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Park J, Jeon H, Choi EK. Digital health intervention on patient safety for children and parents: A scoping review. J Adv Nurs 2024; 80:1750-1760. [PMID: 37950382 DOI: 10.1111/jan.15954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore digital health interventions on patient safety for children and their parents. DESIGN A scoping review. METHODS The PCC 'Participants, Concepts, and Contexts' guided the selection of studies that focused on children under 19 years of age or their parents, patient safety interventions for children, and digital health technology for patient safety interventions. This study was conducted using the Arksey and O'Malley framework's five steps. We reported the review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. DATA SOURCES PubMed, CINAHL, Embase, Web of Science, and Cochrane were searched for articles published up to November 2022. RESULTS A total of 13 articles were included and categorized according to the following criteria to describe the results: intervention characteristics, type of digital technology, and outcome characteristics. Regarding intervention characteristics, we identified two categories, prevention and risk management. Additionally, we identified four types of digital technology, mobile applications, web-based technologies, computer kiosks and electronic health records. Finally, in studies focussing on child safety, parental safety behaviours were used to assess injury risk or detect changes related to prevention. CONCLUSION Patient safety interventions provided through appropriate digital technologies should be developed to enhance continuum of care for children from hospitalization to home after discharge. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Digital health interventions can bolster the role of healthcare providers in patient safety in and out of hospitals, thus improving children's safety and quality of care. IMPACT What problem did the study address? Although the various advantages of digital health technology have been demonstrated, the potential role of digital technology in patient safety interventions for children has not been explored. What were the main finding? Preventive patient safety interventions and risk management for children have been developed. Where and on whom will the research have an impact? Digital health interventions on patient safety can improve children's safety and quality of care by promoting non-face-to-face engagement of children and parents after discharge and expanding healthcare providers' roles. TRIAL AND PROTOCOL REGISTRATION Registered on the Open Science Framework (https://osf.io/dkvst). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jisu Park
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Heejung Jeon
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute College of Nursing, Yonsei University, Seoul, South Korea
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Kozlowska O, Tallett A, Bond S, Mansbridge SE, Aveyard H, Jenkinson C, Dudbridge A, McRobert N, Lumb A, Rea R, Tan GD, Walthall H. Developing and exploring the validity of a patient reported experience measure for adult inpatient diabetes care. Diabet Med 2024; 41:e15266. [PMID: 38150334 DOI: 10.1111/dme.15266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
AIM To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. METHOD 27 in-depth interviews were conducted to inform the development of the 42-item PREM which was cognitively tested with 10 people. A refined 38-item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. RESULTS The PREM had low drop-out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. CONCLUSIONS This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality.
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Affiliation(s)
- Olga Kozlowska
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | | | - Samuel Bond
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Sarah E Mansbridge
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Helen Aveyard
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Nicky McRobert
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alistair Lumb
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Rustam Rea
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Garry D Tan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Helen Walthall
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Hodge O, Rasekaba T, Blackberry I, Steer CB. Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care. Curr Opin Support Palliat Care 2024; 18:9-15. [PMID: 38252057 DOI: 10.1097/spc.0000000000000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
PURPOSE OF REVIEW There is a growing movement towards person-centred, age-friendly healthcare in the care of older adults, including those with cancer. The Age-Friendly Health Systems (AFHS) initiative uses the 4Ms framework to enable this change. This review documents the utility and implications of 4Ms implementation across different settings, with a particular focus on cancer care. RECENT FINDINGS The AFHS initiative 4Ms framework uses a set of core, evidence-based guidelines (focussing on What Matters, Medication, Mentation and Mobility) to improve person-centred care. The successful implementation of the 4Ms has been documented in many different healthcare settings including orthopaedics primary care, and cancer care. Implementation of the 4Ms framework into existing workflows complements the use of geriatric assessment to improve care of older adults with cancer. Models for implementation of the 4Ms within a cancer centre are described. Active engagement and education of healthcare providers is integral to success. Solutions to implementing the What Matters component are addressed. SUMMARY Cancer centres can successfully implement the 4Ms framework into existing workflows through a complex change management process and development of infrastructure that engages healthcare providers, facilitating cultural change whilst employing quality improvement methodology to gradually adapt the status quo to age-friendly processes.
