Development of competencies aimed at client‐centred care: an evaluation study

Abstract

The aim of this study was to evaluate a learning programme for Dutch community nurses and auxiliary nurses aimed at the development of competencies with respect to client‐centred care for chronically ill clients. The study was guided by the Kessels's Eight‐fields model. Several stakeholders, including clients, participated in the development, execution and evaluation of the programme. The concept of client‐centred care, client goals and competencies for nurses were identified systematically. Competencies identified were a care‐process in dialogue, enabling client participation and dealing with tensions. Principles of development of competencies were applied in the design of learning activities. The programme was evaluated at three levels: learning processes; performance of competencies in practice; and perceived client‐centredness by clients. Three home‐care organizations were involved in the evaluation study. In total, 175 employees participated in the basic module and 34 nurses and auxiliary nurses participated in the advanced module. In total, 107 chronically ill clients were involved in the study, of which 50 in the evaluation group and 57 in a group checking for selection bias. Findings indicate a positive impact on two of the evaluation levels: learning processes and the performance of nurse's competencies in practice. No statistical impact was found on clients 2 months after the end of the programme. The process evaluation provided knowledge concerning pre‐conditions for learning processes and performance of competencies in practice. The study concludes that it seems that a change towards client‐centred care has been initiated. Client‐centred care encompasses more, however, than competence development in individual nurses. A corporate approach is recommended, encompassing the support of the primary process of client‐centred care by the entire care organization. Further research aimed at the implementation of client‐centred care is recommended.

Advancing patient-centered care through transformative educational leadership: a critical review of health care professional preparation for patient-centered care

“…9,[37][38][39][40][41][42] Finally, several continuing education initiatives are described across a wide variety of professional fields, ranging from brief workshops to elaborate interdisciplinary training programs or extended action research projects. [43][44][45][46][47][48] It is outside the interests of this article to perform criteriabased comparisons between the above-cited educational initiatives. We made a case earlier for the need to foster in practitioners and students a reconceptualization of PCC itself.…”

Nurses’ Experiences of Providing Care to Dementia Patients Through Home Health Care

“…14 The nurse–care recipient relationship is central to PCC, 16 and a principal PCC theme is a continuous nurse–care recipient dialogue; in dementia care, trusting relationships are an important component. 12,16,53 Through the reorganization of nursing resources, an increased opportunity for nurse–care recipient interactions was realized, and the participants recognized that time spent outside of their traditionally task-focused and time-limited roles was needed. The participants believed that the basis for improved interpersonal relationships is dependent on the familiarity that a nurse and a care recipient have for one another; it is in this nurse–care recipient familiarity that a relationship is developed and trust is created.…”

Ready for goal setting? Process evaluation of a patient-specific goal-setting method in physiotherapy

“…Questions focussed on the actual use of the ‘new’ elements of the PSG (compared to the original PSC instrument) and concerned the extent to which the physiotherapist had informed the patient about the PSG, had used the PSG to set treatment goals, had involved patients in treatment planning, and had used the PSG to evaluate therapy (lower rows Table 4 ). Third, the physiotherapist’s client-centred competences were assessed by a 7-item questionnaire that was derived from the ‘Care in Dialogue’ Competency scale [ 29 ], using its ‘enabling client participation’ subscale. Items were scored on a 4-point Likert scale (1 = not really, 2 = to a limited extent, 3 = regularly, 4 = very often).…”