Nurs Res. 2023;72(6):421-429. doi: 10.1097/NNR.0000000000000680. Epub 2023 Aug 3.
Care delivery that is not person-centered has been called discordant care . There has been a shift to incorporate more of a person's narrative into their individual healthcare treatment plan to reduce discordant care. Aligning with this shift in healthcare delivery, we developed a person-centered narrative intervention (PCNI) to address existing gaps in delivery of person-centered care.
This study aimed to evaluate the feasibility of conducting a randomized study and describe the outcomes of PCNI to usual care on the following person (patient)-reported outcomes: perceptions of the quality of communication with their nurses and their psychosocial and existential well-being.
This study's design was an Obesity-Related Behavioral Intervention Trials model Phase II proof-of-concept randomized study. The participants were people admitted to an acute care hospital diagnosed with heart failure and/or end-stage renal disease.
Despite COVID-19 challenges, the PCNI was feasible in an acute care setting; it showed a moderate positive difference between conditions in the person's perception of their quality of communication and a small positive difference in their perception of feeling heard and understood. For our secondary outcomes of anxiety, depression, and psychosocial illness effect, there were small or no effects in the acute care setting.
Using a person-centered narrative, such as the PCNI, can help inform delivery of care that incorporates a person's (patient's) beliefs, values, and preferences into their healthcare. This study used a pragmatic approach to evaluate the PCNI in real time in an acute care setting to assess patient-reported outcomes. These positive results in a small sample indicate the need for continued testing of the PCNI. These promising effects require further testing in a Phase III efficacy study within a larger randomized controlled clinical trial.
非以患者为中心的医疗护理被称为不和谐护理。目前已经出现了一种转变，即将更多患者的个人叙事纳入其个人医疗保健治疗计划，以减少不和谐护理的发生。为了适应医疗服务提供方式的这一转变，我们开发了一种以患者为中心的叙事干预（PCNI），以解决提供以患者为中心的护理方面现存的差距。
本研究旨在评估开展随机研究的可行性，并描述 PCNI 对常规护理在以下患者（患者）报告结局方面的效果：对与护士沟通质量的感知，以及他们的心理社会和存在状况。
本研究设计为肥胖相关行为干预试验模型的 II 期概念验证随机研究。参与者为因心力衰竭和/或终末期肾病而被收入急性护理医院的人群。
尽管受到 COVID-19 的挑战，PCNI 在急性护理环境中是可行的；它在患者对沟通质量的感知方面显示出条件之间的中度积极差异，在他们感到被倾听和理解的感知方面显示出较小的积极差异。对于我们的次要结局，即焦虑、抑郁和心理社会疾病影响，在急性护理环境中几乎没有或没有效果。
使用以患者为中心的叙事，如 PCNI，可以帮助提供将患者（患者）的信念、价值观和偏好纳入其医疗保健的护理。本研究采用实用方法，实时在急性护理环境中评估 PCNI，以评估患者报告的结局。这些在小样本中得到的积极结果表明需要继续对 PCNI 进行测试。这些有希望的效果需要在更大的随机对照临床试验中进行 III 期疗效研究进一步测试。
