthcare settings during the coronavirus disease 2019 (COVID-19) pandemic. In the US, several strategies have been deployed to work around the restrictions on family presence in hospitals, most of which focused on communication between the patient and family, and collaboration between the family and the healthcare team. Sharp Memorial Hospital, an acute care hospital in San Diego California, US, was determined to maintain its person-centred care practices during the pandemic. A Family Resource Centre started operating in March 2020 with the aim of enabling hospitalised patients and their families to connect in a safe manner. This article describes this innovative approach to maintaining person-centred care in hospital during restrictions on family presence.
Collapse
Affiliation(s)
- Mark Munsey
- Sharp Memorial Hospital, San Diego California, US
| | | | - Pam Wells
- Sharp Memorial Hospital, San Diego, CA, US
| | | |
Collapse
|
8
|
Carbone S, Kokorelias KM, Berta W, Law S, Kuluski K. Stakeholder involvement in care transition planning for older adults and the factors guiding their decision-making: a scoping review. BMJ Open 2022; 12:e059446. [PMID: 35697455 PMCID: PMC9196186 DOI: 10.1136/bmjopen-2021-059446] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To synthesise the existing literature on care transition planning from the perspectives of older adults, caregivers and health professionals and to identify the factors that may influence these stakeholders' transition decision-making processes. DESIGN A scoping review guided by Arksey and O'Malley's six-step framework. A comprehensive search strategy was conducted on 7 January 2021 to identify articles in five databases (MEDLINE, Embase, CINAHL Plus, PsycINFO and AgeLine). Records were included when they described care transition planning in an institutional setting from the perspectives of the care triad (older adults, caregivers and health professionals). No date or study design restrictions were imposed. SETTING This review explored care transitions involving older adults from an institutional care setting to any other institutional or non-institutional care setting. Institutional care settings include communal facilities where individuals dwell for short or extended periods of time and have access to healthcare services. PARTICIPANTS Older adults (aged 65 or older), caregivers and health professionals. RESULTS 39 records were included. Stakeholder involvement in transition planning varied across the studies. Transition decisions were largely made by health professionals, with limited or unclear involvement from older adults and caregivers. Seven factors appeared to guide transition planning across the stakeholder groups: (a) institutional priorities and requirements; (b) resources; (c) knowledge; (d) risk; (e) group structure and dynamic; (f) health and support needs; and (g) personality preferences and beliefs. Factors were described at microlevels, mesolevels and macrolevels. CONCLUSIONS This review explored stakeholder involvement in transition planning and identified seven factors that appear to influence transition decision-making. These factors may be useful in advancing the delivery of person and family-centred care by determining how individual-level, group-level and system-level values guide decision-making. Further research is needed to understand how various stakeholder groups balance these factors during transition planning in different health contexts.
Collapse
Affiliation(s)
- Sarah Carbone
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Kristina Marie Kokorelias
- St John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Whitney Berta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Susan Law
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Kerry Kuluski
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| |
Collapse
|
9
|
Wiles LK, Kay D, Luker JA, Worley A, Austin J, Ball A, Bevan A, Cousins M, Dalton S, Hodges E, Horvat L, Kerrins E, Marker J, McKinnon M, McMillan P, Pinero de Plaza MA, Smith J, Yeung D, Hillier SL. Consumer engagement in health care policy, research and services: A systematic review and meta-analysis of methods and effects. PLoS One 2022; 17:e0261808. [PMID: 35085276 PMCID: PMC8794088 DOI: 10.1371/journal.pone.0261808] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/11/2021] [Indexed: 12/14/2022] Open
Abstract
To assess the effects of consumer engagement in health care policy, research and services. We updated a review published in 2006 and 2009 and revised the previous search strategies for key databases (The Cochrane Central Register of Controlled Trials; MEDLINE; EMBASE; PsycINFO; CINAHL; Web of Science) up to February 2020. Selection criteria included randomised controlled trials assessing consumer engagement in developing health care policy, research, or health services. The International Association for Public Participation, Spectrum of Public Participation was used to identify, describe, compare and analyse consumer engagement. Outcome measures were effects on people; effects on the policy/research/health care services; or process outcomes. We included 23 randomised controlled trials with a moderate or high risk of bias, involving 136,265 participants. Most consumer engagement strategies adopted a consultative approach during the development phase of interventions, targeted to health services. Based on four large cluster-randomised controlled trials, there is evidence that consumer engagement in the development and delivery of health services to enhance the care of pregnant women results in a reduction in neonatal, but not maternal, mortality. From other trials, there is evidence that involving consumers in developing patient information material results in material that is more relevant, readable and understandable for patients, and can improve knowledge. Mixed effects are reported of consumer-engagement on the development and/or implementation of health professional training. There is some evidence that using consumer interviewers instead of staff in satisfaction surveys can have a small influence on the results. There is some evidence that consumers may have a role in identifying a broader range of health care priorities that are complementary to those from professionals. There is some evidence that consumer engagement in monitoring and evaluating health services may impact perceptions of patient safety or quality of life. There is growing evidence from randomised controlled trials of the effects of consumer engagement on the relevance and positive outcomes of health policy, research and services. Health care consumers, providers, researchers and funders should continue to employ evidence-informed consumer engagement in their jurisdictions, with embedded evaluation. Systematic review registration: PROSPERO CRD42018102595.
