BMC Nursing | |
Experiences of person-centred care - patients’ perceptions: qualitative study | |
Lars-Eric Olsson2  Anders Jarneborn3  Inger Ekman2  Eric Carlström2  Tariq Saleem J Alharbi1  | |
[1] Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE 405 30 Gothenburg, Sweden;Centre for Person-centred Care (GPCC), Gothenburg University, Gothenburg, Sweden;Department of Medicine, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden | |
关键词: Patients’ experience; Patient-centred care; Person-centred care; Implementing care; Health care models; Deductive content analysis; | |
Others : 1090862 DOI : 10.1186/1472-6955-13-28 |
|
received in 2014-04-19, accepted in 2014-09-25, 发布年份 2014 | |
【 摘 要 】
Background
Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation.
Methods
Sixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model.
Results
The implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience.
Conclusions
The findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
【 授权许可】
2014 Alharbi et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150128163847384.pdf | 229KB | download |
【 参考文献 】
- [1]Longtin Y, Sax H, Leape LL, Sheridan SE, Donalson L, Pittet D: Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc 2010, 85(1):53-62.
- [2]Ekman I, Swedberg K, Taft K, Lindseth A, Norberg A, Brink E, Carlsson J, Dahlin-Ivanoff S, Johansson I-L, Kjellgren K, Lidén E, Öhlén J, Olsson L-E, Rosén H, Rydmark M, Stibrant Sunnerhagen K: Person-centered care: ready for prime time. Eur J Cardiovasc Nurs 2011, 10(4):248-251.
- [3]Nutting PA, Crabtree BF, Miller WL, Stange KC, Stewart E, Jaén C: Transforming physician practices to patient-centered medical homes: lessons from the National Demonstration Project. Health Aff 2011, 30(3):439-445.
- [4]Coulter A, Ellins J: Patient-Focused Interventions: A Review of the Evidence. London, England: The Health Foundation and Picker Institute Europe; 2006:7-20.
- [5]Landi F, Onder G, Russo A, Tabbacanti S, Rollo R, Federici S, Tua E, Cesari M, Bernabei R: A new model of integrated home care for the elderly: impact on hospital use. J Clin Epidemiol 2001, 54(9):968-970.
- [6]Moons KG, Altman DG, Vergouwe Y, Royston P: Prognosis and prognostic research: application and impact of prognostic models in clinical practice. BMJ 2009, 338(606):1487-1490.
- [7]Carlström ED, Ekman I: Organisational culture and change: implementing person-centred care. J Health Organ Manag 2012, 26(2):175-191.
- [8]Alharbi TS, Ekman I, Olsson L-E, Dudas K, Carlström E: Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care. Health Policy 2012, 108:294-301.
- [9]Alharbi T, Ekman I, Olsson L-E, Carlström E: The impact of organizational culture on the outcome of hospital care: after the implementation of person-centered care. Scand J Public Health 2013, 8(2–3):294-301.
- [10]Gustafsson RÅ: Origins of authority: the organization of medical care in Sweden. Int J Health Serv 1989, 19(1):121-133.
- [11]Ågren B: Chain of care development in Sweden: results of a national study. Int J Integr Care 2003, 3:1-8.
- [12]Söder M: Swedish social disability research: a short version of a long history. Scand J Disabil Res 2013, 15(1):90-107.
- [13]Saltman RB, Figueras R: Analyzing the evidence on European health care reforms. Health Aff 1989, 17(2):85-108.
- [14]Klavus J, Vohlonen I, Kunnunen J, Koistinen V, Virtanen M: Evaluating health care financing in a highly decentralized beveridge model. Health 2012, 4(11):1046-1952.
- [15]Crummer MB, Carter V: Critical pathways: the pivotal tool. J Cardiovasc Nurs 1993, 7(4):30-37.
- [16]World Health Organization World Alliance for Patient Safety: Global Patient Safety Challenge 2005–2006: Clean Care is Safer Care. Geneva: World Health Organization; 2005.
- [17]World Health Organization: The Vienna Recommendations on Health Promoting Hospitals. Copenhagen: WHO Regional Office for Europe; 1997.
- [18]Pollitt C, Bouckaert G: Public Management Reform: A Comparative Analysis. New York: Oxford University Press; 2004.
- [19]Socialdepartementet: Vårdval i primärvården, Prop. 2008/09:74. [http://www.regeringen.se/content/1/c6/11/71/76/18be3b95.pdf webcite]
- [20]Socialdepartementet: Vårdval i Sverige, SOU 2008:37. [http://www.regeringen.se/content/1/c6/10/29/06/103be5e1.pdf webcite]
- [21]Dunér A, Nordström M: The roles and functions of the informal support networks of older people who receive formal support: a Swedish qualitative study. Ageing Soc 2007, 27(1):67-85.
- [22]Emanuel EJ, Emanuel LL: Four models of the physician-patient relationship. JAMA 1992, 267(16):2221-2226.
- [23]Kizer KW: Establishing health care performance standards in an era of consumerism. JAMA 2001, 286(10):1213-1217.
- [24]Henderson S: Power imbalance between nurses and patients: a potential inhibitor of partnership in care. J Clin Nurs 2003, 12(4):501-508.
- [25]Eldh AC, Ekman I, Ehnfors M: Conditions for patient participation and non-participation in health care. Nurs Ethics 2006, 13(5):503-514.
- [26]Say R, Murtagh M, Thomson R: Patients’ preference for involvement in medical decision making: a narrative review. Patient Educ Couns 2006, 60(2):102-114.
- [27]Levinson W, Kao A, Kuby A, Thisted RA: Not all patients want to participate in decision making: a national study of public preferences. J Gerontol Intern Med 2005, 20(6):531-535.
- [28]Marshall SS, Haywood KK, Fitzpatrick R: Patient Involvement and Collaboration in Shared Decision-Making: A Review. Oxford: National Centre for Health Outcomes Development; 2005.
- [29]Makoul G, Clayman ML: An integrative model of shared decision making in medical encounters. Patient Educ Couns 2006, 60(3):301-312.
- [30]Attree P, Morris S, Payne S, Vaughan S, Hinder S: Exploring the influence of service user involvement on health and social care services for cancer. Health Expect 2010, 14(1):48-58.
- [31]Laugharne R, Priebe S, McCabe R, Garland N, Clifford D: Trust, choice and power in mental health care: experiences of patients with psychosis. Int J Soc Psychiatry 2012, 58(5):496-504.
- [32]Groene O: Patient centredness and quality improvement efforts in hospitals: rationale, measurement, implementation. Health Aff 2011, 23(5):531-537.
- [33]Alharbi T, Carlström E, Ekman I, Olsson L-E: Implementation of person-centred care: management perspective. J Hosp Adm 2014, 3(3):107-120.
- [34]Légaré F, Stacey D, Graham ID, Elwyn G, Pluye P, Gagnon MP, Frosch D, Harrison MB, Kryworuchko J, Pouliot S, Desroches S: Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. BMC Health Serv Res 2008, 3(8):2.
- [35]Weston WW: Informed and shared decision-making: the crux of patient centered care. Can Med Assoc J 2001, 165(4):438-439.
- [36]Olsson L-E, Karlsson J, Ekman I: The integrated care pathway reduced the number of hospital days by half: a prospective comparative study of patients with acute hip fracture. J Orthop Surg Res 2006, 1(3):1-17.
- [37]Hsieh H, Shannon S: Three approaches to qualitative content analysis. Qual Health Res 2005, 15(9):1277-1288.
- [38]Mayring P: Qualitative content analysis. In A Companion to Qualitative Research. London: SAGE; 2004.