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- Ekman, Nina, et al.
(författare)
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A state-of-the-art review of direct observation tools for assessing competency in person-centred care
- 2020
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 109
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Direct observation is a common assessment strategy in health education and training, in which trainees are observed and assessed while undertaking authentic patient care and clinical activities. A variety of direct observation tools have been developed for assessing competency in delivering person-centred care (PCC), yet to our knowledge no review of such tools exists.OBJECTIVE: To review and evaluate direct observation tools developed to assess health professionals' competency in delivering PCC.DESIGN: State-of-the-art review DATA SOURCES: Electronic literature searches were conducted in PubMed, ERIC, CINAHL, and Web of Science for English-language articles describing the development and testing of direct observation tools for assessing PCC published until March 2017.REVIEW METHODS: Three authors independently assessed the records for eligibility. Duplicates were removed and articles were excluded that were irrelevant based on title and/or abstract. All remaining articles were read in full text. A data extraction form was developed to cover and extract information about the tools. The articles were examined for any conceptual or theoretical frameworks underlying tool development and coverage of recognized PCC dimensions was evaluated against a standard framework. The psychometric performance of the tools was obtained directly from the original articles.RESULT: 16 tools were identified: five assessed PCC holistically and 11 assessed PCC within specific skill domains. Conceptual/theoretical underpinnings of the tools were generally unclear. Coverage of PCC domains varied markedly between tools. Most tools reported assessments of inter-rater reliability, internal consistency reliability and concurrent validity; however, intra-rater reliability, content and construct validity were rarely reported. Predictive and discriminant validity were not assessed.CONCLUSION: Differences in scope, coverage and content of the tools likely reflect the complexity of PCC and lack of consensus in defining this concept. Although all may serve formative purposes, evidence supporting their use in summative evaluations is limited. Patients were not involved in the development of any tool, which seems intrinsically paradoxical given the aims of PCC. The tools may be useful for providing trainee feedback; however, rigorously tested and patient-derived tools are needed for high-stakes use.
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| 2. |
- Ekman, Nina, et al.
(författare)
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Observable indicators of person-centred care: an interview study with patients, relatives and professionals
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Objective To identify key observable indicators of person-centred care (PCC) from interviews with patients, relatives and professionals with experience of receiving or working with PCC. Design A qualitative interview study using deductive content analysis. Setting Primary and hospital care settings in Western Sweden. Participants Twelve participants with extensive experience of receiving or working with PCC were interviewed: two patients, two patients representative with long-term conditions, one relative and informal carer, three registered nurses, one physician, two occupational therapists and one social worker/researcher. Results Nine observable indicators were identified and subsumed under three predetermined categories: initiating, working and safeguarding the partnership. The first category comprised three subcategories: welcoming, interested and courteous reception; agreeing on structure and aims of the conversation; and eliciting patients' wishes for involvement of significant others. The second category comprised four subcategories: attentive, empathic and encouraging manner; promoting mutual understanding; promoting patient engagement; and encouraging and friendly body language. The last category consisted of two subcategories: collaboration and transparency in documentation and verifying that patient's and professional's views, goals and wants are correctly documented. Conclusion Our results underline the need for health professionals to actively and conscientiously convey to patients their interest in and respect for the patient as a person and their willingness to collaborate as partners in their care from the very outset of the interaction. Non-verbal behaviours were seen to play a major role in shaping patients' impressions of health professionals. Given that patients' first impressions were considered to impact the content, course and outcomes of the interaction, more research attention should be given to their implications for the effective delivery of PCC.
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| 3. |
- Hansson, Malin, 1975, et al.
(författare)
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Work situation and professional role for midwives at a labour ward pre and post implementation of a midwifery model of care - A mixed method study
- 2020
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Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2631. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo). Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n=16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n=58). Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives-Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives-An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses. Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations.
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| 4. |
- Jakobsson, Sofie, 1968, et al.
(författare)
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Self-rated health over a two-year period after breast cancer surgery : prospective ratings and retrospective rating by means of a health-line
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are difficulties in clinical assessment of patients' health, and there is a need for evaluating instruments that measures self-rated health over time and that are based on the patient's own experiences of their health situation.AIM: To describe the trajectory of self-rated health given in a retrospective health-line and its correspondence with the ratings of health given at six different time points during 2 years following a first breast cancer surgery.DESIGNS AND METHODS: An explorative prospective cohort study presented according to the STROBE guideline. At six time points, 459 women (26-63 years) completed assessments of self-rated health during 2 years following a first breast cancer surgery. Subsequently, the women retrospectively rated health month by month over the two years by means of a health-line. The women were included consecutively in 2007-2009, last data collection was performed in 2012. Statistical analyses were used to compare the health-line with previous ratings.RESULTS: Most women (74-88%) rated their health as good, very good or excellent at all six time points. Health-line ratings were somewhat lower than the ratings made at the actual time-point; however, the illustrated trajectories back in time followed the same patterns as the women had reported during the two years. The lowest ratings of self-rated health were reported at four months after surgery. The retrospective illustrations varied greatly, and poorer health was reported by women undergoing chemotherapy, with lower education and who reported more life events.CONCLUSIONS: Even if the retrospective ratings by the health-line were somewhat lower than the ratings at the actual time-point, the health-line captures the health trajectory. The individual graphic illustration by means of a health-line may serve as a basis for assessment and support patient health narratives. The findings indicate that life event, lower education and chemotherapy influence concurrent and retrospective self-assessment of health.
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