Patient and family-centered care for children: A concept analysis

Background

Family-centered care has evolved into patient and family-centered care. Although this is not a new concept; however, its application to nursing practice is very challenging among nurses due to its ambiguity.

Objective

This study aimed to clarify the concept of patient and family-centered care for children.

Methods

Walker and Avant's concept analysis method was used. A literature search was also done using the following databases: Google Scholar, ProQuest, ScienceDirect, and Scopus, for articles published from 2011 to 2021.

Results

The defining attributes of patient and family-centered care are partnership, communication, respect, and compassion. Antecedents include patient and family involvement, readiness to collaborate and participate, competency and desire of the care professional team, supportive environment, and policies. Consequences of the patient and family-centered care include improved child outcomes and quality of life, promotion of patient safety, increased patient and family satisfaction, enhancement of humanistic values, reduction of hospitalization cost and length of stay, and decreased stress, anxiety, and depression in family members.

Conclusion

Four attributes of patient and family-centered care, its antecedents, and consequences may aid researchers in better understanding the concept and its application in nursing practice. This concept can also be used to establish quality care delivery strategies and promote professional relationships between nurses, patients, and families in clinical settings.

Patients' and Care Partners' Perspectives on Dignity and Respect During Acute Care Hospitalization

BACKGROUND

Delivering patient-centered care (PCC) is essential to our healthcare system. Patient dignity and respect are foundational elements of PCC. Understanding patients' and their care partner's perspectives on the meaning of dignity and respect within a clinical care environment is critical to achieving our goal of PCC.

OBJECTIVE

The aim of the study was to understand how patients and their care partners define, describe, and experience dignity and respect during hospitalization.

METHODS

We conducted a qualitative study with 22 patients and care partners hospitalized in high-acuity patient care areas in 1 academic medical center. Data collected from semistructured interviews were analyzed using grounded theory open coding in Atlas Ti software.

RESULTS

Our data provide a definition of dignity and respect during hospitalization from the patient and care partner perspective and a conceptual model of the factors needed to enhance patients' and care partners' experience of dignity and respect in the hospital setting. Dignity was felt to be intrinsic to personhood including the recognition of that person's value by others. Respect was characterized as the behavioral or social norms that acknowledge dignity. Determinants of dignity and respect were categorized at the organizational (macro) level and within the microsystem between clinicians, patients, and their care partners.

CONCLUSIONS

The definition of dignity and respect and the conceptual model presented here represent an important supplement to our understanding of dignity and respect during hospitalization. Healthcare organizations should focus on the key factors found in this study to create a culture that treats patients with dignity and respect.

Respect: An Integrative Review

Feeling respected is a universal human experience. The notion of respect is ubiquitous and discussed at varying levels of discourse. An integrative review of the literature on the phenomenon of respect is discussed. Literature was reviewed from the disciplines of philosophy, psychology, sociology, business, theology, and nursing. Three themes emerged from this literature review: respect honors inherent worth, respect intentionally co-shapes identity, and respect emerges with earned admiration.

First Nations Women’s Encounters with Mainstream Health Care Services

Health care encounters are important areas for study because they reflect social, political, economic, and ideological relations between patients and the dominant health care system. This study examines mainstream health care encounters from the viewpoint of First Nations women from a reserve community in northwestern Canada. Perspectives from critical medical anthropology and the concept of cultural safety provided the theoretical orientation for the study. Critical and feminist ethnographic approaches were used to guide in-depth interviews conducted with 10 First Nations women. Findings were organized around two broad themes that characterized women’s descriptions of “invalidating” and “affirming” encounters. These narratives revealed that women’s encounters were shaped by racism, discrimination, and structural inequities that continue to marginalize and disadvantage First Nations women. The women’s health care experiences have historical, political, and economic significance and are reflective of wider postcolonial relations that shape their everyday lives.

Respect in the care of older patients in acute hospitals

The aim of this study was to describe the experiences of older patients and their next of kin with regards to respect in the care given in an acute hospital. The data were collected using tape-recorded interviews (10 patients and 10 next of kin) and analysed via inductive content analysis. Based on the analysis, the concept of respect can be defined by the actions taken by nurses (polite behaviour, the patience to listen, reassurance, response to information needs, assistance in basic needs, provision of pain relief, response to wishes and time management) and next of kin (support, assistance and advocacy) and by factors related to the environment (appreciation of older people in society, management of health-care organizations, the nursing culture, the flow of information and patient placement). The information will be used to develop an instrument for assessing how well respect is maintained in the care of older patients.

Health Care Communications with Diverse Ethnic Groups

The concept of respect is rooted in the core value of human relations, and interpersonal relationships with others. The notion of respect in these relationships is entrenched in the broader context of the processes of relationships between professionals and clients in general, along with the philosophical and ethical foundations of respect. Although nursing principles and values, such as autonomy and dignity have built their foundation of care on the concept of respect, these concepts (ie. autonomy and dignity) are still different from respect. Respect within health professional-client relationships, indicates that respect is a fundamental concept within nursing, permeating a number of other concepts that provide purposeful nursing care within the process of nurse-client relationships and respect has been discussed as an ethical and moral concept of care that addresses the values of human dignity in the nursing discipline, however research examining the client's perspectives of respect as an ethical principle of care, especially within Canada's diverse population is non-existent. There is limited research from the client's perspective addressing challenges communicating the concept of respect in relationships between health professionals and clients, specifically research directed at immigrant or the vulnerable population.

Intercultural residential care in New Zealand

Along with other Organization for Economic Cooperation and Development (OECD) countries, New Zealand's society is aging such that an increase in the number of older people requiring residential care is predicted. What cannot be foreseen is how culturally defined health beliefs affect the care given to older people in residential care. In this article, the authors describe and discuss the culturally based health beliefs of some Pacific Islands caregivers and predominately European (Pakeha) older people resident at one long-term care facility in Auckland, New Zealand. The delivery of care is influenced by culturally related beliefs about "being old." Racism is evident in residential care, and the authors discuss the reactions of caregivers, residents, and management. This research extends the discussion of caregiving and receiving in to the cross-cultural setting, and the findings highlight a number of elements in cultural differences between carer and cared-for that might affect care practices at the residential facility studied.

Issues for nurses in rural and remote Canada

Canada is a vast country with great diversity in its landscape, industry, culture and communities. The healthcare issues and concerns of people living in rural and remote areas are as fully diverse as the people and the landscape. This article describes the context of rural and remote nursing practice in Canada and discusses issues of health status and the social determinants of health, geographical isolation, professional isolation and cultural safety. It concludes with current initiatives in practice, education, research and policy. Particular issues facing nurses in rural and remote First Nations communities are highlighted.