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医疗保健中的以……为中心:家庭本位医疗、个人本位医疗和儿童本位医疗的概念综合

Centeredness in Healthcare: A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care.

作者信息

Coyne Imelda, Holmström Inger, Söderbäck Maja

机构信息

School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.

School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.

出版信息

J Pediatr Nurs. 2018 Sep-Oct;42:45-56. doi: 10.1016/j.pedn.2018.07.001. Epub 2018 Jul 10.

Abstract

BACKGROUND

Increasingly within healthcare, different kind of 'centeredness' are used to denote the focus of care which can create confusion for practitioners.

METHODS

A concept analysis was undertaken to identify the antecedents, attributes and relationship between family-, person-, and child-centered care. PubMed and CINAHL were searched from 2012 to 2017 and thirty-five papers were reviewed.

RESULTS

Both person- and child-centered care are focused on individuals, a symmetric relationship and the tailoring of care to individual needs while family- centered care is focused on the family as a unit of which the child is included. Person-centered care focuses on an adult person with autonomy, while the focus in child-centered care is the individual child as an own actor with rights but still close to a family.

CONCLUSION

It appears at a conceptual level that the concepts of centeredness contain both similarities and differences. Finding ways to structure nursing and focus the care that respects a person's dignity and humanity is essential in healthcare and should be a major goal of health policy and health systems worldwide.

IMPLICATIONS

The identification of the antecedents and attributes embedded in the concepts may help raise professionals' awareness of the different foci and how this will influence one's practice. There is a need to recognize strengths and weaknesses of the centeredness in different settings and environments. Furthermore, it is important to know which approach to apply within different situations so that quality care is enabled for every person, child and family.

摘要

背景

在医疗保健领域,越来越多地使用不同类型的“以……为中心”来表示护理重点,这可能会给从业者带来困惑。

方法

进行了一项概念分析,以确定以家庭为中心、以个人为中心和以儿童为中心的护理之间的前因、属性和关系。检索了2012年至2017年期间的PubMed和CINAHL数据库,并对35篇论文进行了综述。

结果

以个人为中心和以儿童为中心的护理都关注个体、对称关系以及根据个体需求提供个性化护理,而以家庭为中心的护理则将家庭作为一个整体,儿童是其中的一部分。以个人为中心的护理关注具有自主性的成年人,而以儿童为中心的护理重点是作为具有权利但仍与家庭关系密切的独立个体的儿童。

结论

在概念层面上,“以……为中心”的概念既有相似之处,也有不同之处。在医疗保健中,找到构建护理结构并专注于尊重人的尊严和人性的护理方法至关重要,这应该是全球卫生政策和卫生系统的主要目标。

启示

识别概念中包含的前因和属性可能有助于提高专业人员对不同重点的认识以及这将如何影响其实践。有必要认识到在不同环境中“以……为中心”的优势和劣势。此外,了解在不同情况下应采用哪种方法很重要,以便为每个人、儿童和家庭提供高质量的护理。

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