Impact Of Person-centred Care Research Articles

Exploring person-centred care in relation to resource utilization, resident quality of life and staff job strain \u2013 findings from the SWENIS study

BackgroundA critical challenge facing elderly care systems throughout the world is to meet the complex care needs of a growing population of older persons. Although person-centred care has been advocated as the “gold standard” and a key component of high-quality care, the significance of care utilisation in person-centred units as well as the impact of person-centred care on resident quality of life and staff job strain in nursing home care has yet to be explored.The aim of this study was to explore person-centred care and its association to resource use, resident quality of life, and staff job strain.DesignA cross-sectional national survey.MethodsData on 4831 residents and 3605 staff were collected by staff working in nursing homes in 35 randomly selected Swedish municipalities in 2014. Descriptive statistics and regression modelling were used to explore associations between person-centred care and resource use, resident quality of life, and staff job strain.ResultsNo association was found between person-centred care and resource use. Person-centred care was positively associated with resident quality of life and was negatively associated with staff perception of job strain.ConclusionPerson-centred care does not increase resource utilisation in nursing homes, but beneficially impacts resident quality of life and alleviates the care burden in terms job strain among staff.

PERSON-CENTERED CARE RELATED TO RESOURCE USE, RESIDENT QUALITY OF LIFE, AND STAFF JOB STRAIN IN SWEDISH NURSING HOMES

A critical challenge facing aged care systems throughout the world is to meet the complex care needs of a growing population of older persons. Although person-centred care has been advocated as the “gold standard” and a key component of high quality of care, the significance of care utilization in person-centred units as well as the impact of person-centred care on resident quality of life and staff job strain in nursing home care is yet to be explored. Thus, the aim was to explore person-centred care and its association to resource use, resident quality of life and staff job strain. The study is based on a cross-sectional national survey and data on 4831 residents and 3605 staff were collected by staff in 2014, deriving from nursing homes in 35 Swedish municipalities. In this study, descriptive statistics and regression modelling were used to explore this association. The preliminary results showed that person-centred care was positively associated to resource use (i.e care hours) and resident quality of life in Swedish nursing homes, when controlling for resident age, gender and cognitive status. Person-centred care was negatively associated to staff perception of job strain. This indicates that person-centred care provision seem to increase resource use (i.e. slightly more care hours utilized) but also beneficially impact resident quality of life as well as alleviate care burden in terms job strain among staff.

Person‐centred inpatient care – A quasi‐experimental study in an internal medicine context

The aim of this study was to evaluate effects of person-centred inpatient care on care processes in terms of satisfaction with care and person-centred content in medical records, and to evaluate effects on self-reported health and self-efficacy. Internal medicine inpatient care is complex, covering patients varying in age, medical conditions, health status, and other aspects. There has been limited research on the impact of person-centred care (PCC) on satisfaction with care and health outcomes in internal medicine care environments regardless of diagnosis and care pathway. A quasi-experimental study with pre- and postmeasurements. Adult patients admitted to an internal medicine inpatient unit were consecutively included over 16weeks in 2014 and 24weeks in 2015-2016. Data were collected before a person-centred inpatient care intervention (N=204) and 12months after the intervention was implemented (N=177). Data on satisfaction with care and self-reported health were collected at discharge and medical records were reviewed. The intervention included systematically applied person-centred assessment, health plans, and persistent PCC. After the intervention, patients rated higher satisfaction with care regarding essential components of PCC and more patients had received effective pain relief. There were no differences in information on self-care or medications, self-rated health, or self-efficacy. Care focused on the foundations of person-centredness seems to enhance both patients' perceptions of satisfaction and symptom management. Situational aspects such as care pathways should be considered when implementing person-centred inpatient care. CLINICALTRIALS. NCT03725813.

The impact of person-centred care on patients' care experiences in relation to educational level after acute coronary syndrome: secondary outcome analysis of a randomised controlled trial.

Research supporting the benefits of person-centred care is growing, still knowledge about patients' experiences of person-centred care is limited. To evaluate the effects of person-centred care on patients' experiences of care, and also in relation to educational level, after an acute coronary syndrome. A total of 199 patients aged less than 75 years, hospitalised for acute coronary syndrome, were randomly assigned to either standard cardiac care ( n=105) or person-centred care plus standard cardiac care ( n=94). Experience of care was assessed at three healthcare settings (hospital, outpatient and primary care) using the 15-item Picker patient experience questionnaire plus two questions concerning information and documentation. No significant difference was found at the three healthcare settings between the two study groups in the Picker patient experience questionnaire total score. Item level analysis showed that the person-centred care group significantly improved at all three healthcare settings on information received and in documentation of care compared with the standard cardiac care group ( P<0.05). In outpatient care, the person-centred care group reported significantly better family-physician communication ( P=0.004) and information for the family ( P=0.007) compared with the standard cardiac care group. In patients without postsecondary education, the corresponding figures were even more in favour of the person-centred care group ( P=0.0005 and P=0.0049, respectively), and they also reported higher involvement in care decisions ( P=0.023). A person-centred care approach after an event of acute coronary syndrome improves patients' care experiences for information, shared documentation and involvement of family and friends. This effect was especially prominent in patients with a low educational level, who were also more involved in care decisions. Swedish registry, Researchweb.org , ID NR 65 791.

Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care

Many patients with chronic heart failure (CHF) experience uncertainty regarding the treatment and characteristics of their illness. Person-centred care (PCC) emphasizes patient involvement in care. We have previously shown that PCC improved outcomes such as length of hospital stay and activities of daily living in patients with CHF. The impact of PCC on self-reported uncertainty in illness among patients hospitalized for CHF is still unknown. To evaluate whether PCC is associated with less self-reported uncertainty in illness compared with usual care in patients hospitalized for worsening CHF. Using a controlled before-and-after design, eligible CHF patients were assigned to either a usual care group or a PCC intervention group. Patient-reported uncertainty in illness was assessed at hospital discharge with the Cardiovascular Population Scale (CPS). The CPS consists of two domains: 1) Ambiguity (about illness severity); and 2) Complexity (of treatment and system of care). Two hundred and forty-eight patients were included in the study; 123 in the usual care group and 125 in the PCC intervention. The PCC group had better scores than the usual care group in the CPS domains complexity (M=15.2, SD=4.7 vs. M=16.8, SD=4.7; p=0.020) and ambiguity (M=27.8, SD=6.6 vs. M=29.8, SD=6.9; p=0.041). Patients with CHF were less uncertain in their illness after PCC, which may help to equip and empower patients to manage their illness. Together with earlier findings of shortened hospital stay and improved activities of daily living, this indicates that PCC should be a standard approach for hospital care of patients with worsening CHF.