Person Centered Care
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2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Brigitte Lalude Asante ◽  
Franziska Zúñiga ◽  
Lauriane Favez

Abstract Background Leadership has a vital role regarding quality of care in nursing homes. However, few studies have explored upper-level managers’ views on how to assure that residents receive high quality of care. Therefore, this study’s aim was to examine how managers of top-quality nursing homes define, develop and maintain high-quality of care. Method We used interpretive description, an inductive, qualitative approach. Our research included 13 semi-structured interviews with 19 managers. We analyzed their input using reflexive thematic analysis, which is an iterative approach. Results Quality development and maintenance are cyclic processes. Managers in high-performing nursing homes lead with high commitment towards a person-centred quality of care, creating appropriate working conditions and continuously co-creating a vision and the realization of quality of care together with employees. Conclusions This study confirms that, in high-performing nursing homes, a person-centered approach—one where both residents and employees are at the center—is essential for quality development and maintenance. The most effective managers exemplify “person centeredness”: they lead by example and promote quality-focused working conditions. Such strategies motivate employees to provide person-centered care. As this means focusing on residents’ needs, it results in high care quality.


Author(s):  
Ji-Yeong Yun ◽  
In-Young Cho

Recent health care developments have emphasized person-centered care, which highlights individualized treatments rather than focusing solely on the nature of a given disease. Thus, we aim to identify the factors and construct a structural equation model for developing person-centered care competency among senior nursing students based on the social cognitive career theory and a subsequent literature review. We use a hypothetical model to examine the factors influencing person-centered care competency, and using a structured questionnaire, and we collect data on self-awareness, the clinical learning environment, clinical practicum adaptation, nursing professionalism, empathy, and person-centered care competency. The participants include 383 third- and fourth-year senior nursing students who had undergone at least one semester of clinical practice in South Korea. SPSS/WIN 26.0 is used to analyze all obtained data, while AMOS 25.0 is used for structural equation modeling. The final model is confirmed to be suitable for explaining and predicting person-centered care competency among participants. Nursing professionalism, empathy, clinical practicum adaptation, self-awareness, and the clinical learning environment explained 38.8% of the total variance among participants. Strategies and interventions designed to enhance person-centered care competency for senior nursing students should particularly focus on nursing professionalism, empathy, clinical practicum adaptation, self-awareness, and the clinical learning environment.


2021 ◽  
Vol Volume 14 ◽  
pp. 4269-4279
Author(s):  
Khaled Al-Surimi ◽  
Zahra Alhayek ◽  
David Edvardsson ◽  
Badr Al-Khateeb ◽  
Naila Shaheen

2021 ◽  
Vol 12 ◽  
Author(s):  
Lluna María Bru-Luna ◽  
Manuel Martí-Vilar ◽  
César Merino-Soto ◽  
José Livia

The so-called Person-Centered Care (PCC) model identifies three fundamental principles: changing the focus of attention from the disease to the person, individualizing care, and promoting empowerment. The Person-Centered Care Assessment Tool (P-CAT) has gained wide acceptance as a measure of PCC in recent years due to its brevity and simplicity, as well as its ease of application and interpretation. The objective of this study is to carry out a reliability generalization meta-analysis to estimate the internal consistency of the P-CAT and analyze possible factors that may affect it, such as the year of publication, the care context, the application method, and certain sociodemographic properties of the study sample. The mean value of α for the 25 samples of the 23 studies in the meta-analysis was 0.81 (95% CI: 0.79–0.84), with high heterogeneity (squared-I = 85.83%). The only variable that had a statistically significant relationship with the reliability coefficient was the mean age of the sample. The results show that the P-CAT gives acceptably consistent scores when its use is oriented toward the description and investigation of groups, although it may be affected by variables such as the age of participants.


2021 ◽  
pp. 1-24
Author(s):  
Wiebke Mohr ◽  
Anika Rädke ◽  
Adel Afi ◽  
David Edvardsson ◽  
Franka Mühlichen ◽  
...  

Background: Person-centered care (PCC) is an important concept in many countries’ national guidelines and dementia plans. Key intervention categories, i.e., a taxonomy of person-centered (PC)-interventions, to provide person-centered dementia care, are difficult to identify from literature. Objective: This systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care. Methods: Conduct of this systematic review followed Cochrane guidelines. A search of the dimensions ‘Dementia’, ‘Person-Centered Care’, and ‘Intervention’ combined was performed in PubMed, EMBASE, and Web of Science. Study selection was based on 2-stage screening against eligibility criteria, limited to controlled study designs. Information about interventions and outcomes was extracted into an “Effects Table”. The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care. Results: Searches identified 1,806 records. 19 studies were included. These covered a range of psychosocial interventions, oftentimes multi-component interventions, which followed heterogeneous approaches. Studies were conducted in long-term care/hospital settings. Nine key intervention categories were identified: social contact, physical activities, cognitive training, sensory enhancement, daily living assistance, life history oriented emotional support, training and support for professional caregivers, environmental adjustments, and care organization. Conclusion: Our findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of “PC”-including “relationship-centered”-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit. PROSPERO-ID: CRD42021225084.


