Development of the Patient-Centered Nursing Culture Scale for Hospitals

PURPOSE: This study aimed to develop a scale measuring the Patient-Centered Nursing Culture (PCNC) and provide a basic tool to improve PCNC in Korea. METHODS: A conceptual framework and construct factors were extracted through extensive literature review and in-depth interviews with nursing professionals. In total, 59 items were derived based on the pilot survey. Data were collected from 357 nurses working at general hospitals and analyzed for verifying the reliability and validity of the scale. RESULTS: Nine factors containing 54 items were extracted from the exploratory factor analysis to verify the construct validity. The nine factors were top management leadership, policy and procedure, education and training, middle management leadership, supportive teamwork, nursing workplace environment, professional competence, patient-centered nursing activity, and nurses' values. These items were verified by convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α=.96). CONCLUSION: The developed PCNC scale is expected to be used as the tool for the development of theory and improvement of PCNC, the empirical testing for cause and effect of PCNC, the development of interventions, education and training programs for improving PCNC, and indicators for evaluation or accreditation of hospital service quality.

The Relationship between Person-Centered Nursing and Family Satisfaction in ICUs / 중환자간호학회지

PURPOSE: This study aims to identify the relationship between person-centered critical care nursing (PCCN) and family satisfaction for intensive care unit (ICU) nurses.METHODS: This research used a cross-sectional survey. The participants were 142 nurses and 121 family members from 8 ICUs in 4 hospitals in B city. The questionnaire survey was conducted between December 2018 and March 2019. The eight ICUs were divided into those that scored high and those that scored low for person-centered care relative to the average score for PCCN, and the difference in family satisfaction between the ICUs with high and low scores was compared using t-test.RESULTS: The mean score of PCCN was 3.68±0.40 out of 5. In the subcategories of PCCN, “comfort”was the highest at 3.95±0.49, followed by “respect” at 3.73±0.57, “compassion” at 3.59±0.57, and “individuality” at 3.47±0.54. The average score of family satisfaction with the ICUs was 3.45±0.67 out of 5. In its subcategories, “emotion” was the highest at 3.69±0.72, followed by “information” at 3.61±0.75, “participation” at 3.30±0.79, and ”resources‘ at 3.20±0.80. The family satisfaction (3.75±0.54) with the ICU of the highest-scoring PCCN was significantly higher than the family satisfaction (3.25±0.53) with the ICU with the lowest-scoring PCCN (t=4.97, p<.001).CONCLUSION: The results suggest that the PCCN scores of ICU nurses should be promoted to improve family satisfaction. It is necessary to pursue a variety of ways to secure the provision of person-centered nursing practice in ICUs.

Establishment of patient-centered nursing mode and its effect on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients / 中国中西医结合急救杂志

Objective To contribute the patient-centered nursing mode and discuss its influence on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients. Methods A total of 108 emergency surgery patients admitted to Xiangyang No.1 People's Hospital Affiliated of Hubei University of Medicine from January 2014 to January 2017 were enrolled as research subjects, and they were divided into an observation group and a control group according to difference in nursing modes, 54 cases in each group. During the peri-operational period, the patients in control group were given routine nursing mode, while in the observation group, the patients received patient-centered nursing mode. The blood pressure, heart rate and levels of various kinds of hormone (insulin, cortisol, epinephrine) and interleukin-6 (IL-6) before and after intervention were measured; the Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the psychological stress changes; after operation, the rate of using analgesics, incidence of postoperative infection, Visual analogue scale (VAS), anus exhaust time, off-bed activity time and sleep quality scale scores were recorded to evaluate the quality of patients' postoperative rehabilitation. Results The diastolic blood pressure, systolic blood pressure, heart rate and levels of insulin, cortisol and IL-6 in two groups before operation and 2 hours after operation were significantly higher than those on admission, while the levels of epinephrine were lower than the level on admission, the degrees of increase or decrease of the observation group were slower than those of the control group, and the changes were more significant at 2 hours after operation [diastolic blood pressure (mmHg, 1 mmHg = 0.133 kPa) was 120.58±13.09 vs. 135.35±15.44, systolic blood pressure (mmHg) was 74.69±10.97 vs. 80.50±11.34, heart rate (bpm) was 83.47±11.64 vs. 92.59±12.00, insulin (mmol/L) was 12.58±1.62 vs. 15.96±1.46, cortisol (μg/L) was 128.72±20.53 vs. 140.47±21.58, epinephrine (ng/L) was 38.96±7.24 vs. 35.25±8.01, IL-6 (ng/L) was 157.64±27.06 vs.183.45±29.37, all P ＜ 0.05]. After interference, the HAMA and HAMD scores of the two groups were significantly lower than those before intervention, and the degree of decrease in the observation group was more obvious (HAMA score: 11.58±2.16 vs. 16.74±2.80, HAMD score: 9.42±2.03 vs. 13.38±2.71, both P ＜ 0.05); the rate of using analgetic [25.93% (14/54) vs. 57.41% (31/54)], incidence of postoperative infection [3.70% (2/54) vs. 16.67% (9/54)], VAS scores (4.63±1.21 vs. 6.87±1.74), anus exhaust time (days: 1.53±0.33 vs. 1.86±0.26), off-bed activity time (days: 1.57±0.19 vs. 1.72±0.24) and sleep quality scale scores (5.84±2.07 vs. 9.33±2.39) in observation group were significantly less than those in control group (all P ＜ 0.05). Conclusion The contribution and application of patient-centered nursing mode in treating emmergency surgery patients during peri-operational period is helpful to ameliorate the patients' degree of physiological and psychological stress reactions, and this mode has important significance in promoting the quality of patients' postoperative rehabilitation.

Factors Related to Intensive Care Unit Nurses' Patient Centered Communication Competency / 중환자간호학회지

PURPOSE: This study aimed to provide primary data for developing a program to enhance communication competence by identifying the patient-centered communication competency level of Intensive Care Unit (ICU) nurses and the related factors.METHOD: Data were collected from August 28th to October 8th, 2015, from 199 ICU nurses working in 30 tertiary hospitals. The study questionnaire included items assessing the patient-centered communication competency of ICU nurses, nursing organizational culture, types of communication, the Teamwork Measurement Tool, the Perceived Nursing Work Environment tool, and the Wong & Law Emotional Intelligence Scale. The collected data were analyzed using descriptive statistics, a correlation test, and a multiple regression.RESULTS: The ICU nurses' mean score on patient-centered communication competency was 3.97 points. The factors influencing the patient-centered communication competency level of ICU nurses were professionalism (p =.002), innovation-oriented organizational culture (p =.015), and emotional intelligence (p < .001). These variables explained 42.2% of the total variance in the patient-centered communication competency of ICU nurses.CONCLUSION: These findings suggest the need for developing a patient-centered communication competency improvement program that focuses on improving ICU nurses' professionalism and emotional intelligence, and facilitates the creation of an innovation-oriented organizational culture.