Factors influencing hospitalized patients' perception of individualized nursing care: a cross-sectional study

Patients' Individualized Care Perceptions and Health Literacy Using an Interactive App During Breast and Prostate Cancer Treatment: Two Parallel Randomized Controlled Trials

The use of symptom management mobile apps can reduce patients' symptom burden during cancer treatment, but the evidence is lacking about their effect on care. Moreover, if patients' health literacy can be improved, it needs to be more rigorously tested. This study aimed to evaluate patients' perceptions of individualized care and health literacy using an interactive app in two randomized trials. Patients undergoing neoadjuvant chemotherapy for breast cancer (N = 149) and radiotherapy for prostate cancer (N = 150) were consecutively included and randomized into one intervention or control group. Outcome measures were Individualized Care Scale, Swedish Functional Health Literacy Scale, and Swedish Communicative and Critical Health Literacy Scale. In the breast cancer trial, no group differences were observed regarding individualized care or health literacy. Most patients had sufficient health literacy levels. In the prostate cancer trial, intervention group patients rated higher perceived individualized care regarding decision control at follow-up than the control group. Less than half had sufficient health literacy levels and intervention group patients significantly improved their ability to seek, understand, and communicate health information. Education level explained significant variance in health literacy in both trials. Using an interactive app can positively affect individualization in care and health literacy skills among patients treated for prostate cancer, although further research is warranted.

Patients' Perception Towards Quality of Nursing Care and Associated Factors at Agaro General Hospital, Southwest Ethiopia: A Cross-Sectional Study

Introduction

Quality care is currently on the agenda of policy-makers at national and international levels. Patient-centeredness is considered an integral component of healthcare quality dimensions in addition to its effectiveness and safety. This indicates that healthcare should be viewed from a patient's perspective.

Methods and Materials

An institution-based cross-sectional study was conducted with a total sample size of 422 using systematic random sampling among patients admitted to the Agaro General Hospital. SPSS software version 25.0 was used to enter and analyze the data. The relationship between the dependent variable and covariates was determined using multivariable binary logistic regression analysis.

Results

A total of 405 patients participated in this study with a response rate of 96.0%. The overall percentage of positive perception was 76.3%. Clients aged 31-40 years were more likely [AOR: 2.191, 95% CI: 1.033-4.645, p-value: .041] and clients aged ≥ 51 years were less likely to perceive positively [AOR: 0.490, 95% CI: 0.271-0.886, p-value: .018]. Patients who had paid for receiving care were more likely to perceive it positively [AOR: 3.046, 95% CI 1.043-8.896, p-value: .042]. The odds of positive perception towards the quality of nursing care were higher among patients who thought the hospital cost was medium [AOR: 3.066, 95% CI: 1.286-7.311, p-value: .012], low [AOR: 13.859, 95% CI: 2.245-85.562, p-value: .005], and uncertain [AOR: 6.116, 95% CI: 1.988-18.809, p-value: .002].

Conclusion and Recommendations

Most patients had a positive perception of the quality of nursing care. Being elderly and feeling towards hospital costs have a negative influence whereas having paid for the treatment has a positive influence on the patients' perception of nursing care. Hence the need increases with age, and healthcare providers should pay great attention while providing care for elderly patients.

Specific nursing improves postoperative urine control function and the self-efficacy of patients undergoing radical prostatectomies

BACKGROUND

Radical prostatectomy is a treatment for prostate cancer (PC), but most patients suffer urinary incontinence, decreased urinary control function, and poor prognoses after the surgery. Specific nursing intervention is a nursing model based on the patients' individual conditions and disease progression.

OBJECTIVE

To investigate the effects of specific nursing intervention on the urinary control functions and self-efficacy of radical prostatectomy patients.

METHODS

From April 1, 2016 to June 30, 2019, 149 patients who underwent radical prostatectomies in our hospital were retrospectively selected for this observational study and assigned to two groups in accordance with the different nursing intervention method each patient underwent. Seventy-six patients who underwent specific nursing intervention were included in the observation group (OG), and 73 patients who underwent routine nursing intervention were included in the control group (CG). The clinical symptoms, the urodynamic indexes, the recoveries of urinary control function, the incidences of urinary incontinence, and the complications were observed in both groups. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were used to evaluate the unhealthy emotions. The self-efficacy scale (GSES) and SF-36 were used to evaluate the self-efficacy and the quality of life (QOL), respectively.

