Lor Maichou, Crooks Natasha, Tluczek Audrey
University of Wisconsin-Madison, School of Nursing, Madison, WI.
University of Wisconsin-Madison, School of Nursing, Madison, WI.
Nurs Outlook. 2016 Jul-Aug;64(4):352-366. doi: 10.1016/j.outlook.2016.02.006. Epub 2016 Mar 8.
For decades person-, patient-, family-centered, and culturally competent care models have been evolving and conceptualized in the literature as separate. To our knowledge, there has not been a systematic approach to comparing all four of these conceptual models of care.
To explicate and compare four conceptual care models: person-, patient-, family-centered, and culturally competent care.
A comparative concept analysis informed by Rogers' evolutionary concept analysis was used to compare 32 nursing research on person-, patient-, family-centered care, and culturally-competent care published between 2009 and 2013.
Collective results of analyses of 32 nursing research articles found 12 attributes: collaborative relationship, effective communication, respectful care, holistic perspective, individualized care, inter-professional coordination, self-awareness, empowerment, family as unit of care, interpersonal relationships, cultural knowledge, and cultural skills. Antecedents included: lack of empirical evidence, poor patient outcomes, implementation problems, knowledge deficits, patient/parent emotional distress, poor patient-provider relationships, and health disparities. Consequences included: improved health-related outcomes, increased satisfaction, enhanced patient/family-provider relationships, reduced hospitalization, improved quality of life, improved quality of parent-child relationships, increased trust, enrollment in research, insights about biases, and appreciation for cultural differences. Social justice, advocated by scholars and national organizations, was absent from all studies.
Findings informed the proposed blended conceptual care framework that embraces the attributes of each care model and includes social justice.
几十年来，以人、患者、家庭为中心以及具有文化胜任力的护理模式在文献中各自独立发展并形成概念。据我们所知，尚未有系统的方法来比较这四种护理概念模式。
阐述并比较四种护理概念模式：以人、患者、家庭为中心以及具有文化胜任力的护理。
采用基于罗杰斯进化概念分析的比较概念分析方法，对2009年至2013年间发表的32项关于以人、患者、家庭为中心的护理以及具有文化胜任力的护理的护理研究进行比较。
对32篇护理研究文章的分析结果共发现12个属性：合作关系、有效沟通、尊重护理、整体视角、个性化护理、跨专业协作、自我意识、赋权、以家庭为护理单位、人际关系、文化知识和文化技能。先行因素包括：缺乏实证证据、患者预后不佳、实施问题、知识不足、患者/家长情绪困扰、医患关系不佳以及健康差异。结果包括：改善与健康相关的结局、提高满意度、增进患者/家庭与医护人员的关系、减少住院时间、改善生活质量、改善亲子关系质量、增加信任、参与研究、洞察偏见以及欣赏文化差异。所有研究均未提及学者和国家组织倡导的社会正义。
研究结果为所提出的融合概念护理框架提供了依据，该框架包含每种护理模式的属性并纳入了社会正义。
