Development of patient-centred care in acute hospital settings: A meta-narrative review

Janerka, Carrie; Leslie, Gavin; Gill, Fenella J.

doi:10.1016/j.ijnurstu.2023.104465

Cited by 21 publications

(8 citation statements)

References 138 publications

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“…It is reasonable to suspect that inpatient psychiatric facilities that already had “cultures of betrayal” were predisposed to not invest in COVID-19 mitigation as much as facilities that had greater cultures of safety and quality. Indeed, there is significant evidence demonstrating the role that healthcare cultures have on safety outcomes and patient-centered care environments, 22 - 24 and these may also be associated with the overall resources available to facilities (eg, flexible financing, opportunity for reinvestment, staff composition and retention).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Mitigation Activities in Inpatient Psychiatry Were Associated With Patient-Reported Institutional Betrayal, Changes in Trust, and Fear of Getting Sick

Ochman,

Shields

2024

INQUIRY

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Institutional betrayal occurs when the institutions that people depend on fail to protect them from harm, which was exemplified by a failure to manage COVID-19 risks. Inpatient psychiatry provides a rich context for which to understand the effects of institutional betrayal, and this is amplified in the context of the COVID-19 pandemic. Using a retrospective cohort design, we administered an online survey to former patients (n = 172) of inpatient psychiatry hospitalized at the height of the COVID-19 pandemic (March 2020 to February 2021) to understand the relationship between facilities’ use of COVID-19 mitigation activities (ie, offering or requiring face masks, keeping patients and staff 6 feet apart, access to hand sanitizer, use of telemedicine for clinical consults, and routine cleanliness of the unit) and former patients’ reports of institutional betrayal, changes in their trust in mental healthcare providers, fear of getting sick, and having contracted or witnessed someone else contract COVID-19. The quantity of COVID-19 mitigation activities was monotonically negatively associated with the probability of reporting any betrayal, the probability of reduced trust in mental healthcare providers, and the probability of being afraid of getting sick always or most of the time while hospitalized. COVID-19 mitigation activities either directly affected these psychological outcomes, or facilities that engaged in robust mitigation had greater cultures of safety and care quality. Additional qualitative work is needed to understand these mechanisms.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Mitigation Activities in Inpatient Psychiatry Were Associated With Patient-Reported Institutional Betrayal, Changes in Trust, and Fear of Getting Sick

Ochman,

Shields

2024

INQUIRY

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“…An increasing amount of research supports the beneficial effects of compassionate and empathic healthcare interactions on patients’ psychological health outcomes 1. Nevertheless, patients’ voices are frequently absent from the narratives on this subject, even though empathy and compassion are essential to person-centred care and patient safety 2. The concept of empathy is multifaceted, encompassing both affective and cognitive aspects 3.…”

Section: Contextmentioning

confidence: 99%

Communication skills and helping behaviours beyond routine interactions are the key indicators of empathic and compassionate nursing care according to patients

Petty

2024

Evid Based Nurs

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“…For this reason, we chose to focus on hospital settings, which include a different make-up of teams, more frequent social interactions, social status hierarchies that revolve around medical specialisation and arguably fewer opportunities to develop patient-clinician relationships than other settings. [26][27][28] These differences in hospital settings have implications for changing healthcare professional behaviours that may differ to other settings. 27 Contextualisation in healthcare settings refers to the processes involved in adapting, delivering and monitoring healthcare.…”

Section: Open Accessmentioning

confidence: 99%

“…However, there are also narrower subsets of contextual features that differ between these settings. For this reason, we chose to focus on hospital settings, which include a different make-up of teams, more frequent social interactions, social status hierarchies that revolve around medical specialisation and arguably fewer opportunities to develop patient–clinician relationships than other settings 26–28. These differences in hospital settings have implications for changing healthcare professional behaviours that may differ to other settings 27…”

Section: Introductionmentioning

confidence: 99%

Multicomponent processes to identify and prioritise low-value care in hospital settings: a scoping review

Tyack,

Carter,

Allen

et al. 2024

BMJ Open

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ObjectivesThis scoping review mapped and synthesised original research that identified low-value care in hospital settings as part of multicomponent processes.DesignScoping review.Data sourcesElectronic databases (EMBASE, PubMed, CINAHL, PsycINFO and Cochrane CENTRAL) and grey literature were last searched 11 July and 3 June 2022, respectively, with no language or date restrictions.Eligibility criteriaWe included original research targeting the identification and prioritisation of low-value care as part of a multicomponent process in hospital settings.Data extraction and synthesisScreening was conducted in duplicate. Data were extracted by one of six authors and checked by another author. A framework synthesis was conducted using seven areas of focus for the review and an overuse framework.ResultsTwenty-seven records were included (21 original studies, 4 abstracts and 2 reviews), originating from high-income countries. Benefit or value (11 records), risk or harm (10 records) were common concepts referred to in records that explicitly defined low-value care (25 records). Evidence of contextualisation including barriers and enablers of low-value care identification processes were identified (25 records). Common components of these processes included initial consensus, consultation, ranking exercise or list development (16 records), and reviews of evidence (16 records). Two records involved engagement of patients and three evaluated the outcomes of multicomponent processes. Five records referenced a theory, model or framework.ConclusionsGaps identified included applying systematic efforts to contextualise the identification of low-value care, involving people with lived experience of hospital care and initiatives in resource poor contexts. Insights were obtained regarding the theories, models and frameworks used to guide initiatives and ways in which the concept ‘low-value care’ had been used and reported. A priority for further research is evaluating the effect of initiatives that identify low-value care using contextualisation as part of multicomponent processes.

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Development of patient-centred care in acute hospital settings: A meta-narrative review

Cited by 21 publications

References 138 publications

COVID-19 Mitigation Activities in Inpatient Psychiatry Were Associated With Patient-Reported Institutional Betrayal, Changes in Trust, and Fear of Getting Sick

COVID-19 Mitigation Activities in Inpatient Psychiatry Were Associated With Patient-Reported Institutional Betrayal, Changes in Trust, and Fear of Getting Sick

Communication skills and helping behaviours beyond routine interactions are the key indicators of empathic and compassionate nursing care according to patients

Multicomponent processes to identify and prioritise low-value care in hospital settings: a scoping review

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