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Affiliation(s)
- Oliver Hodge
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury Campus, NSW
| | | | - Irene Blackberry
- John Richards Centre for Rural Ageing Research
- Care Economy Research Institute, La Trobe University, Wodonga, VIC
| | - Christopher B Steer
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury Campus, NSW
- John Richards Centre for Rural Ageing Research
- Border Medical Oncology and Haematology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
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Kneck Å, Ewertzon M, Leksell J, Årestedt K, Amsberg S. I have never been invited-A cross-sectional explorative study of family members' experiences of encounters with healthcare professionals in diabetes care. Scand J Caring Sci 2024; 38:82-91. [PMID: 37526063 DOI: 10.1111/scs.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
AIM To explore the experiences of family members of adult persons with type 1 diabetes concerning both the approach of healthcare professionals and feelings of alienation in encounters with professional diabetes care. METHODS A cross-sectional explorative quantitative and qualitative design. The Family Involvement and Alienation Questionnaire-Revised (FIAQ-R), including an open-ended question, was answered by 37 family members of adult persons with type 1 diabetes. Analyses included descriptive statistics and qualitative analysis. The study has received ethical approval. RESULTS Family members rated the approach of the healthcare professionals as being somewhat positive and considered that the approach towards them is important. They only felt partially alienated from the professional care. Qualitative data revealed that the family members often lacked direct access to the professional care and that their involvement was dependent on their relationship with the person with diabetes. Findings highlighted that the family members' wish to be involved in the care was sometimes unanswered. CONCLUSION Based on the findings, it is reasonable to stress the importance of considering family members' perspectives and involving them in diabetes care to improve overall patient support.
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Affiliation(s)
- Åsa Kneck
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Mats Ewertzon
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Janeth Leksell
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Susanne Amsberg
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
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Laureano CD, Laranjeira C, Querido A, Dixe MA, Rego F. Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review. Healthcare (Basel) 2024; 12:445. [PMID: 38391820 PMCID: PMC10888148 DOI: 10.3390/healthcare12040445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
In mental health and psychiatric care, the use of involuntary psychiatric treatment for people with mental disorders is still a central and contentious issue. The main objective of this scoping review was to map and systematize the literature on ethical issues in clinical decision-making about involuntary psychiatric treatment. Five databases (Embase, PsycINFO, CINAHL, Medline, and Scopus) were searched for articles on this topic. Out of a total of 342 articles found, 35 studies from 14 countries were included based on the selection criteria. The articles were analyzed using the inductive content analysis approach. The following main categories were identified: (1) ethical foundations that guide clinical decision-making; (2) criteria for involuntary psychiatric treatment; (3) gaps, barriers, and risks associated with involuntary psychiatric treatment; (4) strategies used to reduce, replace, and improve the negative impact of involuntary treatment; and (5) evidence-based recommendations. Most of the selected articles discuss the logic underlying involuntary treatment of the mentally ill, exploring ethical principles such as autonomy, beneficence, non-maleficence, or justice, as well as how these should be properly balanced. During the process of involuntary psychiatric admission, there was a notable absence of effective communication and a significant power imbalance that disenfranchised those seeking services. This disparity was further intensified by professionals who often use coercive measures without a clear decision-making rationale and by family members who strongly depend on hospital admission. Due to the pluralistic and polarized nature of opinions regarding legal capacity and the complexity and nuance of involuntary admission, further studies should be context-specific and based on co-production and participatory research.
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Affiliation(s)
- Cláudio Domingos Laureano
- Psychiatric and Mental Health Service, Local Health Unit of the Leiria Region-Hospital of Santo André, Rua das Olhalvas, 2410-197 Leiria, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal
| | - Carlos Laranjeira
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic University of Leiria, Campus 2-Morro do Lena, Alto do Vieiro-Apart. 4137, 2411-901 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Ana Querido
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic University of Leiria, Campus 2-Morro do Lena, Alto do Vieiro-Apart. 4137, 2411-901 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Maria Anjos Dixe
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic University of Leiria, Campus 2-Morro do Lena, Alto do Vieiro-Apart. 4137, 2411-901 Leiria, Portugal
| | - Francisca Rego
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
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Carter B, Young S, Ford K, Campbell S. The Concept of Child-Centred Care in Healthcare: A Scoping Review. Pediatr Rep 2024; 16:114-134. [PMID: 38391000 PMCID: PMC10885088 DOI: 10.3390/pediatric16010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system.
