Jakimowicz Samantha, Stirling Christine, Duddle Maree
Faculty of Health, University of Technology, Sydney, Australia.
J Clin Nurs. 2015 Jan;24(1-2):19-33. doi: 10.1111/jocn.12676. Epub 2014 Sep 19.
To systematically review the qualitative evidence on factors that affect the experience of patients attending nurse-led clinics and compare with key elements of person-centred care.
As the number of nurse-led clinics increases in response to health system needs, evaluation has focused on clinical outcomes and cost. Patient experiences are less researched and yet, they are an important influence on clinical outcomes and an indicator of person-centred care. A detailed review of existing research in this area is needed.
A systematic review of primary, qualitative literature was conducted using the Joanna Briggs Institute methodology of meta-aggregation.
Published research from 1990-2012 was located using CINAHL, PubMed, Medline and PsycINFO. Reference lists were searched and analysed. Two reviewers assessed the papers for methodological quality using instruments from the Joanna Briggs Institute to critically appraise, extract data and meta-aggregate findings.
Eleven studies met all inclusion criteria. Three meta-synthesis statements were derived from 46 findings aggregated to nine categories. The key themes relating to establishment of a therapeutic relationship, effective communication, and clinical skills and collaboration mapped closely to the person-centred care framework.
Concepts central to person-centred care proved to be factors impacting patients' subjective experience. Further research is warranted to meet the challenge to transform the key concepts of the person-centred care model into everyday nursing practice.
Knowledge of patients' feelings and the importance of person-centred, individualised care may contribute to development of future training and re-training programs in basic nursing skills. This is significant in that it contributes to future positive patient experience.
系统回顾关于影响就诊于护士主导诊所的患者体验的因素的定性证据，并与以患者为中心的护理的关键要素进行比较。
随着为满足卫生系统需求而设立的护士主导诊所数量的增加，评估主要集中在临床结果和成本上。对患者体验的研究较少，然而，它们对临床结果有重要影响，并且是以患者为中心的护理的一个指标。需要对该领域的现有研究进行详细回顾。
采用乔安娜·布里格斯研究所的元聚合方法对原发性定性文献进行系统回顾。
使用CINAHL、PubMed、Medline和PsycINFO检索1990年至2012年发表的研究。对参考文献列表进行检索和分析。两名评审员使用乔安娜·布里格斯研究所的工具评估论文的方法学质量，以进行批判性评价、提取数据和对研究结果进行元聚合。
11项研究符合所有纳入标准。从汇总为9类的46项研究结果中得出了3条元综合陈述。与建立治疗关系、有效沟通以及临床技能与协作相关的关键主题与以患者为中心的护理框架密切相关。
以患者为中心的护理的核心概念被证明是影响患者主观体验的因素。有必要进行进一步研究，以应对将以患者为中心的护理模式的关键概念转化为日常护理实践的挑战。
了解患者的感受以及以患者为中心的个性化护理的重要性，可能有助于制定未来基础护理技能的培训和再培训计划。这很重要，因为它有助于未来患者获得积极的体验。