RESULTS

After the nursing, the improvement in the clinical symptoms in the OG was significantly better than it was in CG. The improvement in the postoperative urodynamic indexes in the OG was significantly better than it was in the CG. The recovery of urinary control function in the OG was significantly higher than it was in the CG. The incidence of urinary incontinence in OG was significantly lower than it was in the CG. The incidence of complications in the OG was significantly lower than it was in the CG. The SAS and SDS scores in the OG were significantly lower than they were in the CG. After the intervention, the patients' GSES and SF-36 scores in the OG were significantly higher than they were in the CG.

CONCLUSION

Specific nursing intervention can ameliorate the urinary control functions and self-efficacy, reduce unhealthy emotions, and improve the QOL of radical prostatectomy patients.

PERCEIVED INDIVIDUALIZED CARE AND THE SATISFACTION LEVELS OF PATIENTS HOSPITALIZED IN INTERNAL MEDICINE DEPARTMENTS: A CROSS-SECTIONAL AND CORRELATIONAL SURVEY

Objective: Individualized nursing care, which indicates the belief on the uniqueness and worthiness of human beings, improves the quality of healthcare and contributes to patient satisfaction. The aim of this study is to determine the relationship between the perceived individualized care and the level of satisfaction with nursing care for patients hospitalized in internal medicine departments. Methods: This study was carried on 250 patients hospitalized in internal medicine department of a university hospital in Turkey between December 2019 and February 2020. Patient information form, individualized care scale and the Newcastle satisfaction with nursing scale were used for data collection. Mann-Whitney U, Kruskal-Wallis H and Spearman’s rho correlation test were used for data analysis. Results: Participants believed that the nursing interventions supported their individuality and had positive perceptions about the individuality in their own care. They were highly satisfied with the nursing interventions. Besides there was a positive correlation between the scores obtained from the individualized care scale and Newcastle satisfaction with nursing scale. Finally, age and education levels of the patients had a positive impact on perceived individualized care and the level of satisfaction with nursing care. Conclusion: The findings suggest that individuality of each patient should be prioritized during the nursing interventions in order to increase patient satisfaction and improve the quality of nursing care.

Individualized Care: Perceptions of Gynecologic Oncology Patients and Nurses

The purpose of the descriptive study was to assess the individualized care perceptions of gynecologic oncology patients and nurses. The study was conducted between June 1, 2015, and September 30, 2015, at a university hospital and at a training and research hospital in Ankara, Turkey. The study sample included 152 patients who received inpatient treatment at the selected hospitals' gynecologic oncology clinics, and 29 nurses are working at these clinics. The number of the patients was determined by using One-Sample t-Test Power Analysis. The questionnaire was filled by the researcher using face-to-face interview method. The data were analyzed by using Independent Samples t Test, the Mann-Whitney U test, ANOVA, and Kruskal-Wallis H tests. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used to determine whether distribution of the parameters was normal. Patients' perception on "nurses support their individuality" was found to be X̅ = 3.07 ± 0.97 and their perception on "nurses provide individual care" was X̅ = 2.33 ± 0.69. As patients' perception on "nurses support their individuality" increased, their perception on "nurses provide individual care service" also increased (r = 0.736; p = 0.001). The patients' satisfaction with care was at a moderate level (63.16 ± 14.97). The level of perception on "nurses support the individuality of patients during care practices (X̅ = 1.65 ± 0.58) and provide individual care service to the patients (X̅ = 1.61 ± 0.62)" was low. Nurses stating that they supported the individuality of patients provided individual care to their patients (r = 0.828; p = 0.001). The nurses' perception on "they support patients' individuality" and "they provide individual care service" was lower than patients' perception on "nurses support their individuality" and "nurses provide individual care." The nurses' job satisfaction (general satisfaction) was at a moderate level (3.08). In this study, nurses' perception on individualized care was lower than patients' perception.

Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.

Inpatient satisfaction with nursing care in a backward region: a cross-sectional study from northwestern China

OBJECTIVES

The aim of the study was to examine the level of patient satisfaction with nursing care and identify the factors affecting satisfaction from the inpatient's perspective in a backward region of China.

DESIGN

This was a cross-sectional study.

SETTING

The study was conducted at a tertiary hospital located in northwest China.