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Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK
| | - Sarah Young
- Launceston Clinical School, Tasmanian School of Medicine, College of Health & Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Karen Ford
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Steven Campbell
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
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Howe J, MacPhee M, Duddy C, Habib H, Wong G, Jacklin S, Oduola S, Upthegrove R, Carlish M, Allen K, Patterson E, Maidment I. A realist review of medication optimisation of community dwelling service users with serious mental illness. BMJ Qual Saf 2023:bmjqs-2023-016615. [PMID: 38071586 DOI: 10.1136/bmjqs-2023-016615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/14/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Severe mental illness (SMI) incorporates schizophrenia, bipolar disorder, non-organic psychosis, personality disorder or any other severe and enduring mental health illness. Medication, particularly antipsychotics and mood stabilisers are the main treatment options. Medication optimisation is a hallmark of medication safety, characterised by the use of collaborative, person-centred approaches. There is very little published research describing medication optimisation with people living with SMI. OBJECTIVE Published literature and two stakeholder groups were employed to answer: What works for whom and in what circumstances to optimise medication use with people living with SMI in the community? METHODS A five-stage realist review was co-conducted with a lived experience group of individuals living with SMI and a practitioner group caring for individuals with SMI. An initial programme theory was developed. A formal literature search was conducted across eight bibliographic databases, and literature were screened for relevance to programme theory refinement. In total 60 papers contributed to the review. 42 papers were from the original database search with 18 papers identified from additional database searches and citation searches conducted based on stakeholder recommendations. RESULTS Our programme theory represents a continuum from a service user's initial diagnosis of SMI to therapeutic alliance development with practitioners, followed by mutual exchange of information, shared decision-making and medication optimisation. Accompanying the programme theory are 11 context-mechanism-outcome configurations that propose evidence-informed contextual factors and mechanisms that either facilitate or impede medication optimisation. Two mid-range theories highlighted in this review are supported decision-making and trust formation. CONCLUSIONS Supported decision-making and trust are foundational to overcoming stigma and establishing 'safety' and comfort between service users and practitioners. Avenues for future research include the influence of stigma and equity across cultural and ethnic groups with individuals with SMI; and use of trained supports, such as peer support workers. PROSPERO REGISTRATION NUMBER CRD42021280980.
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Affiliation(s)
- Jo Howe
- Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Maura MacPhee
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Claire Duddy
- Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hafsah Habib
- Pharmacy School, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Geoff Wong
- Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon Jacklin
- School of Pharmacy and Bioengineering, Keele University, Keele, UK
| | - Sheri Oduola
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Birmingham Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Max Carlish
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Katherine Allen
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Emma Patterson
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Ian Maidment
- Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
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Barker ME, Leach KT, Levett-Jones T. Patient's views of empathic and compassionate healthcare interactions: A scoping review. NURSE EDUCATION TODAY 2023; 131:105957. [PMID: 37734368 DOI: 10.1016/j.nedt.2023.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing empathy and compassion from the perspective of researchers or clinicians. There has been limited attention to the perspectives of patients. OBJECTIVE The objective of this scoping review was to map the literature to identify patients' views of healthcare provider behaviours that exemplify empathic and compassionate interactions. METHOD This review used the Joanna Briggs Institute scoping review methodology. A comprehensive search of eight electronic databases was conducted with English language studies published in the last 10 years considered for inclusion. RESULTS Database searching resulted in 459 records for initial screening. After de-duplication and conducting a title and abstract review, 32 full-text articles were screened for eligibility. A total of 14 studies met the inclusion criteria and were critically reviewed using the Mixed Methods Appraisal Tool. The included papers profiled studies that had been conducted in clinical settings across seven countries. The healthcare encounters described in the papers were with a range of healthcare providers. Two overarching and interconnected categories of behaviours were identified as indicative of empathic/compassionate encounters: (1) communication skills such as listening, touch, body language, eye contact and positive demeanour; and (2) helping behaviours demonstrated by small acts of kindness that go beyond routine healthcare. CONCLUSION Given the breadth of studies describing the positive impact of empathy/compassion on people's physical and psychosocial wellbeing, the results from this review are valuable and shed new light on patients' views and experiences. The results provide a deeper understanding of healthcare provider behaviours that exemplify empathic and compassionate healthcare interactions and can be used to inform the education and training of healthcare providers from all disciplines.
