Patient-Provider-Relationship in the Hospital Care of the Elderly—A Qualitative, Multi-Perspective Study

Abstract

For many years, there has been a growing demand for patient-centered care in inpatient settings, but a lack of clear consensus on how to exactly implement such programs. The main aim of this study was to analyze patient-centered care in the acute-care setting in a multidimensional manner from the perspectives of elderly patients, their relatives, and an independent observer. A multi-method design was used to capture the three perspectives. Passive observations and post-situational interviews with patients were integrated with semi-structured interviews with patients and their relatives. 18 elderly patients and their relatives (n = 8) were recruited on wards for internal medicine of six hospitals. The data show significant deficits in patient-centered care in the acute-care setting. Although individual patients have different needs, certain categories of deficits emerge as universally relevant, one being the patient-provider-relationship. Patients express a desire for more frequent contact with the hospital staff. Access to doctors and nurses is particularly limited at night and on weekends. The patients are aware of these limitations and often do not draw attention to their own needs to reduce the workload on the staff. The wishes and needs of patients are not always adequately addressed. However, patients, relatives and the independent observer take positive notice of some employees because of their patient-centered attitude. The results show that there is still a need for improvement of patient-centered care. Participants from all three perspectives described differences between employees within the same institutional setting. This finding suggests that patient-centered care strongly depends on the personality of the individual caregiver.