Patients’ experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study

Liz/ EA Laird, Tanya McCance, Brendan McCormack, Bernadette Gribben

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BackgroundThe drive towards person-centred approaches to care delivery has been increasingly promoted. This is in response to the significant challenges within health and social care organisations, which impact on the care experience for patients and their families.ObjectiveThe aim of this paper is to illuminate the experiences of patients of care received in hospital wards during the intervention phase of a programme to develop person-centred practice.DesignA narrative enquiry study was conducted which is a particular way of exploring complex cultural or social patterns. Structural narrative analysis was used to generate explanation and interpretation of in-hospital patients’ care experience.SettingRecruitment was from four different hospital sites in one health care organisation, focussing on patients who were admitted to the nine wards/units where the nursing teams were participating in a practice development programme that had the intention of promoting person-centredness.ParticipantsParticipants were people aged over 18 and receiving care and treatment in the identified wards/units. Twenty-six patients were recruited.MethodsNarrative interviews were audio-recorded at four month intervals and transcribed. The records were subjected to a process of structural analysis.ResultsThe findings offer insight into patients’ experiences of care in a range of clinical settings in which an explicit intervention to promote person-centred practice was underway. There was one overriding theme formulated: Vulnerability at the junctures of systems, care processes and nurses’ responses. From this main theme, we derived four sub-themes: (1) confronting vulnerability, (2) experiencing exemplary care, (3) experiencing misalignments in systems, care processes and nurses’ responses, and (4) sharing in a sense of belonging with ward nurses.ConclusionsIn-hospital patients are exposed to vulnerability in the care experience. They placed value on exemplary care. Experiences of misalignments in systems, care processes and nurses’ responses disempower patients and heighten a sense of vulnerability. The ward nursing teams were generating a family like atmosphere. Patients responded by sharing a sense of belonging with ward nurses. These findings confirm components that have influenced the development of person-centred practice, such as the importance of the context and culture of care. They also offer new insights that may contribute to on-going practice development work.
LanguageEnglish
JournalInternational Journal of Nursing Studies
VolumeOnline
Early online date11 May 2015
DOIs
Publication statusPublished - 21 May 2015

Fingerprint

Nursing Staff
Nurses
Patient Care
Team Nursing
Organizations
Delivery of Health Care
Atmosphere
Interviews

Keywords

  • Hospital care
  • Narrative enquiry
  • Person-centred practice
  • Practice development

Cite this

@article{89e8de78773343f4afcccf6d5de2e26b,
title = "Patients’ experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study",
abstract = "BackgroundThe drive towards person-centred approaches to care delivery has been increasingly promoted. This is in response to the significant challenges within health and social care organisations, which impact on the care experience for patients and their families.ObjectiveThe aim of this paper is to illuminate the experiences of patients of care received in hospital wards during the intervention phase of a programme to develop person-centred practice.DesignA narrative enquiry study was conducted which is a particular way of exploring complex cultural or social patterns. Structural narrative analysis was used to generate explanation and interpretation of in-hospital patients’ care experience.SettingRecruitment was from four different hospital sites in one health care organisation, focussing on patients who were admitted to the nine wards/units where the nursing teams were participating in a practice development programme that had the intention of promoting person-centredness.ParticipantsParticipants were people aged over 18 and receiving care and treatment in the identified wards/units. Twenty-six patients were recruited.MethodsNarrative interviews were audio-recorded at four month intervals and transcribed. The records were subjected to a process of structural analysis.ResultsThe findings offer insight into patients’ experiences of care in a range of clinical settings in which an explicit intervention to promote person-centred practice was underway. There was one overriding theme formulated: Vulnerability at the junctures of systems, care processes and nurses’ responses. From this main theme, we derived four sub-themes: (1) confronting vulnerability, (2) experiencing exemplary care, (3) experiencing misalignments in systems, care processes and nurses’ responses, and (4) sharing in a sense of belonging with ward nurses.ConclusionsIn-hospital patients are exposed to vulnerability in the care experience. They placed value on exemplary care. Experiences of misalignments in systems, care processes and nurses’ responses disempower patients and heighten a sense of vulnerability. The ward nursing teams were generating a family like atmosphere. Patients responded by sharing a sense of belonging with ward nurses. These findings confirm components that have influenced the development of person-centred practice, such as the importance of the context and culture of care. They also offer new insights that may contribute to on-going practice development work.",
keywords = "Hospital care, Narrative enquiry, Person-centred practice, Practice development",
author = "Laird, {Liz/ EA} and Tanya McCance and Brendan McCormack and Bernadette Gribben",
year = "2015",
month = "5",
day = "21",
doi = "10.1016/j.ijnurstu.2015.05.002",
language = "English",
volume = "Online",

