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Person-centered care in nurse-led outpatient rheumatology clinics. From experience to measurement.

Bala, Sidona-Valentina LU (2017)
Abstract (Swedish)
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... (More)
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.
(Less)
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author
supervisor
opponent
  • professor em Danielson, Ella, Göteborg
organization
alternative title
Personcentrerad vård på sjuksköterskemottagningar inom reumatologisk öppenvård : Från upplevelse till mätning
publishing date
type
Thesis
publication status
published
subject
keywords
lived experience, measurement instrument, nurse-led rheumatology clinics, outpatient framework, person-centered care, rheumatoid arthritis, patient perspective, personcentrerad vård, mätinstrument, reumatologisk öppenvård, sjuksköterskemottagning
pages
89 pages
publisher
Lund University, Faculty of Medicine
defense location
City Hall, Helsingborg
defense date
2017-09-01 09:00
ISBN
978-91-7619-501-7
language
English
LU publication?
no
id
31dc68ec-2183-4b79-ae78-fdd146490e25
date added to LUP
2017-08-08 11:31:44
date last changed
2017-08-11 13:17:16
@phdthesis{31dc68ec-2183-4b79-ae78-fdd146490e25,
  abstract     = {Abstract<br/>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.<br/><br/>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<br/>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<br/>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).<br/><br/>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<br/>validity. RMT supported the accordance between the PCCoc/rheum and the conceptual framework, and its measurement properties were generally supported.<br/><br/>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<br/>of care from a PCC perspective in nurse-led rheumatoid arthritis clinics.<br/>},
  author       = {Bala, Sidona-Valentina},
  isbn         = {978-91-7619-501-7},
  keyword      = {lived experience,measurement instrument,nurse-led rheumatology clinics,outpatient framework,person-centered care,rheumatoid arthritis,patient perspective,personcentrerad vård,mätinstrument,reumatologisk öppenvård,sjuksköterskemottagning},
  language     = {eng},
  pages        = {89},
  publisher    = {Lund University, Faculty of Medicine},
  title        = {Person-centered care in nurse-led outpatient rheumatology clinics. From experience to measurement.},
  year         = {2017},
}