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Santos JDC, Arreguy-Sena C, Pinto PF, Lopes ROP, Vilela TDC, Brandão MAG. Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method. Rev Gaucha Enferm 2023; 44:e20220170. [PMID: 37672401 DOI: 10.1590/1983-1447.2023.20220170.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 01/20/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. METHOD Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. RESULTS Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. CONCLUSION There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.
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Affiliation(s)
- Jéssica de Castro Santos
- Universidade Federal do Rio de Janeiro (UFRJ). Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Cristina Arreguy-Sena
- Universidade Federal de Juiz de Fora (UFJF). Faculdade de Enfermagem. Juiz de Fora, Minas Gerais, Brasil
| | - Paulo Ferreira Pinto
- Universidade Federal de Juiz de Fora (UFJF). Faculdade de Educação Física e Desportos. Juiz de Fora, Minas Gerais, Brasil
| | - Rafael Oliveira Pitta Lopes
- Universidade Federal do Rio de Janeiro (UFRJ). Centro Multidisciplinar UFRJ- Macaé. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Talyta do Carmo Vilela
- Universidade Federal de Juiz de Fora (UFJF). Faculdade de Enfermagem. Juiz de Fora, Minas Gerais, Brasil
| | - Marcos Antônio Gomes Brandão
- Universidade Federal do Rio de Janeiro (UFRJ). Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
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Tyler N, Planner C, Shears B, Hernan A, Panagioti M, Giles S. Developing the Resident Measure of Safety in Care Homes (RMOS): A Delphi and Think Aloud Study. Health Expect 2023; 26:1149-1158. [PMID: 36797827 PMCID: PMC10154851 DOI: 10.1111/hex.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE This study aimed to develop a measure of contributory factors to safety incidents in care homes to be completed by residents and/or their unpaid carers. INTRODUCTION Care home residents are particularly vulnerable to patient safety incidents, due to higher likelihood of frailty, multimorbidity and cognitive decline. However, despite residents and their carers wanting to be involved in safety initiatives, there are few mechanisms for them to contribute and make meaningful safety improvements to practice. METHODS We developed 73 evidence-based items from synthesis and existing measures, which we presented to a panel of stakeholders (residents/carers, health/social care professionals and researchers). We used two online rounds of Delphi to generate consensus (80%) on items important to include in the Resident Measure of Safety in Care Homes (RMOS); a consensus meeting was later held. The draft RMOS developed through the Delphi was presented to participants during 'Think Aloud' interviews using cognitive testing techniques. RESULTS The 29-item RMOS was developed. Forty-three participants completed Delphi round 1, and 27 participants completed round 2, 11 participants attended the consensus meeting and 12 'Think Aloud' interviews were conducted. Of the 73 original items, 42 items that did not meet consensus in Delphi round 1 were presented in round 2. After the consensus meeting, it was agreed that 35 items would comprise the RMOS questionnaire and were presented in the 'Think Aloud' interviews. Participants suggested numerous changes to items mostly to improve comprehension and ability to answer. CONCLUSION We have a developed an evidence-based RMOS, with good face validity, to assess contributory factors to safety in care homes from a resident/carer perspective. Future work will involve psychometrically testing the items in a pilot and developing a complementary simplified, dementia-friendly version to promote inclusivity. PATIENT OR PUBLIC INVOLVEMENT Four patient and public contributors worked with researchers to develop the online questionnaires. Patients (residents) and carers participated on the consensus panel. One member of the research team is an expert by lived experience and was involved in design and analysis decisions. The item list and instructions for the questionnaires were reviewed for face validity, understanding and acceptability by a patient and public involvement group and modified.
