Patients' Point of View about Nurses' Support of Individualized Nursing Care in Training Hospitals Affiliated with Tabriz University of Medical Sciences

Individualized Care: Perceptions of Gynecologic Oncology Patients and Nurses

The purpose of the descriptive study was to assess the individualized care perceptions of gynecologic oncology patients and nurses. The study was conducted between June 1, 2015, and September 30, 2015, at a university hospital and at a training and research hospital in Ankara, Turkey. The study sample included 152 patients who received inpatient treatment at the selected hospitals' gynecologic oncology clinics, and 29 nurses are working at these clinics. The number of the patients was determined by using One-Sample t-Test Power Analysis. The questionnaire was filled by the researcher using face-to-face interview method. The data were analyzed by using Independent Samples t Test, the Mann-Whitney U test, ANOVA, and Kruskal-Wallis H tests. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used to determine whether distribution of the parameters was normal. Patients' perception on "nurses support their individuality" was found to be X̅ = 3.07 ± 0.97 and their perception on "nurses provide individual care" was X̅ = 2.33 ± 0.69. As patients' perception on "nurses support their individuality" increased, their perception on "nurses provide individual care service" also increased (r = 0.736; p = 0.001). The patients' satisfaction with care was at a moderate level (63.16 ± 14.97). The level of perception on "nurses support the individuality of patients during care practices (X̅ = 1.65 ± 0.58) and provide individual care service to the patients (X̅ = 1.61 ± 0.62)" was low. Nurses stating that they supported the individuality of patients provided individual care to their patients (r = 0.828; p = 0.001). The nurses' perception on "they support patients' individuality" and "they provide individual care service" was lower than patients' perception on "nurses support their individuality" and "nurses provide individual care." The nurses' job satisfaction (general satisfaction) was at a moderate level (3.08). In this study, nurses' perception on individualized care was lower than patients' perception.

Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.

Current developments in delivering customized care: a scoping review

BACKGROUND

In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care.

METHODS

Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included "care customization", "personalized service and health care", individualized care" and "targeting population" in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers.

RESULTS

We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation.

CONCLUSIONS

There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.