}

TY - JOUR

T1 - Patients’ experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study

AU - Laird, Liz/ EA

AU - McCance, Tanya

AU - McCormack, Brendan

AU - Gribben, Bernadette

PY - 2015/5/21

Y1 - 2015/5/21

N2 - BackgroundThe drive towards person-centred approaches to care delivery has been increasingly promoted. This is in response to the significant challenges within health and social care organisations, which impact on the care experience for patients and their families.ObjectiveThe aim of this paper is to illuminate the experiences of patients of care received in hospital wards during the intervention phase of a programme to develop person-centred practice.DesignA narrative enquiry study was conducted which is a particular way of exploring complex cultural or social patterns. Structural narrative analysis was used to generate explanation and interpretation of in-hospital patients’ care experience.SettingRecruitment was from four different hospital sites in one health care organisation, focussing on patients who were admitted to the nine wards/units where the nursing teams were participating in a practice development programme that had the intention of promoting person-centredness.ParticipantsParticipants were people aged over 18 and receiving care and treatment in the identified wards/units. Twenty-six patients were recruited.MethodsNarrative interviews were audio-recorded at four month intervals and transcribed. The records were subjected to a process of structural analysis.ResultsThe findings offer insight into patients’ experiences of care in a range of clinical settings in which an explicit intervention to promote person-centred practice was underway. There was one overriding theme formulated: Vulnerability at the junctures of systems, care processes and nurses’ responses. From this main theme, we derived four sub-themes: (1) confronting vulnerability, (2) experiencing exemplary care, (3) experiencing misalignments in systems, care processes and nurses’ responses, and (4) sharing in a sense of belonging with ward nurses.ConclusionsIn-hospital patients are exposed to vulnerability in the care experience. They placed value on exemplary care. Experiences of misalignments in systems, care processes and nurses’ responses disempower patients and heighten a sense of vulnerability. The ward nursing teams were generating a family like atmosphere. Patients responded by sharing a sense of belonging with ward nurses. These findings confirm components that have influenced the development of person-centred practice, such as the importance of the context and culture of care. They also offer new insights that may contribute to on-going practice development work.

AB - BackgroundThe drive towards person-centred approaches to care delivery has been increasingly promoted. This is in response to the significant challenges within health and social care organisations, which impact on the care experience for patients and their families.ObjectiveThe aim of this paper is to illuminate the experiences of patients of care received in hospital wards during the intervention phase of a programme to develop person-centred practice.DesignA narrative enquiry study was conducted which is a particular way of exploring complex cultural or social patterns. Structural narrative analysis was used to generate explanation and interpretation of in-hospital patients’ care experience.SettingRecruitment was from four different hospital sites in one health care organisation, focussing on patients who were admitted to the nine wards/units where the nursing teams were participating in a practice development programme that had the intention of promoting person-centredness.ParticipantsParticipants were people aged over 18 and receiving care and treatment in the identified wards/units. Twenty-six patients were recruited.MethodsNarrative interviews were audio-recorded at four month intervals and transcribed. The records were subjected to a process of structural analysis.ResultsThe findings offer insight into patients’ experiences of care in a range of clinical settings in which an explicit intervention to promote person-centred practice was underway. There was one overriding theme formulated: Vulnerability at the junctures of systems, care processes and nurses’ responses. From this main theme, we derived four sub-themes: (1) confronting vulnerability, (2) experiencing exemplary care, (3) experiencing misalignments in systems, care processes and nurses’ responses, and (4) sharing in a sense of belonging with ward nurses.ConclusionsIn-hospital patients are exposed to vulnerability in the care experience. They placed value on exemplary care. Experiences of misalignments in systems, care processes and nurses’ responses disempower patients and heighten a sense of vulnerability. The ward nursing teams were generating a family like atmosphere. Patients responded by sharing a sense of belonging with ward nurses. These findings confirm components that have influenced the development of person-centred practice, such as the importance of the context and culture of care. They also offer new insights that may contribute to on-going practice development work.

KW - Hospital care

KW - Narrative enquiry

KW - Person-centred practice

KW - Practice development

U2 - 10.1016/j.ijnurstu.2015.05.002

DO - 10.1016/j.ijnurstu.2015.05.002

M3 - Article

VL - Online

ER -