Khuan Lee, Juni Muhamad Hanafiah
Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Asian Nurs Res (Korean Soc Nurs Sci). 2017 Sep;11(3):216-222. doi: 10.1016/j.anr.2017.08.001. Epub 2017 Aug 14.
Advocates for societal change and consumerism have been instrumental in popularizing patient involvement in various aspects of health care. Patient involvement in bedside handovers during shift changes should facilitate patient-centered care. This study's purpose was to explore Malaysian nurses' opinions about patient involvement during bedside handovers, and whether patient involvement during bedside handovers reflected patient-centered care.
A qualitative study with four focus-group discussions was conducted with 20 registered nurses from general wards in a Malaysian public hospital. Semi-structured interviews were used to elicit participants' opinions. NVivo 10 software was used for data management and content analysis was used to analyze the data.
Several participants used inconsistent methods to involve patients in bedside handovers and others did not involve the patients at all. The participants' interpretations of the concept of patient-centered care were ambiguous; they claimed that patient involvement during bedside handovers was impractical and, therefore, not reflective of patient-centered care. Some nurses' subjective views of patient involvement as impractical during bedside handovers were manifested in their deliberate exclusion of patients from the handover process.
Changes in patient involvement and nursing practices congruent with patient-centered care require that nurse educators in hospital settings reform nursing education to focus on fostering of communication skills needed to function in nurse-patient partnerships. Guidelines for patient involvement consistent with patient-centered values should be developed using ward nurses' subjective views and introduced to all registered nurses in practice.
社会变革倡导者和消费主义者在推动患者参与医疗保健的各个方面发挥了重要作用。患者参与交接班时的床边交接应有助于以患者为中心的护理。本研究的目的是探讨马来西亚护士对床边交接时患者参与的看法,以及床边交接时的患者参与是否反映了以患者为中心的护理。
对一家马来西亚公立医院普通病房的20名注册护士进行了一项包含四次焦点小组讨论的定性研究。采用半结构化访谈来获取参与者的意见。使用NVivo 10软件进行数据管理,并采用内容分析法对数据进行分析。
一些参与者采用不一致的方法让患者参与床边交接,而其他参与者根本不让患者参与。参与者对以患者为中心的护理概念的理解含糊不清;他们声称患者参与床边交接不切实际,因此不能反映以患者为中心的护理。一些护士认为患者参与床边交接不切实际的主观观点体现在他们故意将患者排除在交接过程之外。
与以患者为中心的护理相一致的患者参与和护理实践的改变要求医院环境中的护士教育工作者改革护理教育,以专注于培养在护患伙伴关系中发挥作用所需的沟通技能。应利用病房护士的主观观点制定符合以患者为中心价值观的患者参与指南,并将其引入所有执业注册护士。