Collapse
Affiliation(s)
- Louise K. Wiles
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Debra Kay
- Health Consumer Advocate/Representative, Adelaide, South Australia, Australia
| | - Julie A. Luker
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Anthea Worley
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Jane Austin
- Health Performance Council, Adelaide, South Australia, Australia
| | - Allan Ball
- National Disability Insurance Agency, Adelaide, South Australia, Australia
| | - Alan Bevan
- Health Consumer Advocate/Representative, Adelaide, South Australia, Australia
| | | | - Sarah Dalton
- The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- Agency for Clinical Innovation, St Leonards, New South Wales, Australia
| | - Ellie Hodges
- Lived Experience Representative, Adelaide, South Australia, Australia
| | - Lidia Horvat
- Safer Care Victoria, Melbourne, Victoria, Australia
| | - Ellen Kerrins
- SAHMRI Community Advisory Group, Adelaide, South Australia, Australia
| | - Julie Marker
- Health Consumer Advocate/Representative, Adelaide, South Australia, Australia
| | | | - Penelope McMillan
- Health Consumer Advocate/Representative, Adelaide, South Australia, Australia
| | - Maria Alejandra Pinero de Plaza
- Health Consumer Advocate/Representative, Adelaide, South Australia, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
- National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, South Australia, Australia
| | - Judy Smith
- Royal District Nursing Service, Keswick, South Australia, Australia
| | - David Yeung
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- SA Pathology, Adelaide, South Australia, Australia
| | - Susan L. Hillier
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- * E-mail:
| |
Collapse
|
10
|
Drake EK, Weeks LE, van Manen M, Curran J, McKibbon S. The delivery of palliative and end-of-life care to adolescents and young adults living with cancer: a scoping review protocol. JBI Evid Synth 2021; 19:3384-3393. [PMID: 34283816 DOI: 10.11124/jbies-20-00444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This review will provide an overview of the evidence on the delivery of palliative and end-of-life care to adolescents and young adults living with cancer, by identifying knowledge gaps and discussing the key characteristics and types of evidence in this field. INTRODUCTION Adolescents and young adults receive their diagnoses at an important stage of development, and often access health systems that are ill-equipped to deal with them, leading to many unmet needs. Some of these needs can be addressed by holistic palliative care services. A better understanding of the literature in this area is needed to identify what is known about the delivery of care to adolescents and young adults. INCLUSION CRITERIA This review will consider studies that pertain to the delivery of palliative and end-of-life care for adolescents and young adults living with cancer. Relevant research may be in the context of ambulatory services, advance care planning, palliative care units, home care, hospices, and end-of-lifecare facilities. Studies that concern other oncology populations will be excluded. METHODS CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), APA PsycINFO (EBSCO), and Web of Science (Science Citation Index Expanded and Social Sciences Citation Index; Clarivate Analytics) databases will be searched, along with other sources of gray literature. No date limit will be set. Two independent reviewers will screen titles and abstracts for studies that meet the review's inclusion criteria and the fulltext of eligible studies will be reviewed. Data from studies that are eligible for inclusion will be extracted using two independent reviewers and presented in a tabular form with an accompanying narrative summary.
Collapse
Affiliation(s)
- Emily K Drake
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,IWK Health, Halifax, NS, Canada.,Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Lori E Weeks
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Dalhousie University, Halifax, NS, Canada.,Nova Scotia Health, Halifax, NS, Canada
| | - Michael van Manen
- John Dossetor Health Ethics Centre, University of Alberta, Edmonton, AB, Canada
| | - Janet Curran
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,IWK Health, Halifax, NS, Canada.,Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Shelley McKibbon
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
11
|
Gibson BE, Fadyl JK, Terry G, Waterworth K, Mosleh D, Kayes NM. A posthuman decentring of person-centred care. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:292-307. [PMID: 34506255 DOI: 10.1080/14461242.2021.1975555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
In this paper, we examine person-centred care through a Deleuzian posthuman lens with the aim of exploring what becomes possible when the concepts of both person and care are de-centred. We do so through a consideration of the sets of relations that produce 'the client' in health care contexts. Our analysis maps particular entangled material-semiotic forces producing 'M/michael', a young man with a diagnosis of Duchenne muscular dystrophy, within a rehabilitation clinic. Drawing on Deleuzian notions of assemblage, affect, and becoming we explore 'person-care' as an active production that dynamically enacts persons-as-clients through clinical arrangements. Persons are thus reconceptualised in terms of locally produced subject positions and their care relations, rather than pre-existing beings who can be 'centred' within health services. Paradoxically, by de-centring persons and care, we work to conjure ways to strengthen the aspirations of person centredness to humanise health practices. In doing so, we consider different possibilities for re-imagining clinical work and contribute to debates regarding how healthcare conceptualises and addresses disability, health, and wellbeing. We suggest that such posthuman analyses can open up new ways of understanding and re/forming healthcare.
