The Diabetes Simulation Challenge: Enhancing Patient Perspective-Taking for Medical Students

The Diabetes Simulation Challenge is a unique training tool to foster empathy, a key facet of patient-centered care, for medical students. Thirty-two medical students participated in a 24-hour perspective-taking activity as part of their curriculum, during which they simulated some common experiences of living with a chronic health condition, specifically type 1 diabetes. Students’ written reflections were analyzed using a phenomenological qualitative approach to provide a composite description of the experience. An exhaustive, iterative method of thematic analysis that included manual coding was used to determine whether this activity led to expressions of empathy or thoughts and beliefs consistent with patient-centered health care. Nine unique themes emerged, six of which indicated that students adopted the perspective of an individual with a chronic illness. Most of the students’ reflections illustrated an understanding of the behavioral, social, and emotional challenges related to living with type 1 diabetes, as well as increased empathy toward individuals with the disease. Medical students who aim to provide patient-centered care benefited from this perspective-taking exercise, and training programs should consider using such methods to extend learning beyond traditional didactic education.

From a View of the Hospital as a System to a View of the Suffering Patient

Purpose: Hospitals aspire to provide patient-centered care but are far from achieving it. This qualitative mixed methods study explored the capacity of hospital directors to shift from a hospital systemic-view to a suffering patient-view applying the Salutogenic theory.Methods: Following IRB, we conducted in-depth narrative interviews with six directors of the six Israeli academic tertiary public hospitals, focusing on their managerial role. In a second meeting we conducted vignette interviews in which we presented each director with a narrative of a suffering young patient who died at 33 due to medical misconduct, allowing self-introspection. Provisional coding was performed for data analysis to identify categories and themes by the three dimensions of the sense-of-coherence, an anchor of Salutogenics: comprehensibility, manageability, and meaningfulness.Results: While at the system level, directors reported high comprehensibility and manageability in coping with complexity, at the patient level, when confronted with the vignette, directors acknowledged their poor comprehensibility of patients' needs and patient's experience during hospitalizations. They acknowledged their poor capacity to provide patient-centered care. Meaningfulness in the narrative interview focused on the system while meaningfulness in the vignette interview focused on providing patient care.Conclusions: The evident gaps between the system level and the patient level create lack of coherence, hindering the ability to cope with complexity, and are barriers to providing patient-centered care. To improve the delivery of patient-centered care, we suggest ways to consolidate the views, enabling the shift from a systemic-view to a patient-view.

PENINGKATAN UPAYA PATIENT-CENTERED CARE (PCC) OLEH PERAWAT MELALUI OPTIMALISASI PERAN PERAWAT PENANGGUNG JAWAB ASUHAN (PPJA)

Pelayanan yang berpusat kepada pasien merupakan inti dari mutu pelayanan kesehatan di rumah sakit. Perawat memiliki peran penting dalam menjaga mutu kualitas asuhan pelayanan bagi pasien. Perawat Penanggung Jawab Asuhan (PPJA) harus memiliki kompetensi yang unggul agar dapat memberikan asuhan terbaik selama 24 jam bagi pasien. Pengabdian masyarakat ini bertujuan untuk meningkatkan pengetahuan perawat tentang konsep PCC dan peran PPJA. Metode yang digunakan dalam pengabdian masyarakat antara lain metode ceramah, tanya jawab dan pemodelan. Kegiatan pengabdian masyarakat ini dilakukan melalui Zoom CloudMeeting serta melibatkan 227 perawat dari beberapa rumah sakit. Melalui kegiatan abdimas ini diharapkan perawat PPJA mampu menerapkan asuhan keperawatan yang berpusat kepada pasien sehingga mutu layanan keperawatan semakin meningkat.Kata kunci: Mutu Keperawatan; Patient Centered Care; Perawat Penanggung Jawab Asuhan AbstractPatient-Centered Care (PCC) is the core of the quality of health services in hospital. Nurseshave an important role in maintaining the quality of service care for patients. Primary Nurseof care must have superior competence in order to provide the best 24 hour care for patients.This community service aims to increase nurse’s knowledge about the PCC concept and therole of Nurse in Charge. The methods used in community service include lecture, question andanswer and modelling methods. This community service though Zoom Cloud Meetings andinvolved 277 nurses from several hospital in Indonesia. Through this community serviceactivity, it is hoped that nurses will be able to implement the PCC to the patient so that thequality of nursing service will increase.Keyword: Nursing Quality; Patient-Centered Care, Primary Nurse

Patient-Centered Care for Patients with Cardiometabolic Diseases: An Integrative Review

Patient-centered care is essential in high-quality health care, as it leads to beneficial outcomes for patients. The objective of this review is to systematize indicators for the care of patients with cardiometabolic diseases based on patient-centered care, extending from the stages of diagnostic evaluation and care planning to intervention. An integrative literature review was conducted by searching seven scientific databases, and a narrative analysis was performed. A total of 15 articles were included, and indicators related to diagnosis and care planning/intervention were extracted. In the planning of care centered on the person with cardiometabolic diseases, the individuality, dynamics of the processes, flexibility and the participation of all stakeholders should be taken into account. The needs of the person must be addressed through the identification of problems; establishment of individual goals; shared decision making; information and education; systematic feedback; case management; meeting the patient’s preferences and satisfaction with care; engagement of the family; and therapeutic management. The indicators for intervention planning extracted were behavioral interventions, therapeutic management programs, lifestyle promotion, shared decision making, education patient and information, interventions with the use of technology, promotion of self-management, program using technology, therapeutic relationship, therapeutic adherence programs and specialized intervention.