scholarly journals Person-Centered Healthcare Practice in a Pandemic Context: An Exploration of People's Experience of Seeking Healthcare Support

2021 ◽  
Vol 2 ◽  
Author(s):  
Eleanor Curnow ◽  
Vaibhav Tyagi ◽  
Lisa Salisbury ◽  
Kim Stuart ◽  
Barbara Melville-Jóhannesson ◽  
...  
Keyword(s):  
Problem Solving ◽  
Health Professionals ◽  
Online Survey ◽  
Collaborative Problem Solving ◽  
Active Listening ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Person Centered Care ◽  
Centered Care ◽  
Novel Coronavirus

Background: The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered “lens.”Methods: Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences.Results: There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving.Discussion: People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.

scholarly journals Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

2021 ◽  
Vol 18 (5) ◽  
pp. 2205
Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Quality Care ◽  
Structured Interviews ◽  
Rehabilitation Hospital ◽  
Person Centered Care ◽  
Centered Care ◽  
Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

scholarly journals Digital tools as promoters for person-centered care practices in chronic care? Healthcare professionals’ experiences from rheumatology care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma Granström ◽  
Carolina Wannheden ◽  
Mats Brommels ◽  
Helena Hvitfeldt ◽  
Monica E. Nyström
Keyword(s):  
Chronic Care ◽  
Healthcare Professionals ◽  
Single Case ◽  
Digital Tools ◽  
Work Practices ◽  
Structured Interviews ◽  
Person Centered Care ◽  
Centered Care ◽  
Care Practices ◽  
Perceived Impact

Abstract Background Person-centered care (PCC) emphasize the importance of supporting individuals’ involvement in care provided and self-care. PCC has become more important in chronic care as the number of people living with chronic conditions is increasing due to the demographic changes. Digital tools have potential to support interaction between patients and healthcare providers, but empirical examples of how to achieve PCC in chronic care and the role of digital tools in this process is limited. The aim of this study was to investigate strategies to achieve PCC used by the healthcare professionals at an outpatient Rheumatology clinic (RC), the strategies’ relation to digital tools, and the perceived impact of the strategies on healthcare professionals and patients. Methods A single case study design was used. The qualitative data consisted of 14 semi-structured interviews and staff meeting minutes, covering the time period 2017–2019. The data were analyzed using conventional content analysis, complemented with document analyses. Results Ten strategies on two levels to operationalize PCC, and three categories of perceived impact were identified. On the individual patient level strategies involved several digital tools focusing on flexible access to care, mutual information sharing and the distribution of initiatives, tasks, and responsibilities from provider to patients. On the unit level, strategies concerned involving patient representatives and individual patients in development of digital services and work practices. The roles of both professionals and patients were affected and the importance of behavioral and cultural change became clear. Conclusions By providing an empirical example from chronic care the study contributes to the knowledge on strategies for achieving PCC, how digital tools and work practices interact, and how they can affect healthcare staff, patients and the unit. A conclusion is that the use of the digital tools, spanning over different dimensions of engagement, facilitated the healthcare professionals’ interaction with patients and the patients’ involvement in their own care. Digital tools complemented, rather than replaced, care practices.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

Strengthening Resident, Proxy, and Staff Engagement in Injury Prevention in Skilled Nursing Facilities

2021 ◽  
Author(s):  
Tingzhong Michelle Xue ◽  
Cathleen S Colón-Emeric ◽  
Laurie Herndon ◽  
Emily J Hecker ◽  
Sarah D Berry ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Skilled Nursing Facility ◽  
Interdisciplinary Teams ◽  
Nursing Assistants ◽  
Time Constraints ◽  
Active Listening ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Open Communication ◽  
Skilled Nursing

