• Title/Summary/Keyword: Patient-Centered care

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Academic Medicine Is Patient-Centered Medicine (Academic Medicine은 환자 중심 의료이다)

  • An, Shinki
    • Korean Medical Education Review
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    • v.21 no.2
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

Development of Patient-Centered Healthcare Services Evaluation Scale (환자중심 의료서비스 평가도구 개발)

  • Lee, So Ra;Yang, Nam Young
    • Journal of Home Health Care Nursing
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    • v.27 no.2
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    • pp.198-209
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    • 2020
  • Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.

Factors affecting to the Person-Centered Care among Critical Care Nurses (중환자실 간호사의 인간중심간호에 영향을 주는 요인)

  • Choi, Seunghye
    • Journal of Korean Critical Care Nursing
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    • v.13 no.2
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    • pp.36-44
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    • 2020
  • Purpose : The person-centered care is essential for better patient outcome. This study was conducted to identify the factors affecting to the person-centered care among intensive care unit (ICU) nurses. Method : This study was cross sectional survey, and the participants included 107 ICU nurses who provided a written consent to participate in the study. Using a structured survey, nurse's compassion fatigue, compassion satisfaction, and person-centered care among ICU nurses were assessed. The collected data were analyzed using t-test, ANOVA, and Pearson correlation test with SPSS 23.0 program. The factors affecting patient-centered care were analyzed using multiple regression. Results : According to the multiple regression analysis, education level, perceived caregivers need priority and compassion satisfaction were positive affecting factors to the person-centeredness of ICU nurses. Conclusion : In conclusion, the compassion satisfaction was an affecting factor to the person-centered care, however compassion fatigue didn't affect to the person-centered care among ICU nurses. Therefore, the strategy enhancing compassion satisfaction among ICU nurses will be needed to increase person centeredness.

The Effect of Bioethics Awareness and Patient-Centered Care on Attitude of Terminal Care of Hospice Nurses (호스피스 간호사의 생명윤리의식과 환자중심간호가 임종간호태도에 미치는 영향)

  • Kawoun Seo
    • Journal of Practical Engineering Education
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    • v.15 no.2
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    • pp.475-484
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    • 2023
  • This study was conducted to identify the influences of bioethics awareness and patient-centered care on attitude of terminal care of hospice nurses. The participants were 145 nurses working in hospice care center of hospitals in Korea. Data were collected during May and June in 2018 and were analyzed with descriptive statistics, t-test, one way ANOVA, Pearson's correlation coefficient, and multiple hierarchecal regression analysis using SPSS 24.0 program. Attitude of terminal care was influenced by hospice specialist certification (β=.15, p=.031), bioethics awareness (β=-.24, p=.003), and patient-centered care (β=.36, p<.001) in the regression model. These variables explained 36.9% of attitude of terminal care. In order to improve the attitude of terminal care of hospice nurses, programs for improving patient-centered care competence including bioethics awareness should be provided.

A Concept Analysis on Patient-Centered Care in Hospitalized Older Adults with Multimorbidity (복합질환을 가진 입원노인 대상 환자중심간호 개념분석)

  • Son, Youn-Jung;Yoon, Heun-Keung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.61-72
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    • 2019
  • Purpose : The aim of this study was to explore the attributes, antecedents, and consequences of patient-centered care (PCC) for older adults with multimorbidity in acute care hospitals. Methods : The concept analysis performed by Walker and Avant was used to analyze PCC. Fifteen studies from the literature related to PCC appear in systematic literature reviews in the fields of theology, medicine, psychology, and nursing. Results : PCC in acute care hospitals was defined according to the five attributes of 'maintaining patient autonomy', 'empowering self-care', 'individualized and relationship-based care', 'shared decision-making', and 'creating a homelike environment'. Antecedents of PCC were found to be a respect for patients' preferences, qualifications of the nursing staff, care coordination and integration, and organizational support. Consequences of effective PCC were a functional status; health-related quality of life; satisfaction with care, mortality, and medical costs from the perspective of the patient and family; and quality of care and therapeutic relationships from nurses' viewpoints. Conclusion : PCC as defined by the results of this study will contribute to the foundation of institutionalization and the creation of a safe and healthy acute care hospital culture focused on patients' preferences and values.