2021 ◽  
Author(s):  
Mu’taman Jarrar ◽  
Mohammad Al-Bsheish ◽  
Badr Aldhmadi ◽  
Waleed Albaker ◽  
Ahmed Meri ◽  
...  

Abstract Background Patient safety and quality are concerns of healthcare systems, and several reforms and efforts have focused on this concern. Person-centeredness and nurse work environment are key elements for providing high quality and safe patient care, as structural and process factors. Limited existing studies suggest a mediation role of person-centeredness from a nursing perspective. Accordingly, this study aim to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. Methods A quantitative cross-sectional survey collected data from 1,055 nurses working in medical and surgical units in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. Results A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-hour shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-hour shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned for more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety. Conclusion Medical and surgical nurses working in a healthy environment had a high level of person-centeredness, which is, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and preventing patient harm.


2021 ◽  
Vol 35 (9) ◽  
pp. 265-280
Author(s):  
Kristina Rosengren ◽  
Petra Brannefors ◽  
Eric Carlstrom

PurposeThis study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).Design/methodology/approachA literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.FindingsResults from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).Practical implicationsAdoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.Social implicationsEvidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.Originality/valueOur findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiken Hjuler Persson ◽  
Christian Backer Mogensen ◽  
Jens Søndergaard ◽  
Helene Skjøt-Arkil ◽  
Pernille Tanggaard Andersen

Abstract Background Healthcare services have become more complex, globally and nationally. Denmark is renowned for an advanced and robust healthcare system, aiming at a less fragmented structure. However, challenges within the coordination of care remain. Comprehensive restructures based on marketization and efficiency, e.g. New Public Management (NPM) strategies has gained momentum in Denmark including. Simultaneously, changes to healthcare professionals’ identities have affected the relationship between patients and healthcare professionals, and patient involvement in decision-making was acknowledged as a quality- and safety measure. An understanding of a less linear patient pathway can give rise to conflict in the care practice. Social scientists, including Jürgen Habermas, have highlighted the importance of communication, particularly when shared decision-making models were introduced. Healthcare professionals must simultaneously deliver highly effective services and practice person-centered care. Co-morbidities of older people further complicate healthcare professionals’ practice. Aim This study aimed to explore and analyse how healthcare professionals’ interactions and practice influence older peoples’ clinical care trajectory when admitted to an emergency department (ED) and the challenges that emerged. Methods This qualitative study arises from a hermeneutical stand within the interpretative paradigm. Focusing on the healthcare professionals’ interactions and practice we followed the clinical care trajectories of seven older people (aged > 65, receiving daily homecare) acutely hospitalized to the ED. Participant observations were combined with interviews with healthcare professionals involved in the clinical care trajectory. We followed-up with the older person by phone call until four weeks after discharge. The study followed the code of conduct for research integrity and is reported in accordance with the Standards for Reporting Qualitative Research (SRQR) guidelines. Results The analysis revealed four themes: 1)“The end justifies the means – ‘I know what is best for you’”, 2)“Basic needs of care overruled by system effectiveness”, 3)“Treatment as a bargain”, and 4)“Healthcare professionals as solo detectives”. Conclusion Dissonance between system logics and the goal of person-centered care disturb the healthcare practice and service culture negatively affecting the clinical care trajectory. A practice culture embracing better communication and more person-centered care should be enhanced to improve the quality of care in cross-sectoral trajectories.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Abukari Kwame ◽  
Pammla M. Petrucka

AbstractProviding healthcare services that respect and meet patients’ and caregivers’ needs are essential in promoting positive care outcomes and perceptions of quality of care, thereby fulfilling a significant aspect of patient-centered care requirement. Effective communication between patients and healthcare providers is crucial for the provision of patient care and recovery. Hence, patient-centered communication is fundamental to ensuring optimal health outcomes, reflecting long-held nursing values that care must be individualized and responsive to patient health concerns, beliefs, and contextual variables. Achieving patient-centered care and communication in nurse-patient clinical interactions is complex as there are always institutional, communication, environmental, and personal/behavioural related barriers. To promote patient-centered care, healthcare professionals must identify these barriers and facitators of both patient-centered care and communication, given their interconnections in clinical interactions. A person-centered care and communication continuum (PC4 Model) is thus proposed to orient healthcare professionals to care practices, discourse contexts, and communication contents and forms that can enhance or impede the acheivement of patient-centered care in clinical practice.


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