Abstract Background and Objectives Engaging residents, their proxies, and skilled nursing facility (SNF) staff through effective communication has potential for improving fall-related injury prevention. The purpose of this study was to understand how multiple stakeholders develop and communicate fall-related injury prevention plans to enhance sustained implementation. Research Design and Methods Descriptive qualitative study using framework analysis applied to open-ended semi-structured interviews (n=28) regarding experiences of communication regarding fall-related injury prevention, guided by the Patient and Family Engaged Care framework. Participants included residents at high risk of injury and their proxies, nursing assistants, nurses, and a nurse practitioner from three SNFs in the Eastern U.S. (Massachusetts and North Carolina). Results Interdisciplinary teams were viewed as essential for injury prevention. However, the roles of the interdisciplinary team members were sometimes unclear. Communication structures were often hierarchical, which reduced engagement of nursing assistants and frustrated proxies. Practices that enhanced engagement included knowing the residents, active listening skills, and use of strategies for respecting autonomy. Engagement was inhibited by time constraints, lack of proactive communication among staff, and by challenges eliciting the perspectives of residents with dementia. Resident barriers included desire for autonomy, strong preferences, and language differences. Discussion and Implications Strengthening team meeting processes and cultivating open communication and collaboration could facilitate staff, resident, and proxy engagement in injury prevention planning and implementation. Skill building and targeting resources to improve communication can address barriers related to staff practices, resident characteristics, and time constraints.

“I worry about this patient EVERY day”: Geriatrics Clinicians’ Challenges in Caring for Unrepresented Older Adults

2021 ◽  
pp. 073346482110412
Author(s):  
Kara B. Dassel ◽  
Linda S. Edelman ◽  
Jennifer Moye ◽  
Casey Catlin ◽  
Timothy W. Farrell
Keyword(s):  
Older Adults ◽  
Patient Outcomes ◽  
Online Survey ◽  
Ethical Dilemmas ◽  
Adverse Outcomes ◽  
Person Centered Care ◽  
Risk Characteristics ◽  
Centered Care ◽  
Survey Responses ◽  
Outpatient Settings

Unrepresented older adults are at risk for adverse outcomes, and clinicians who care for them may face ethical dilemmas and unique challenges when making person-centered care recommendations. However, little is known about their perspectives on clinical challenges in caring for this population. An online survey was used to assess issues around providing care for unrepresented patients. Ninety-two American Geriatrics Society members working with older adults in inpatient and/or outpatient settings completed the survey. Descriptive qualitative analysis of narrative survey responses identified five broad themes: (a) health risk characteristics of patients, (b) care decisions facing the team, (c) psychosocial considerations by the team, (d) patient outcomes, and (e) burden of the provider and/or health system. These findings demonstrate that geriatrics clinicians face challenges in working with unrepresented adults in both inpatient and outpatient settings. We interpret these results in light of existing literature and propose collaborative approaches that may improve outcomes.

Preparing Christian Health Workers for International Work: Evaluating a Short Global Health Course

2020 ◽  
Vol 7 (5) ◽  
pp. 21-30
Author(s):  
Sneha Kirubakaran ◽  
Douglas Shaw ◽  
Lawrie McArthur ◽  
Angus Miller ◽  
Anthony Radford
Keyword(s):  
Health Education ◽  
Global Health ◽  
Health Professionals ◽  
Online Survey ◽  
Health Workers ◽  
International Health ◽  
Structured Interviews ◽  
Global Health Education ◽  
Health And Development ◽  
The Impact

Improving global health education to ensure health professionals are prepared and competent in the world’s increasingly interconnected health-scape is a vital need.  For many health professionals, global health education is facilitated through short, pre-departure courses in cross-cultural health and development work.  There is currently limited literature on both the availability and the effectiveness of such courses.  Our research aim was to explore the impact of a short course in global health education, designed and delivered by an Australian not-for-profit organisation, Intermed SA (Intermed).  We conducted a short online survey of Intermed graduates, followed by semi-structured interviews with selected participants.  The results indicate that Intermed’s International Health and Development course was effective in achieving the course objectives as assessed by graduates, whilst also having a positive practical impact on the graduates’ professional development.