Collapse
Affiliation(s)
- Barbara E Gibson
- Department of Physical Therapy, University of Toronto and Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Joanna K Fadyl
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Gareth Terry
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Kate Waterworth
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Donya Mosleh
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Nicola M Kayes
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
12
|
Betz CL, Zalon ML, Caramanica L, Arslanian-Engoren C. Nurse competencies for transitions of care: Implications for education and practice. Nurs Forum 2020; 56:358-364. [PMID: 33373047 DOI: 10.1111/nuf.12544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/24/2020] [Accepted: 12/13/2020] [Indexed: 11/27/2022]
Abstract
Although there are a number of transitions of care initiatives that address specific needs as patients move across healthcare settings, adverse events still occur during handoffs. Transitions of care create periods of vulnerability for populations with complex needs that include communication gaps, medication changes, and poorly coordinated treatment plans, often without involving patients and their families. This paper outlines what nurses need to know to provide for safe transitions of care across the healthcare continuum. The theoretical basis for transitions of care at the macro level, examples of nurse-led models for transitions of care, and key activities and implications for nursing education and practice are described. A holistic framework for effective transitions of care across healthcare settings can guide nursing educators in the development of specific nursing competencies for transitions of care.
Collapse
Affiliation(s)
- Cecily L Betz
- University of Southern California Keck School of Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Margarete L Zalon
- University of Scranton Department of Nursing, Scranton, Pennsylvania, USA
| | - Laura Caramanica
- Tanner Health System School of Nursing, University of West Georgia, Carrollton, Georgia, USA
| | | |
Collapse
|
13
|
Chi-Lun-Chiao A, Chehata M, Broeker K, Gates B, Ledbetter L, Cook C, Ahern M, Rhon DI, Garcia AN. Patients' perceptions with musculoskeletal disorders regarding their experience with healthcare providers and health services: an overview of reviews. Arch Physiother 2020; 10:17. [PMID: 32983572 PMCID: PMC7517681 DOI: 10.1186/s40945-020-00088-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/15/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives This overview of reviews aimed to identify (1) aspects of the patient experience when seeking care for musculoskeletal disorders from healthcare providers and the healthcare system, and (2) which mechanisms are used to measure aspects of the patient experience. Data sources Four databases were searched from inception to December 20th, 2019. Review methods Systematic or scoping reviews examining patient experience in seeking care for musculoskeletal from healthcare providers and the healthcare system were included. Independent authors screened and selected studies, extracted data, and assessed the methodological quality of the reviews. Patient experience concepts were compiled into five themes from a perspective of a) relational and b) functional aspects. A list of mechanisms used to capture the patient experience was also collected. Results Thirty reviews were included (18 systematic and 12 scoping reviews). Relational aspects were reported in 29 reviews and functional aspects in 25 reviews. For relational aspects, the most prevalent themes were “information needs” (education and explanation on diseases, symptoms, and self-management strategies) and “understanding patient expectations” (respect and empathy). For functional aspects, the most prevalent themes were patient’s “physical and environmental needs,” (cleanliness, safety, and accessibility of clinics), and “trusted expertise,” (healthcare providers’ competence and clinical skills to provide holistic care). Interviews were the most frequent mechanism identified to collect patient experience. Conclusions Measuring patient experience provides direct insights about the patient’s perspectives and may help to promote better patient-centered health services and increase the quality of care. Areas of improvement identified were interpersonal skills of healthcare providers and logistics of health delivery, which may lead to a more desirable patient-perceived experience and thus better overall healthcare outcomes. Trial registration Systematic review registration: PROSPERO (CRD42019136500).
Collapse
Affiliation(s)
- Alan Chi-Lun-Chiao
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Mohammed Chehata
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Kenneth Broeker
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Brendan Gates
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Leila Ledbetter
- Duke University Medical Center Library, Durham, North Carolina USA
| | - Chad Cook
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Duke Clinical Research Institute, Durham, North Carolina USA
| | - Malene Ahern
- University of Wollongong, Australian Health Services Research Institute, Sydney, New South Wales Australia
| | - Daniel I Rhon
- Center for the Intrepid, Brooke Army Medical Center, San Antonio, TX USA
| | - Alessandra N Garcia
- College of Pharmacy & Health Sciences, Physical Therapy Program, Lillington, North Carolina USA
| |
Collapse
|