Carl-Johan Cederwall1, Sepideh Olausson2, Louise Rose3, Silvana Naredi4, Mona Ringdal5. 1. Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Sahlgrenska University Hospital, Central intensive care unit, CIVA, Gröna stråket 2, 413 45, Gothenburg, Sweden. Electronic address: carl-johan.cederwall@vgregion.se. 2. Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden. 3. Lawrence S. Bloomberg Faculty of Nursing and Interdepartmental Division of Critical Care Medicine, University of Toronto, 155 College St, Suite 276, Toronto, ON, M5T 1P8, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Provincial Centre of Weaning Excellence/Prolonged Ventilation Weaning Centre, Michael Garron Hospital, Toronto, Canada. 4. Department of Anaesthesiology and Intensive Care at Institute of Clinical Sciences, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden. 5. Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Sweden.
Abstract
OBJECTIVE: To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. RESEARCH METHODOLOGY: Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. SETTING: This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. FINDINGS: Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. CONCLUSION: We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research.
OBJECTIVE: To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. RESEARCH METHODOLOGY: Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. SETTING: This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. FINDINGS: Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. CONCLUSION: We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research.
Authors: Kimberly J Rak; Laura Ellen Ashcraft; Courtney C Kuza; Jessica C Fleck; Lisa C DePaoli; Derek C Angus; Amber E Barnato; Nicholas G Castle; Tina B Hershey; Jeremy M Kahn Journal: Am J Respir Crit Care Med Date: 2020-04-01 Impact factor: 21.405