Cheraghi Mohammad Ali, Esmaeili Maryam, Salsali Mahvash
School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran.
Holist Nurs Pract. 2017 Nov/Dec;31(6):359-368. doi: 10.1097/HNP.0000000000000233.
Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician). Data obtained were analyzed according to the analysis stages of grounded theory and constant comparison to identify the concepts, context, and process of the study. The core category of this grounded theory is "humanizing care," which consisted of 4 interrelated phases, including patient acceptance, purposeful patient assessment and identification, understanding patients, and patient empowerment. A core category of humanizing care integrated the theory. Humanizing care was an outcome and process. Patient-centered care is a dynamic and multifaceted process provided according to the nurses' understanding of the concept. Patient-centered care does not involve repeating routine tasks; rather, it requires an all-embracing understanding of the patients and showing respect for their values, needs, and preferences.
以患者为中心的护理既是其本身的一个目标，也是改善健康结果的一种手段。然而，以患者为中心的护理在全球医疗服务中的应用是多种多样的。本文报道了一项旨在引入以患者为中心护理的研究。本研究的目的是探索重症监护病房提供以患者为中心护理的过程。该研究采用了扎根理论方法。在德黑兰医科大学的5个重症监护病房收集了数据。目的抽样和理论抽样指导了数据收集，对27名参与者（护士、患者和医生）进行了29次半结构化访谈。根据扎根理论的分析阶段和持续比较对获得的数据进行分析，以确定研究的概念、背景和过程。这个扎根理论的核心类别是“人性化护理”，它由4个相互关联的阶段组成，包括患者接纳、有目的的患者评估与识别、理解患者以及患者赋权。人性化护理这一核心类别整合了该理论。人性化护理既是一个结果，也是一个过程。以患者为中心的护理是一个动态的、多方面的过程，是根据护士对这一概念的理解提供的。以患者为中心的护理并不涉及重复常规任务；相反，它需要对患者有全面的理解，并尊重他们的价值观、需求和偏好。
