School of Nursing, Ulster University, Newtownabbey, United Kingdom of Great Britain and Northern Ireland.
J Clin Nurs. 2022 Oct;31(19-20):2921-2934. doi: 10.1111/jocn.16119. Epub 2021 Nov 10.
Exploring the influence of the 100% single-room environment on staff and patient experience of person-centred practice in an acute-care setting.
Current building guidance for the NHS advocates increasing the single-room inpatient environment. There is little evidence of the impact of this design in adult acute-care settings on the experience and delivery of person-centred care.
Ethnography, underpinned by McCormack and McCance's Person-centred Practice Framework.
Data collection took place between March and June 2018. Staff and patients in a National Health Service hospital in the United Kingdom took part in observations of practice (n = 108 hours); face to face inpatient interviews (n = 9); and participatory reflective staff groups (n = 3). A reflexive journal was kept by the researcher throughout the study. Reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Themes relating to care delivery and interactions were identified. Staff and patients' views converged around visibility and isolation. Patients appreciated the privacy afforded by the single rooms, while staff experienced a psychological shift, being viewed (and viewing themselves) as 'visitors'. There was space for more sympathetic presencing, encouraging patients to speak more openly, to facilitate knowing and authentic engagement. However, time remained an issue resulting in more task-focused care.
Changes to the physical environment have an impact on the delivery and experience of person-centred practice. While the facilities enhance patient experience, the interweaving of engagement, emotional support and the development of therapeutic relationships remain challenging.
探索 100%单人房环境对以患者为中心的实践在急性护理环境中的员工和患者体验的影响。
英国国民保健制度目前的建筑指南提倡增加单人病房住院环境。在成人急性护理环境中，这种设计对以患者为中心的护理的体验和提供的影响几乎没有证据。
受 McCormack 和 McCance 的以人为中心的实践框架的支持的民族志。
数据收集于 2018 年 3 月至 6 月进行。英国国民保健制度医院的工作人员和患者参与了实践观察（108 小时）；面对面的住院患者访谈（9 次）；和参与性反思员工小组（3 次）。研究人员在整个研究过程中都保留了一份反思日记。报告符合定性研究报告的统一标准（COREQ）检查表。
确定了与护理提供和互动相关的主题。工作人员和患者的观点在可见性和隔离方面趋于一致。患者欣赏单人房提供的隐私，而工作人员则经历了一种心理转变，被视为（并将自己视为）“访客”。有更多的同情存在的空间，鼓励患者更开放地说话，促进了解和真实的参与。然而，时间仍然是一个问题，导致更多以任务为中心的护理。
物理环境的变化会对以患者为中心的实践的提供和体验产生影响。虽然这些设施提高了患者的体验，但参与、情感支持和治疗关系的发展仍然具有挑战性。
