Brown Michael, Chouliara Zoë, MacArthur Juliet, McKechanie Andrew, Mack Siobhan, Hayes Matt, Fletcher Joan
Edinburgh Napier University, NHS Lothian, Edinburgh, UK.
Learning Disability Service, NHS Lothian, Edinburgh, UK.
J Clin Nurs. 2016 Apr;25(7-8):972-82. doi: 10.1111/jocn.13142. Epub 2016 Feb 11.
To investigate the experiences of patients with intellectual disabilities, family and paid carers regarding the role of liaison nurses and the delivery of compassionate, person-centred care. From this to propose a model of person-centred care embedded in these experiences.
People with intellectual disabilities have a high number of comorbidities, requiring multidisciplinary care, and are at high risk of morbidity and preventable mortality. Provision of compassionate, person-centred care is essential to prevent complications and avoid death.
A qualitative design was adopted with Interpretative Phenomenological Analysis for data analysis.
Semistructured interviews and focus groups were conducted. Data were analysed with a focus on compassionate, person-centred care elements and components. Themes were modelled to develop a clinically meaningful model for practice.
Themes identified vulnerability, presence and the human interface; information balance; critical points and broken trust; roles and responsibilities; managing multiple transitions; 'flagging up' and communication.
The findings provide the first 'anatomy' of compassionate, person-centred care and provide a model for operationalising this approach in practice. The applicability of the model will have to be evaluated further with this and other vulnerable groups.
This is the first study to provide a definition of compassionate, person-centred care and proposes a model to support its application into clinical practice for this and other vulnerable groups.
调查智障患者、家属及付费护理人员对于联络护士的角色以及提供富有同情心的、以患者为中心的护理的体验。据此提出一个基于这些体验的以患者为中心的护理模式。
智障患者共病情况较多,需要多学科护理,且发病和可预防死亡风险较高。提供富有同情心的、以患者为中心的护理对于预防并发症和避免死亡至关重要。
采用质性设计,运用诠释现象学分析法进行数据分析。
开展半结构式访谈和焦点小组讨论。分析数据时重点关注富有同情心的、以患者为中心的护理要素和组成部分。对主题进行建模,以开发一个具有临床意义的实践模型。
确定的主题包括脆弱性、陪伴及人际互动;信息平衡;关键点与信任破裂;角色与责任;应对多次转变;“标记”与沟通。
研究结果首次剖析了富有同情心的、以患者为中心的护理,并提供了一个在实践中实施该方法的模型。该模型的适用性还需在这一群体及其他弱势群体中进一步评估。
这是第一项为富有同情心的、以患者为中心的护理提供定义并提出一个模型以支持其在这一群体及其他弱势群体临床实践中应用的研究。