Comparative Study of Prototype Hospitals in Lima with the Person-Centered Care Index Rated by Health Professionals

2019 ◽  
Author(s):  
Alberto Perales ◽  
Levent Kirisci ◽  
Juan E. Mezzich ◽  
Elard Sánchez ◽  
Lorenzo Barahona ◽  
...  
Keyword(s):  
Health Care ◽  
Comparative Study ◽  
Health Professionals ◽  
Person Centered Care ◽  
The World ◽  
Centered Care ◽  
Care Index

Background: Interest in person-centered medicine is growing in response to serious contemporary limitations and distortions in medicine and health care across the world. The development of generic instruments with substantial metric features to appraise progress toward person-centered care is providing instrumentation to advance the emerging field.

Productive features of problem solving in chemical kinetics: more than just algorithmic manipulation of variables

2019 ◽  
Vol 20 (1) ◽  
pp. 175-186 ◽  
Author(s):  
Jon-Marc G. Rodriguez ◽  
Kinsey Bain ◽  
Nicholas P. Hux ◽  
Marcy H. Towns
Keyword(s):  
Problem Solving ◽  
Chemical Kinetics ◽  
Order System ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Conceptual Approach ◽  
Critical Feature ◽  
Chemistry Students ◽  
Mathematics Knowledge ◽  
And Mathematics

Problem solving is a critical feature of highly quantitative physical science topics, such as chemical kinetics. In order to solve a problem, students must cue into relevant features, ignore irrelevant features, and choose among potential problem-solving approaches. However, what is considered appropriate or productive for problem solving is highly context-dependent. This study is part of a larger project centered on students’ integration of chemistry and mathematics knowledge and skills. The data for this study came from semi-structured interviews with 40 general chemistry students using a think-aloud protocol. Interview prompts involved students working through two chemical kinetics problems, one involving a second-order system and one involving a zero-order system. In both cases, students could solve the problem using the data provided and relevant equations, or by taking a conceptual approach and considering the relationship between quantities. Using the resource-based model of cognition as our theoretical framework, analysis focused on characterizing the productive and unproductive problem-solving routes used by students. Findings emphasize the role of using conceptual reasoning and reflecting on one's work during problem solving, which have implications for instructors as they guide students to think about chemical kinetics and to solve problems across quantitative topics in science, technology, engineering, and mathematics.

Acceptability and willingness to participate in the Tailored Activity Program: perceptions of people living with dementia, their care partners and health professionals

2020 ◽  
Vol 21 (3) ◽  
pp. 259-273
Author(s):  
Sally Bennett ◽  
Catherine Travers ◽  
Jacki Liddle ◽  
Sandra Smith ◽  
Lindy Clemson ◽  
...  
Keyword(s):  
Health Professionals ◽  
Willingness To Participate ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Face To Face ◽  
Activity Program ◽  
Care Partners ◽  
The Usa ◽  
Qualitative Descriptive ◽  
To Receive

AbstractObjectives:The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia.Methods:This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes.Results:Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered.Discussion:While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.

scholarly journals The work process and care production in a Brazilian indigenous health service

2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Aridiane Alves Ribeiro ◽  
Giovanni Gurgel Aciole ◽  
Cássia Irene Spinelli Arantes ◽  
Jeff Reading ◽  
Donna L.M. Kurtz ◽  
...  
Keyword(s):  
Indigenous Health ◽  
Temporary Employment ◽  
Systematic Observation ◽  
Structured Interviews ◽  
Work Process ◽  
Mato Grosso ◽  
Institutional Rules ◽  
Person Centered Care ◽  
Centered Care ◽  
Health Support

Abstract Objective: To understand the constitutive elements of the work process and care production in an Indigenous Health Support Service. Methods: Case study. Systematic observation and semi-structured interviews were conducted in January and February of 2012. The participants were 10 nursing professionals of an Indigenous Health Support Center, located in Mato Grosso do Sul state, Brazil. The work process was used as a conceptual and analytical category. Results: Through interpretative analysis, the data were organized into three categories. The results showed that care production was focused on procedures and guided by rigid institutional rules and bureaucracy. The prioritization of institutional rules and procedures was detrimental to the provision of person-centered care. Conclusion: The temporary employment contracts and rigid bureaucratic organization generated a tense work environment. These aspects do not maximize the efforts of the nursing staff to provide person-centered care.

Sign in / Sign up

Export Citation Format

Share Document