PARTICIPANTS

Patients admitted to the ward for at least 48 hours were chosen to participate in the survey.

PRIMARY OUTCOME MEASURE

The Newcastle Satisfaction with Nursing Care Scale was used. Data were collected from 219 patients.

RESULTS

The overall inpatient satisfaction with nursing care was 78.15±4.74. Patients were more satisfied with nurses who respected their privacy and treated them as individuals (67.7%). Patients were least satisfied with the type of information nurses gave them (11.7%) and with the sufficient awareness of their needs. Patients who were married, had a history of hospitalisation, surgery and were taken charge of by junior nurses had higher satisfaction.

CONCLUSIONS

The overall level of patient satisfaction was moderate. Patient-centred individualised care and providing sufficient information model of care are needed. There was a need for nurses to be aware of patients' individualised care needs and to provide them with more information. This study may suggest/urge hospital administrators, policymakers and nurses to be more sensitive with patients' married status, history of hospitalisation and surgery, the professional title of in charged nurses when care is provided. Ultimately to achieve better outcome of patients' hospitalisation.

Educating Parents on Vitamin K Prophylaxis for Newborns

Vitamin K is important in the clotting cascade, and vitamin K prophylaxis is important in preventing vitamin K deficiency bleeding (VKDB) in newborns. Breastfed newborns have been found to be particularly vulnerable to VKDB. Although oral vitamin K is available, there is no version for newborns approved by the U.S. Food and Drug Administration (FDA), and if a dose is missed, the risk of VKDB may more than double. Therefore, an injection is recommended by the American Academy of Pediatrics to prevent VKDB in newborns. Nurses often administer the newborn vitamin K injection, and they play a key role in educating parents and helping them make informed decisions about vitamin K prophylaxis for their newborns.

Preliminary construction of evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital

Objectives

To construct a comprehensive evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients’ nursing services.

Method

We used the Delphi method to conduct two rounds of expert consultations with 41 experts.

Result

The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.

Conclusions

We formed an evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital and classified it into five categories: hospital environment, nursing attitude, nursing skills, information exchange, and emotional support. The indicator system is scientific and reliable. It can provide a basis for nursing staffs to identify and meet the needs of inpatients’ care services.

Barriers and facilitators involved in standardised care plan individualisation process in acute hospitalisation wards: A grounded theory approach

OBJECTIVE

To identify and classify the barriers and facilitators of the individualisation process of the standardised care plan in hospitalisation wards.

BACKGROUND

The administration of individualised care is one of the features of the nursing process. Care plans are the structured record of the diagnosis, planning and evaluation stages of the nursing process. Although the creation of standardised care plan has made recording easier, it is still necessary to record the individualisation of the care. It is important to study the elements that influence the individualisation process from the nurses' perspective.

DESIGN

Qualitative study with the grounded theory approach developed by Strauss and Corbin.

METHODS

Thirty-nine nurses from three hospitals participated by way of theoretical sampling. In-depth interviews were conducted, as well as participant observation, document analysis and focus group discussion. The analysis consisted of open, axial and selective coding until data saturation was reached. EQUATOR guidelines for qualitative research (COREQ) were applied.

RESULTS

For both barriers and facilitators, three thematic categories emerged related to organisational, professional and individual aspects. The identified barriers included routines acquired in the wards, the tradition of narrative records, lack of knowledge and limited interest in individualisation. The identified facilitators included holding clinical care sessions, use of standardised care plan and an interface terminology, the nurse's expertise and willingness to individualise.

CONCLUSION

The individualisation process of the standardised care plan involves multiple barriers and facilitators, which influence its degree of accuracy.

RELEVANCE TO CLINICAL PRACTICE

Implementing strategies at an organisational level, professional level and individual level to improve the way the process is carried out would encourage individualising the standardised care plan in a manner that is consistent with the needs of the patient and family; it would improve the quality of care and patient satisfaction.

Women's perception of support and control during childbirth in The Gambia, a quantitative study on dignified facility-based intrapartum care

Background

In The Gambia, a woman faces 1 in 24-lifetime risk of maternal death due to pregnancy and childbirth, yet, only 57% of deliveries are conducted by skilled birth attendants. However, poor provider attitude has been identified as one of the contributing factors hampering the efforts of the government in improving access to skilled care during childbirth. This study, therefore, explored women’s perception of support and control during childbirth in The Gambia.

