School of Nursing, Takarazuka University, Osaka, Japan.
Faculty of Letters, Teikyo University, Tokyo, Japan.
Int J Rheum Dis. 2023 Sep;26(9):1779-1787. doi: 10.1111/1756-185X.14828. Epub 2023 Jul 15.
To investigate nurses' opinions and practices regarding psychological support and patient-centered care (PCC) for patients with rheumatoid arthritis.
Registered nurses engaged in rheumatic care in Japan were asked to complete the questionnaire regarding nurses' perceived necessity, understanding, and implementation of psychological support, and six patient supports related to PCC, using a seven-point Likert scale. Correlation on practice between psychological support and PCC was evaluated.
A total of 53 nurses participated. Nurses indicated high necessity of providing psychological support, whereas implementation was statistically significantly lower than necessity and motivation. Nurses' answers showed significantly lower implementation compared with understanding regarding basic concepts of psychological support: listening, empathy, acceptance, open questions, and closed questions. Most nurses (54.7%) sometimes provided psychological support, followed by often (34.0%), always (5.7%), and not at all (5.6%). Perceived necessity of PCC was rated high. However, its implementation was significantly lower than necessity for all evaluated cares, such as patients' need-based support and support to patients' families, related to PCC. Positive correlations were observed between the implementation of psychological support and PCC. Nurses stressed the importance of psychological support for patient education and shared decision-making.
This preliminary study indicated that most nurses considered psychological support and PCC necessary, but their implementation was relatively low. As psychological support is also crucial to shared decision-making, in addition to PCC, barriers to its implementation should be addressed to improve patients' outcomes and quality of life.
调查护士对类风湿关节炎患者心理支持和以患者为中心的护理（PCC）的意见和实践。
要求在日本从事风湿护理的注册护士使用七点 Likert 量表完成关于护士对心理支持的感知必要性、理解和实施以及与 PCC 相关的六项患者支持的问卷。评估心理支持与 PCC 之间实践的相关性。
共有 53 名护士参与。护士表示提供心理支持的必要性很高，而实施情况在统计学上显著低于必要性和动机。与心理支持的基本概念（倾听、同理心、接受、开放式问题和封闭式问题）相比，护士的回答显示出理解与实施之间存在显著差异。大多数护士（54.7%）偶尔提供心理支持，其次是经常（34.0%）、总是（5.7%）和从不（5.6%）。对 PCC 的必要性感知评分较高。然而，其实施情况在所有评估的护理中均显著低于必要性，例如与 PCC 相关的患者基于需求的支持和对患者家属的支持。心理支持与 PCC 的实施之间存在正相关。护士强调心理支持对患者教育和共同决策的重要性。
这项初步研究表明，大多数护士认为心理支持和 PCC 是必要的，但实施情况相对较低。由于心理支持对于共同决策也很重要，除了 PCC 之外，还应解决其实施的障碍，以改善患者的结果和生活质量。
