a Daphne Cockwell School of Nursing , Ryerson University.
b Centre for Health & Social Care Research , Kingston University & St George's, University of London.
Health Commun. 2018 Jun;33(6):716-723. doi: 10.1080/10410236.2017.1306476. Epub 2017 Apr 12.
There is limited evidence of the extent to which Healthcare professionals implement patient-centered care (PCC) and of the factors influencing their PCC practices in acute care organizations. This study aimed to (1) examine the practices reported by health professionals (physicians, nurses, social workers, other healthcare providers) in relation to three PCC components (holistic, collaborative, and responsive care), and (2) explore the association of professionals' characteristics (gender, work experience) and a contextual factor (caseload), with the professionals' PCC practices. Data were obtained from a large scale cross-sectional study, conducted in 18 hospitals in Ontario, Canada. Consenting professionals (n = 382) completed a self-report instrument assessing the three PCC components and responded to standard questions inquiring about their characteristics and workload. Small differences were found in the PCC practices across professional groups: (1) physicians reported higher levels of enacting the holistic care component; (2) physicians, other healthcare providers, and social workers reported implementing higher levels of the collaborative care component; and (3) physicians, nurses, and other healthcare providers reported higher levels of providing responsive care. Caseload influenced holistic care practices. Interprofessional education and training strategies are needed to clarify and address professional differences in valuing and practicing PCC components. Clinical guidelines can be revised to enable professionals to engage patients in care-related decisions, customize patient care, and promote interprofessional collaboration in planning and implementing PCC. Additional research is warranted to determine the influence of professional, patient, and other contextual factors on professionals' PCC practices in acute care hospitals.
医护人员实施以患者为中心的护理(PCC)的程度及其在急症护理机构中影响其 PCC 实践的因素的证据有限。本研究旨在:(1)检查卫生专业人员(医生、护士、社会工作者、其他医疗保健提供者)在三个 PCC 成分(整体、协作和响应性护理)方面报告的实践;(2)探讨专业人员特征(性别、工作经验)和背景因素(工作量)与专业人员 PCC 实践的关联。数据来自于在加拿大安大略省的 18 家医院进行的一项大型横断面研究。同意参与的专业人员(n=382)完成了一份自我报告工具,评估了三个 PCC 成分,并回答了有关其特征和工作量的标准问题。在专业群体之间的 PCC 实践中发现了一些微小的差异:(1)医生报告了更高水平的实施整体护理成分;(2)医生、其他医疗保健提供者和社会工作者报告了更高水平的协作护理成分;(3)医生、护士和其他医疗保健提供者报告了更高水平的提供响应性护理。工作量影响整体护理实践。需要开展跨专业教育和培训策略,以澄清和解决在重视和实践 PCC 成分方面的专业差异。可以修订临床指南,使专业人员能够使患者参与护理相关决策、定制患者护理,并促进规划和实施 PCC 方面的跨专业合作。需要进一步研究,以确定专业、患者和其他背景因素对急症护理医院专业人员 PCC 实践的影响。