Methods

A descriptive cross-sectional study was employed. A convenience sampling method was used to select participants in two regions in The Gambia. A sample size of 200 women who met the eligibility criteria was recruited after informed consent. The demographic-obstetric information sheet and the Support and Control in Birth scale (SCIB) were used to collect data. Data analysis was done using SPSS software version 23.0.

Results

Women’s perceptions of support and control were low. External control 1.85 (SD ± 0.43) recorded the least perception compared to internal control 2.41 (SD ± 0.65) and perception of support 2.52 (SD ± 0.61). Participants reported the lowest perceptions in pain control, involvement in decision making, information sharing and the utilization of different position during birth. Women’s age (p < .001) and mode of delivery (p = .01), significantly predicted women’s perception of internal control. Educational status (p = .02), mode of delivery (p = .04), place of delivery (p < .001) and perception of support (p < .001) significantly predicted women’s perception of external control, whilst birth plan (p = .001), mode of delivery (p = .04), and perception of external control (p < .001) significantly predicted women’s perception of support.

Conclusion

This study concluded that an environment that promotes women feeling a sense of control and support during childbirth should be created in order to ensure a dignified intrapartum care in The Gambia. This can be achieved through effective training of skilled birth attendants on non-pharmacological pain management, effective communication with clients and promoting women’s participation in decision-making regarding their care throughout the process of childbirth.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-2025-5) contains supplementary material, which is available to authorized users.

Individualization process of the standardized care plan in acute care hospitalization units: Study protocol

AIM

To understand the individualization process of the standardized care plan (SCP) that nurses design for hospitalized patients.

BACKGROUND

To apply the nursing process, it is advisable to use SCP to standardize the diagnosis, planning and evaluation stages. However, the fundamental element of this methodology is the individualization of the care plan.

DESIGN

A qualitative study, framed within the constructivist paradigm and applying the Grounded Theory method, in accordance with Strauss and Corbin's approach.

METHODS

Multicentre study. Theoretical sampling with maximum variation will be used. The data collection will consist of: in-depth individual interviews, participant observation, document analysis, focus group, and the questionnaires for Critical Thinking Assessment in relation to clinical practice and Nursing Competency Assessment for hospital nurses. The qualitative data will be analysed according to the constant comparative method of Strauss and Corbin's Grounded Theory, which involves performing open, axial and selective coding. The questionnaire results will be used to make a qualitative analysis that will consist of a triangulation between the level of critical thinking, level of expertise and record of the individualization process performed by the nurses. This protocol was approved in July 2015.

DISCUSSION

By knowing the possible stages used in the individualization of a SCP, together with the elements that facilitate or hinder said individualization and nurses' attitudes and experiences regarding this phenomenon, it could help direct improvement strategies in the standardization and individualization process. In addition to recommendations for teaching and research.

Patients' characteristics informing practice: improving individualized nursing care in the radiation oncology setting

PURPOSE

A large number of patients attend for radiotherapy daily. Primary nurses in the study settings aim to individualize care for their patients. The individual characteristics of patients may determine their perceptions of nursing care, and provide guidance in tailoring their care. This study aimed to assess patients' personal characteristics on their perceptions of individualized care (IC) provided by nurses during a course of radiotherapy, and to determine predictor variables that may inform nursing practice.

METHODS

This cross-sectional, exploratory study was conducted in three radiotherapy departments in Australia. Patients (n = 250) completed the Individualized Care Scale_Patient (ICS_P). Data were analyzed using descriptive and inferential statistics, univariate analysis, and multiple regression analysis.

RESULTS

Males reported significantly higher perceptions of IC than females in 7/9 subscales. Patients with head and neck and prostate cancer, as well as those requiring hospitalization during radiotherapy, scored significantly higher in 5/9 subscales. Courses > 30 days, those not receiving chemotherapy, and partnered patients reported greater IC across all subscales. Gender and hospitalization were the main predictor variables for IC.

CONCLUSION

Patients reported moderately high levels of IC during their radiotherapy; however, standard demographic information may provide limited insight into improving care for the individual. Patient characteristics routinely chosen, such as age, gender, and education may not predict how patients perceive their care or support the tailoring of interventions to improve IC. Researching a range of related patient characteristics may prove a more useful concept for future nursing studies aiming to predict outcomes to tailor nursing practice.