Limping along in implementing patient-centered care: Qualitative study
Background & Aim: Patient-centered care is considered a pivotal element of the mission of the healthcare system around the world. However implementing Patient-centered care is not always easy and nurses have admitted this fact reluctantly. The evidence suggests that the first step in implementing Patient-centered care is to change the professionals’ viewpoint, behavior, and understanding. This study examined nurses' perceptions of the components of Patient-centered care and its delivery.
Methods & Materials: This was qualitative descriptive research with a conventional content analysis approach. Face-to-face interviews were conducted with 21 nurses, working in teaching hospitals in Tabriz, Iran, and 5 field notes were collected. Data were analyzed using the Zhang and Wildemuth method of content analysis.
Results: Three main themes and eleven sub-themes were extracted. Nurses identified “Effective Communication”, “Careful Care of Distinctive Needs”, and “Valuing the Patients and Their Rights” as the main elements of Patient-centered care.
Conclusion: Nurses implement some components of Patient-centered care. Yet Patient-centered care remains an ad hoc practice requiring more improvement. This study provided a deeper understanding of nurses' perceptions about the implementation of Patient-centered care and their weaknesses. The finding is consistent with current knowledge, shedding light on Patient-centered care-related practices performed by Iranian nurses and pointing to areas for improvement in implementing Patient-centered care.
2. Eklund JH, Holmström IK, Kumlin T, Kaminsky E, Skoglund K, Höglander J, et al. “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling. 2019;102(1):3-11.
3. Edvardsson D, Watt E, Pearce F. Patient experiences of caring and person‐centredness are associated with perceived nursing care quality. Journal of Advanced Nursing. 2017;73(1):217-27.
4. Jarrar Mt, Rahman HA, Minai MS, AbuMadini MS, Larbi M. The function of patient‐centered care in mitigating the effect of nursing shortage on the outcomes of care. The International journal of health planning and management. 2018;33(2):e464-e73.
5. Hobbs JL. A dimensional analysis of patient-centered care. Nursing research. 2009;58(1):52-62.
6. Hwang J-I, Kim SW, Chin HJ. Patient Participation in Patient Safety and Its Relationships with Nurses' Patient-Centered Care Competency, Teamwork, and Safety Climate. Asian nursing research. 2019;13(2):130-6.
7. Mohammed K, Nolan MB, Rajjo T, Shah ND, Prokop LJ, Varkey P, et al. Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. American journal of medical quality. 2016;31(1):12-21.
8. Coyne I, Holmström I, Söderbäck M. Centeredness in healthcare: a concept synthesis of family-centered care, person-centered care and child-centered care. Journal of pediatric nursing. 2018;42:45-56.
9. Pazokian M, Borhani F. Nurses’ Perspectives on Factors Affecting Patient Safety: A Qualitative Study. Evidence Based Care. 2017;7(3):76-81.
10. Paul T. “Nothing about us without us”: Toward patient-and family-centered care. AMA journal of ethics. 2016;18(1):3-5.
11. Esmaeili M, Cheraghi MA, Salsali M. Explaining the Context of Patient-Centered Care in Critical Care Units. Journal of Holistic Nursing And Midwifery. 2017;27(3):17-26.
12. Asefzadeh S, Navvabi E. Determination of gap in accreditation standards establishment process using Zachman framework at a health-educational hospital. Biotechnology and Health Sciences. 2017;4(2):e38779.
13. Ghane G, Esmaeili M. Status of Patient-centered Care in Health System of Iran. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2019;4(3):1-5.
14. Ghane G, Esmaeili M. Nursing students' perception of patient‐centred care: A qualitative study. Nursing Open. 2019;7(1):383-9.
15. McEwen M, Wills EM. Theoretical basis for nursing: Lippincott Williams & Wilkins; 2017.
16. Zhang Y, Wildemuth B. Qualitative analysis of content. Applications of social research methods to questions in information and library science. 2009. p. 308–19.
17. Guba EG, Lincoln YS. Fourth generation evaluation. Newbury Park: Sage; 1989.
18. Cheraghi MA, Esmaeili M, Salsali M. Seeking Humanizing Care in Patient-Centered Care Process. Holistic nursing practice. 2017;31(6):359-68.
19. Watson J. Nursing, human science and human care. Canada: New York: National League for Nursing; 1988.
20. Haley B, Heo S, Wright P, Barone C, Rettiganti MR, Anders M. Relationships among active listening, self-awareness, empathy, and patient-centered care in associate and baccalaureate degree nursing students. NursingPlus Open. 2017;3:11-6.
21. Jarrar Mt, Minai MS, Al‐Bsheish M, Meri A, Jaber M. Hospital nurse shift length, patient‐centered care, and the perceived quality and patient safety. The International journal of health planning and management. 2019;34(1):e387-e96.
22. Nguyen TK, Bauman GS, Watling CJ, Hahn K. Patient-and family-centered care: a qualitative exploration of oncologist perspectives. Supportive Care in Cancer. 2017;25(1):213-9.
23. Barzegar M, Valizadeh S, Gojazadeh M, Jafarabadi MA, Zamanzadeh V, Shahbazi S. The effects of two educational strategies on knowledge, attitude, concerns, and practices of mothers with febrile convulsive children. Thrita. 2016;5(2):e3341.
24. Boer J, Nieboer AP, Cramm JM. A cross‐sectional study investigating patient‐centred care, co‐creation of care, well‐being and job satisfaction among nurses. Journal of Nursing Management. 2017;25(7):577-84.
25. Shahbazi S, Valizadeh S, Borimnejad L, Rahmani A, Vaismoradi M. Living With Moral Distress: The Perspectives and Experiences of Iranian Nurse Preceptors. Research and theory for nursing practice. 2018;32(4):355-69.
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