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Affiliation(s)
- Natasha Tyler
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,National Institute for Health and Care Research School for Primary Care Research, University of Manchester, Manchester, UK
| | - Claire Planner
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Bethany Shears
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Andrea Hernan
- Faculty of Health, Deakin University, Warrnambool, Australia
| | - Maria Panagioti
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,National Institute for Health and Care Research School for Primary Care Research, University of Manchester, Manchester, UK
| | - Sally Giles
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Paterson C, Roberts C, Bail K. 'Paper care not patient care': Nurse and patient experiences of comprehensive risk assessment and care plan documentation in hospital. J Clin Nurs 2023; 32:523-538. [PMID: 35352417 PMCID: PMC10084263 DOI: 10.1111/jocn.16291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To explore organisation-wide experiences of person-centred care and risk assessment practices using existing healthcare organisation documentation. BACKGROUND There is increasing emphasis on multidimensional risk assessments during hospital admission. However, little is known about how nurses use multidimensional assessment documentation in clinical practice to address preventable harms and optimise person-centred care. DESIGN A qualitative descriptive study reported according to COREQ. METHODS Metropolitan tertiary hospital and rehabilitation hospital servicing a population of 550,000. A sample of 111 participants (12 patients, 4 family members/carers, 94 nurses and 1 allied health professional) from a range of wards/clinical locations. Semi-structured interviews and focus groups were conducted at two time points. The audio recording was transcribed, and an inductive thematic analysis was used to provide insight from multiple perspectives. RESULTS Three main themes emerged: (1) 'What works well in practice' included: efficiency in the structure of the documentation; the Introduction, Situation, Background Assessment, Recommendation (ISBAR) framework and prompting for clinical decision-making were valued by nurses; and direct patient care is always prioritised. (2) 'What does not work well in practice': obtaining the patient's signature on daily care plans; multidisciplinary (MDT) involvement; duplication of paperwork and person-centred goals are not well-captured in care plan documentation. (3) 'Experience of care'; satisfaction of person-centred care; communication in the MDT was important, but sometimes insufficient; patients had variable involvement in their daily care plan; and inadequate integration of care between MDT team which negatively impacted patients. CONCLUSIONS Efficient and streamlined documentation systems should herald feedback from nurses to address their clinical workflow needs and can support, and capture, their decision-making that enables partnership with patients to improve the individualisation of care provision. RELEVANCE TO CLINICAL PRACTICE The integration of effective MDT involvement in clinical documentation was problematic and resulted in unmet supportive care from the patient's perspective.
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Affiliation(s)
- Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services and ACT Health, SYNERGY Nursing and Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia.,School of Nursing, Midwifery and Paramedicine, Robert Gordon University, Aberdeen, UK
| | - Cara Roberts
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services and ACT Health, SYNERGY Nursing and Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia
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Kim S, Kim M. Nursing students' experiences and perceptions of barriers to the implementation of person-centred care in clinical settings: A qualitative study. Nurs Open 2022; 10:1889-1899. [PMID: 36463097 PMCID: PMC9912416 DOI: 10.1002/nop2.1514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 10/06/2022] [Accepted: 11/20/2022] [Indexed: 12/07/2022] Open
Abstract
AIM This study aimed to explore the barriers to implementing person-centred care based on nursing students' experiences during clinical practice. DESIGN This is a descriptive, qualitative study. METHODS Seventeen nursing students were recruited through purposeful sampling from two universities in South Korea. The semi-structured interviews consisting of open-ended questions were conducted. The collected data were analysed using an inductive content analysis method. RESULTS Five main categories were identified from nursing students' experiences: busyness, educational challenges, lack of awareness, lack of relationship building and lack of a policy approach.
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Affiliation(s)
- Seonho Kim
- Department of Nursing ScienceChungbuk National UniversityChungbukCheongju‐SiSouth Korea
| | - Myoungsuk Kim
- College of NursingKangwon National UniversityChuncheon‐SiGangwon‐DoSouth Korea
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Mickelson Weldingh N, Kirkevold M. What older people and their relatives say is important during acute hospitalisation: a qualitative study. BMC Health Serv Res 2022; 22:578. [PMID: 35488250 PMCID: PMC9052562 DOI: 10.1186/s12913-022-07981-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the growing population of older people across the world, providing safe and effective care is an increasing concern. Older persons in need for hospitalisation often have, or are susceptible to develop, cognitive impairment. Hospitals need to adapt to ensure high-quality care for this vulnerable patient group. Several age-friendly frameworks and models aiming at reducing risks and complications have been promoted. However, care for older people must be based on the persons' reported needs, and relatives are often an important part of older persons' social support. The primary aim of this study was to explore older peoples' and their relatives' experiences of acute hospitalisation and determine what is important for them to experience a good hospital stay. The study was not limited to patients with cognitive impairment; but included a wider group of older individuals vulnerable to developing delirium, with or without an underlying chronic cognitive impairment. METHODS This study had a qualitative research design in which people aged 75 years or older and their relatives were interviewed during an acute hospitalisation. The study was conducted at two medical wards at a large university hospital in Norway, and included a total of 60 participants. All interviews were informed by a semi-structured interview guide and were thematically analysed. RESULTS Four major themes were identified in the older people's and the relatives' descriptions of how they experienced the hospital stay and what was important for them during the hospital stay: being seen and valued as a person, individualised care, patient-adapted communication and information, and collaboration with relatives. The themes span both positive and negative experiences, reflecting great variability in the experiences described. The presence of these four characteristics promoted positive experiences among patients and relatives, whereas the absence or negative valuation of them promoted negative experiences. CONCLUSIONS The findings underscore the interrelatedness of older people and their relatives and that patients and relatives are quite consistent in their experiences and opinions. This suggests that listening to the concerns of relatives is important, as they can voice the older patient's needs and concerns in situations where older people might find it difficult to do so. Furthermore, the results underscore how 'small things' matter in relation to how health professionals capture the patient's individual values, need for care, information and involvement of relatives and that these are essential to ensure predictability and security and a good stay for older people and their relatives.
