Aragon Stephen J, Sherrod Dennis R, Mcguinn Laura J, Gesell Sabina B
Department of Healthcare Management, Winston-Salem State University, Winston-Salem, North Carolina.
Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma.
J Best Pract Health Prof Divers. 2018 Fall;11(2):123-134.
Along with clinical technical competence, nurses' interpersonal ability influences patient outcomes. Patient-centeredness, "[p]roviding care that is respectful of, and responsive to, individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions" (IOM, 2001, p. 3), is especially important in assuring that African-American Medicare patients achieve the desired outcomes.
This study was designed to measure the effects of nursing patient-centeredness on African-American female Medicare hospital inpatients across national random test and cross-validation samples; specifically, on their experience-of-care, likelihood of recommending the hospital, and ratings of care. The stability of effects was assessed across samples and a competing model challenge further tested the hypothesis.
Nursing patient-centeredness improves African-American female Medicare hospital patients' experience-of-care and increases the likelihood that they will recommend and highly rate their care.
Supporting the hypothesis, the model fit. Nursing patient-centeredness significantly influenced African-American female Medicare hospital patients' experience-of-care, likelihood of recommending the hospital, and ratings of care (χ = 39.35, = 42, = .588; RMSEA = .000, =.982 CL90% = .000-.043; CFI = 1.000), explaining 71% of the variance of patients' experience-of-care ( < .001). A unit increase in nursing patient-centeredness increased patients' experience-of-care, likelihood of recommending the hospital, and ratings of hospital care by .842, .778, and .798 standardized units, respectively. These results were stable across both the test and cross-validation samples, and the hypothesized model was sustained when compared to the hypothesized competing model (χΔ = 10.974, = 16, = .811).
Nursing performance is often chiefly associated with clinical or technical competence. Patient-centeredness concerns nurses' ability that affects the quality of their interaction with patients and concomitant outcomes. This study provided empirical evidence that nursing patient-centeredness significantly improves African-American female Medicare hospital patients' experience-of-care and increases the likelihood that they will recommend and highly rate their care.
除临床技术能力外，护士的人际能力也会影响患者的治疗结果。以患者为中心，即“提供尊重并响应患者个人偏好、需求和价值观的护理，并确保患者价值观指导所有临床决策”（医学研究所，2001年，第3页），对于确保非裔美国医疗保险患者取得理想治疗结果尤为重要。
本研究旨在通过全国随机测试和交叉验证样本，衡量以患者为中心的护理对非裔美国女性医疗保险住院患者的影响；具体而言，是对她们的护理体验、推荐医院的可能性以及护理评分的影响。跨样本评估了效果的稳定性，并通过一个竞争模型挑战进一步检验了假设。
以患者为中心的护理可改善非裔美国女性医疗保险住院患者的护理体验，并增加她们推荐医院并给予高护理评分的可能性。
该模型拟合，支持了假设。以患者为中心的护理显著影响了非裔美国女性医疗保险住院患者的护理体验、推荐医院的可能性以及护理评分（χ = 39.35，自由度 = 42，效应量 = 0.588；近似误差均方根 = 0.000，拟合优度指数 = 0.982，90%置信区间 = 0.000 - 0.043；比较拟合指数 = 1.000），解释了患者护理体验方差的71%（P < 0.001）。以患者为中心的护理每增加一个单位，患者的护理体验、推荐医院的可能性以及医院护理评分分别增加0.842、0.778和0.798个标准化单位。这些结果在测试样本和交叉验证样本中均稳定，并且与假设的竞争模型相比，假设模型得以维持（χ变化量 = 10.974，自由度 = 16，效应量 = 0.811）。
护理表现通常主要与临床或技术能力相关。以患者为中心涉及护士影响其与患者互动质量及相应结果的能力。本研究提供了实证证据，表明以患者为中心的护理显著改善了非裔美国女性医疗保险住院患者的护理体验，并增加了她们推荐医院并给予高护理评分的可能性。
