Person-centered care in nurse-led outpatient rheumatology clinics. From experience to measurement.
Personcentrerad vård på sjuksköterskemottagningar inom reumatologisk öppenvård : Från upplevelse till mätning
Author
Summary, in English
Abstract
Aim: To describe and understand patients’ experiences as a means to conceptualize and evaluate outpatient person-centered care (PCC) in nurse-led rheumatoid arthritis (RA) clinics.
Methods: Persons with RA were interviewed about how they experienced their nurse-led outpatient care and about the meaning of living with persistent RA. Interviews were analyzed by qualitative content analysis and hermeneutic
phenomenology. Based on these results, existing PCC frameworks and hypothetical logical reasoning, a conceptual framework for nurse-led outpatient PCC was developed and used to operationalize a PCC instrument for outpatient
care in rheumatology (PCCoc/rheum). Acceptability and content validity of the PCCoc/rheum were evaluated, and its measurement properties were tested according to Rasch measurement theory (RMT).
Results: The experience of nurse-led outpatient care was expressed as social environment, professional approach and value-adding measures, all relating to the degree of PCC. Living with persistent RA was revealed as an existence dominated by painful symptoms and treatment, radical changes and limitations in life, a continual struggle to cope with life and to master the illness, and a dependency on those who are close by and the world around. Results also pointed to the need for a stronger PCC approach. An outpatient framework was conceptualized with five related domains, and was used to develop the PCCoc/rheum, which showed good acceptability and content
validity. RMT supported the accordance between the PCCoc/rheum and the conceptual framework, and its measurement properties were generally supported.
Conclusions: Experiences of persons with RA support a central role for PCC. The conceptual framework and the PCCoc/rheum have potentials to improve implementation and evaluation of outpatient PCC and contribute to quality
of care from a PCC perspective in nurse-led rheumatoid arthritis clinics.
Aim: To describe and understand patients’ experiences as a means to conceptualize and evaluate outpatient person-centered care (PCC) in nurse-led rheumatoid arthritis (RA) clinics.
Methods: Persons with RA were interviewed about how they experienced their nurse-led outpatient care and about the meaning of living with persistent RA. Interviews were analyzed by qualitative content analysis and hermeneutic
phenomenology. Based on these results, existing PCC frameworks and hypothetical logical reasoning, a conceptual framework for nurse-led outpatient PCC was developed and used to operationalize a PCC instrument for outpatient
care in rheumatology (PCCoc/rheum). Acceptability and content validity of the PCCoc/rheum were evaluated, and its measurement properties were tested according to Rasch measurement theory (RMT).
Results: The experience of nurse-led outpatient care was expressed as social environment, professional approach and value-adding measures, all relating to the degree of PCC. Living with persistent RA was revealed as an existence dominated by painful symptoms and treatment, radical changes and limitations in life, a continual struggle to cope with life and to master the illness, and a dependency on those who are close by and the world around. Results also pointed to the need for a stronger PCC approach. An outpatient framework was conceptualized with five related domains, and was used to develop the PCCoc/rheum, which showed good acceptability and content
validity. RMT supported the accordance between the PCCoc/rheum and the conceptual framework, and its measurement properties were generally supported.
Conclusions: Experiences of persons with RA support a central role for PCC. The conceptual framework and the PCCoc/rheum have potentials to improve implementation and evaluation of outpatient PCC and contribute to quality
of care from a PCC perspective in nurse-led rheumatoid arthritis clinics.
Department/s
Publishing year
2017
Language
English
Full text
Document type
Dissertation
Publisher
Lund University: Faculty of Medicine
Topic
- Medical and Health Sciences
Keywords
- lived experience
- measurement instrument
- nurse-led rheumatology clinics
- outpatient framework
- person-centered care
- rheumatoid arthritis
- patient perspective
- personcentrerad vård
- mätinstrument
- reumatologisk öppenvård
- sjuksköterskemottagning
Status
Published
Supervisor
- Peter Hagell
- Kristina Forslind
- Bengt Fridlund
- Karin Samuelson
ISBN/ISSN/Other
- ISBN: 978-91-7619-501-7
Defence date
1 September 2017
Defence time
09:00
Defence place
City Hall, Helsingborg
Opponent
- Ella Danielson (professor em)