Development and Evaluation of Humanitude Care Education Program for Nursing Students (간호대학생을 위한 휴머니튜드 케어 교육 프로그램 개발 및 효과)

  • Jeong, Harim;Choi, Heejung
    • Journal of muscle and joint health
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    • v.30 no.1
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    • pp.1-14
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    • 2023
  • Purpose: This study aimed to develop Humanitude care educational program and validate its effects with a sample of third-year nursing students, thereby providing fundamental data for the application of the program to the education of gerontological nursing. Methods: Humanitude care comprised four strategies and five steps for the elderly. In this study, the Humanitude care educational program for nursing students was developed according to ADDIE process. And then, a non-randomized control group pretest-posttest design was adopted to identify the effects of the Humanitude care educational program. The intervention group with 22 third-year nursing students completed the Humanitude care educational program and then participated in clinical practice for 3 weeks. The 25 third-year nursing students in the comparison group participated in clinical practice without taking educational intervention. Differences between the intervention group and control group on Humanitude care knowledge, attitude toward the elderly, patient-centered communication, and care efficacy were analyzed with t-tests. Results: After completing the Humanitude care education, the intervention group showed significantly high scores in Humanitude care knowledge (t=8.82, p<.001), patient-centered communication (t=2.54, p=.015), and care efficacy (t=2.14, p=.040) than the control group. However, after finishing clinical practice, there were no significant differences in all variables between the intervention and control groups. Conclusion: Humanitude care educational program can be adopted as an effective intervention in Humanitude care knowledge, patient-centered communication, and care efficacy of nursing students. However, to continue the educational effect, instructors should facilitate nursing students applying Humanicide care in clinical practice. Ultimately, it can propose a novel educational direction that can be applied to human-centered care in gerontological nursing practice.

Effectiveness of Patient and Family-Centered Care interventions: A Systematic Review (환자-가족중심 의료서비스의 융합적 성과: 체계적 문헌고찰)

  • Yoo, Ji-Yeon;Ahn, Sung-Hee
    • Journal of the Korea Convergence Society
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    • v.10 no.6
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    • pp.365-379
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    • 2019
  • This review aimed to analyze characteristics and performances of patient and family-centered care interventions and evaluate the convergence effectiveness. Randomized controlled trials were searched, selected, data extracted and quality-assessed using the Risk of Bias in 15 databases. Characteristics suggested from 21 studies were provision of information, education, communication and family and friend participation. There were 89 measurement variables of performances. Patient outcome was measured by mortality, length of hospitalization, etc., indicated as significantly improved in 18 studies. This review has provided evidence that patient and family-centered care improved experience and performance of diverse patients, families and health-care providers. There is need to convergence adopt patient and family-centered care and conduct evidence-based studies for improvement of quality of healthcare and patient safety in the future.

The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke (환자중심 목표설정이 아급성기 뇌졸중 환자의 재활치료 성과에 미치는 영향)

  • Won, Jong-im;An, Chang-man;Park, Min-hee
    • Physical Therapy Korea
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    • v.25 no.1
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    • pp.31-38
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    • 2018
  • Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

A Qualitative Content Analysis of the Person-Centered Care Experienced by Critical Care Patients (중환자실 환자가 경험한 인간중심 간호에 관한 질적 내용분석)

  • Hong, Hee Jin;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.21-33
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    • 2018
  • Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

Influence of Ethical Sensitivity and Person-environment Fit on Person-centered Care of Nurses in Long-term Care Hospitals (요양병원 간호사의 윤리적민감성과 개인-환경적합성이 인간중심돌봄에 미치는 영향)

  • Lee, Hye Ran;Yang, Nam Young
    • Journal of Home Health Care Nursing
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    • v.29 no.2
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    • pp.175-182
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    • 2022
  • Purpose: The study examined the effects of ethical sensitivity and person-environment fit on person-centered care of nurses in long-term care hospitals. Methods: The participants were 111 nurses. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis with the SPSS program. Results: The mean of person-centered care was 2.95±0.62 out of 5. There were significant differences in person-centered care in terms of age, shift pattern, total clinical career, and educational experience of person-centered care. Person-centered care and ethical sensitivity, person-centered care and person-environment fit showed a positive correlation. Factors affecting the person-centered care were the age (20-29), shift pattern (three shift), person-environment fit. The explanatory power was 42%. Conclusion: These results can be used to increase the person-environment fit and adopt a differented approach based on age and shift pattern in order to enhance person-centered care. Therefore, it is necessary to develop and apply an person-centered care program for nurses in long-term care hospitals.