Using holistic interpretive synthesis to create practice‐relevant guidance for person‐centred fundamental care delivered by nurses

Abstract

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach.

Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews

“… giving the patient and family their full attention; establishing their needs, concerns and values; being willing to know and understand the patient and family so that the nurses actions are both acceptable and appropriate; and undertaking ongoing evaluation of the relationship quality and functioning (Doherty & Thompson, ; Feo et al., ; Ross et al., ). …”

“…Much is written about person-centred care, but for marginalised communities this seems to get lost amidst an exclusive focus on individuals and universal approaches. Despite expectations that nurses provide person-centred care, guidance to operationalise this in their everyday practice is absent (Feo et al, 2017;Ross, Tod, & Clarke, 2015). Furthermore, Entwistle and Watt (2013) claim that whilst much is talked about person-centred care, its value remains implied rather than explicit and they question whether it is unrealistic in practice.…”

“…• undertaking ongoing evaluation of the relationship quality and functioning (Doherty & Thompson, 2014;Feo et al, 2017;Ross et al, 2015). Doherty and Thompson (2014) stress this can only be achieved when patients and their families are engaged and willing to be involved-for marginalised communities who often are suspicious of health professionals, this involves securing their trust.…”

Editorial: Crossing the caring chasm

“…There is no doubt (and the evidence confirms) that nurses need to be able to build their relationship with their patients on trust (Feo et al . ). Trust derives from moral characteristics of the nurse – their values, attitudes and behaviours.…”

Habermas and the therapeutic function of language

“…For this reason, while not neglecting the technical interest, participants in the therapeutic process must not ignore the practical and emancipatory interests, for such a negligence would eradicate mutual understanding, which is the fundamental condition of therapy (Duffy, , pp. 393–410; Feo et al, , pp. 1–11; Habermas, ; Lundälv & Lindqvist, , pp.…”