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无论如何,中心是谁的?在护理中定义以人(患者)为中心的护理:综合评价。

Whose centre is it anyway? Defining person-centred care in nursing: An integrative review.

机构信息

Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia.

出版信息

PLoS One. 2020 Mar 10;15(3):e0229923. doi: 10.1371/journal.pone.0229923. eCollection 2020.

Abstract

AIM

The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice.

METHOD/DATA SOURCES: An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context.

REVIEW METHODS

The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis.

RESULTS

While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service.

CONCLUSION

The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.

摘要

目的

本次文献回顾的目的是更好地理解当前关于以患者为中心的护理(PCC)的文献,并确定与护理实践相关的 PCC 的明确定义。

方法/数据来源:采用综合文献回顾方法,检索 The Cumulative Index to Nursing and Allied Health Literature(CINAHL)、Medline、Scopus 和 Pubmed 数据库。限制条件为英语语言、1998 年至 2018 年期间发表的全文文章、澳大利亚、新西兰、加拿大、美国、欧洲、爱尔兰和英国的文章。然后,将 PCC 的国际背景与澳大利亚的背景具体相关联。

审查方法

该综述采用主题分析方法,参考 PCC 的概念对主题进行分类和总结。审查过程还遵循了 Meta 分析的首选报告系统(PRISMA)和应用批判性评估技能计划(CASP)工具,以确保纳入的论文质量进行更深入的分析。

结果

虽然存在 PCC 的定义,但在护理行业中没有普遍使用的定义。本次审查发现了三个有助于理解和实践 PCC 的核心主题,即人、实践和权力。本综述揭示了 PCC 的概念与术语的操作之间的错位;这种错位在实践层面以及医疗服务的微观、中观和宏观层面都有发现。

结论

PCC 的概念为护士所熟知,但定义不明确且难以付诸实践。PCC 可能因其明显的修辞性质而受到阻碍,需要进一步研究如何通过其衡量和报告结果来重视和操作 PCC。对文献的调查发现了许多 PCC 的定义,但没有一个被普遍接受和使用的定义。因此,PCC 仍然具有概念性,导致在医疗保健系统和护理服务中如何解释和操作 PCC 存在差异。

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