| 1. |
- Farrell, Carole, et al.
(författare)
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Communication patterns in nurse-led chemotherapy clinics : A mixed-method study
- 2020
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 103:8, s. 1538-1545
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine patterns of nurse-patient communication in fulfilling patients' informational/psychosocial needs, effects of longer consultation/operational aspects on person-centred care experiences.METHODS: Mixed-method design; secondary analysis of transcripts of nurse-patient communication within nurse-led chemotherapy clinics in UK [3]. Purposive sampling (13 nurses); non-participant observations (61 consultations). Qualitative content analysis of audio-recorded transcripts. Quantitative analysis using the Medical Interview Aural Rating Scale [14] to compare mean differences in the number of cues and level of responding using one-way ANOVA, and correlational analyses of discursive spaces.RESULTS: Nurses responded positively to informational cues, but not psychosocial cues. Longer consultations associated with more informational and psychosocial cues (p < .0001), but not nurses' cue-responding behaviours. Four main themes emerged: challenges/opportunities for person-centred communication in biomedical contexts; patients' "life world" versus the "medical world"; three-way communication: nurse, patient and family; implications of continuity of care.CONCLUSIONS: The challenges/opportunities for cue-responding in nurse-led chemotherapy clinics were evident for informational and psychosocial support of patients. Shifting from a biomedical to biopsychosocial focus is difficult.PRACTICE IMPLICATIONS: Further evaluation is needed to integrate biopsychosocial elements into communication education/training. Careful planning is required to ensure continuity and effective use of time for person-centred care.
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| 2. |
- Krook, Maura, et al.
(författare)
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The discharge process : From a patient's perspective
- 2020
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Ingår i: Sage Open Nursing. - : SAGE Publications. - 2377-9608. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Inadequacy in discharge planning, preparation of readiness, and unplanned readmissions are closely linked and could cause misutilization of hospital services, creating higher costs to the health-care system. The information given before discharge is vital and of great importance for the well-being of the patient. The study's objective was to describe the patient's experience of their discharge process. A descriptive study was designed. Fifteen (n = 15) interviews with patients at one University Swedish hospital were held, and a qualitative content analysis was made from the collected data. The results show that accessibility, information, communication, confidence, and participation are pivotal in future development in the discharge process. The findings of this study indicate that in affirmation with the patient's experiences and desires, there is a great urgency for improvement in the discharge process. There is a need to focus on information and communication at discharge by initiating interaction from the nurses together with the doctors at a specific time in the discharge process. The discharge process needs to be more individualized and person-centered which could lead to better patient governance. Both accessibility and continuity need to be improved. The information given needs to be met with the patient's level of understanding.
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| 3. |
- Siouta, Eleni, et al.
(författare)
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Nurses' perceptions of patient involvement in shared decision-making in cardiovascular care
- 2023
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Ingår i: Heliyon. - 2405-8440. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- It is important for nurses to involve patients in their own care to enable shared decision-making. This study aimed to explore the perceptions of nurses regarding the degree to which involvement in shared decision-making takes place in clinical settings during consultations. Previous studies have shown that the use of shared decision-making by healthcare professionals can improve their caring practices and the quality of life of their patients. However, studies have also shown little evidence of the existence of shared decision-making in clinical practice. One step forward can be to clarify nurses' perceptions of patient involvement in shared decision-making. Qualitative data were collected from 10 nurses at four Swedish hospitals using a semi-structured, open-ended interview guide. The data were analyzed using inductive latent content analysis. The results showed that the care practices described by the nurses in the study are clearly different from the healthcare policy and scientific vision of shared decision-making. The nurses in the study believe that, with some exceptions, both healthcare professionals and patients prefer to leave decision-making to medical experts. In order to take advantage of the existing potential for improvement of shared decision-making in cardiologic care, healthcare professionals must be given time to seriously listen to and develop an interest in their patients' lifeworlds. Furthermore, the implementation of shared decision-making requires a mutual initiative and development of knowledge about the decision-making process from healthcare professionals and patients.
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| 4. |
- Siouta, Eleni, et al.
(författare)
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Patient Centeredness from a Perspective of History of the Present : A Genealogical Analysis
- 2020
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Ingår i: Global Qualitative Nursing Research. - : SAGE Publications. - 2333-3936 .- 2333-3936. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The overall aim of this study, performed in Sweden, was to problematize the contemporary national and transnational discourse on patient centeredness, which during recent decades has become a given, having become established as a dogma in conversations, writing, and thinking about patients and health care. We did that by showing that ideas such as patient centeredness can be seen differently from the way they are depicted in contemporary discourses about health care. In the presented analysis, we drew on Foucault's concepts of governmentality, 'history of the present' and genealogy. This means that we reflected on contemporary conceptions of how phenomena, such as the care seeker, have been constructed within other discourses about health care. Empirically, we used different health policy documents-government reports from three different historical periods. The analysis showed that contemporary narratives about centeredness are neither more, nor less, care seeker-centered than the narratives of yesteryear. Rather, the phenomenon of the care seeker is given different frames and meanings within the framework of different economic and historical discourses about health care. Our analysis raised questions about the contemporary construction of patient centeredness. In a world with such huge economic differences between nations, as well as between citizens within most nations, the contemporary discourse may be limited as it does not problematize structural issues in the same way as previous discourses had done. Perhaps what is needed today are national and international patient-centered or person-centered discourses which also discuss policies and practices that are population- and social group-centered. In the final discussion of the analysis, we identified a new patient-centered discourse, which views the patient as a resource among other resources. The most important limitation of this type of study is that it is only about discourses and policy issues and not about daily practical activities.
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