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Affiliation(s)
- Nina Mickelson Weldingh
- Division of Research and Innovation, Department of Research Support Service, Akershus University Hospital, Lørenskog, Norway.
| | - Marit Kirkevold
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Ahn J, Kim M. Influencing Factors on Person-Centered Care Competence among Nursing Students Experienced Clinical Training. Medicina (B Aires) 2021; 57:medicina57121295. [PMID: 34946240 PMCID: PMC8704963 DOI: 10.3390/medicina57121295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Nursing students require appropriate education to improve their person-centered care competence. Therefore, research on the various factors that influence person-centered care competence is necessary. This study aimed to identify factors influencing nursing professional values, satisfaction with major, and perception of the nursing profession on person-centered care competence. Materials and Methods: This study was a descriptive survey, and participants were nursing students from three universities in Korea. Structured self-report questionnaires were used for data collection. Results: Nursing professional values (p < 0.001) were found to be an influencing factor on person-centered care competence (Adjusted R2 = 0.244). However, the perception of the nursing profession, and the satisfaction with the major were not found to be significant influencing factors on person-centered care competence. Conclusions: The findings suggest that fostering nursing professional values in nursing students and developing educational interventions for the same are essential to improve person-centered care competence.
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Tobiano G, Marshall AP, Chaboyer W. Comparing Perceptions of Patient Nonparticipation in Nursing Care: A Secondary Analysis. J Nurs Scholarsh 2021; 53:449-457. [PMID: 33713562 DOI: 10.1111/jnu.12643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Patient participation is characterized by dyadic patient-nurse interactions that enable patients to passively or actively participate in communicative and physical care activities. Less research has been conducted on nonparticipation. Examining this phenomenon may highlight issues to address and identify strategies that may ultimately promote patient participation and move the rhetoric of patient participation to a reality. The aim of this secondary analysis was to explore hospital patients' and nurses' perceptions of nonparticipation in nursing care specifically focused on communication and self-care. DESIGN Secondary supplementary analysis of qualitative data. We collated original transcripts from one dataset that included 20 patient and 20 nurse interviews conducted at two hospitals in Australia, in November 2013 to March 2014. METHODS Interviews were arranged into units of analysis dependent on group (patient/nurse) and setting (public/private hospital) and were reanalyzed using manifest, inductive content analysis. FINDINGS Two categories were found: (a) nurses impeding two-way clinical communication; and (b) patients and nurses disregarding patients' self-care efforts. These categories describe that nonparticipation occurred when nurses inhibited communication, and when patients were not involved in self-care while hospitalized or during discharge planning. CONCLUSIONS Perceptions of nonparticipation differ across settings, having implications for how patient participation recommendations are enacted in different contexts. CLINICAL RELEVANCE There is no one-size-fits-all approach; nurses need to identify common instances of nonparticipation within their setting and develop and implement strategies to promote patient participation that are suited to their context.
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Affiliation(s)
- Georgia Tobiano
- Phi Delta at Large, Senior Research Fellow (End User Engagement), National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University; and Gold Coast Health, Gold Coast, Australia
| | - Andrea P Marshall
- Phi Delta at Large, Professor of Acute and Complex Care in Nursing, Gold Coast Health and Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Wendy Chaboyer
- Phi Delta at Large, Director, National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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