NR 501 Concept Analysis Essay Chamberlain College of Nursing

NR 501: Theoretical Basis Advanced Nursing

Introduction

Nursing is a multifaceted career that transcends the basic medical tasks of administering medication, inserting catheters, and treating injuries. It has evolved into a profession deeply involved in comprehensive patient care. Modern nursing emphasizes enhancing patient involvement and empowerment in their own care. By centering care around patients, we aim to provide them with more information, involvement, and control over their treatment, thereby respecting their preferences, values, needs, and cultural backgrounds (Sitzman & Eichelberger, 2011).

Purpose

This essay employs the Walker and Avant method to conduct a concept analysis of patient-centered care, drawing on various referenced articles. Patient-centered care promotes greater patient engagement and awareness in healthcare interventions and treatments (Scott, 2010). Given the diverse patient populations in healthcare, it is crucial to consider these differences to achieve optimal health outcomes.

Uses

Patient-centered care is enhanced through effective communication between healthcare providers and patients. Communication allows patients to express their needs and preferences, facilitating their understanding and participation in their care. The terminology for patients may vary (e.g., client or resident) based on the setting (e.g., hospital, nursing home), but the essence of patient-centered care remains unchanged. It is crucial to individualize care without regard to the specific setting (Morgan & Yoder, 2011).

Literature Review

Morgan and Yoder (2011) utilized Walker and Avant’s model to explore patient-centered care, identifying four key attributes: individualized care, respect, empowerment, and a holistic approach. These attributes are essential for achieving excellent quality care and improving health outcomes. Training in patient-centered care has become a significant focus within the healthcare industry.

Lusk and Fater (2013) discussed the importance of patient-centered care as one of six key improvements in healthcare. While research indicates the effectiveness of patient-centered care, more data is needed to quantify nursing’s impact on this concept. They suggest that further research linking defined behaviors and attributes to improved outcomes could enhance our understanding of its effectiveness.

Hagan and Donovan (2013) explored the concept of self-advocacy using the Avant and Walker theory. They emphasized the importance of achieving personally relevant goals but noted that certain factors, such as loss of control, health literacy, and coping, require further research to understand their impact fully.

Defining Attributes

Morgan and Yoder (2011) identified the defining attributes of patient-centered care as empowering, holistic, respectful, and individualized. Empowerment encourages patients to be self-confident and proactive in their care. A holistic approach treats the patient as a whole, considering biological, social, spiritual, and psychological aspects. Respect ensures that patients’ decisions regarding their healthcare goals are acknowledged. Individualization involves addressing specific concerns and needs, engaging patients in their care process (Morgan & Yoder, 2011).

Antecedents and Consequences

Antecedents are conditions that precede the concept, while consequences are outcomes resulting from the concept (Morgan & Yoder, 2011). For example, a patient with stage IV ovarian cancer may have antecedents such as the need for specific interventions and the ability to manage her own care. These antecedents must be addressed to maintain patient-centered care. There is a significant correlation between antecedents and attributes; for autonomy to be achieved, the patient must be actively involved in their care (Lusk & Fater, 2013).

Empirical Referents

Empirical referents are measurable instances that demonstrate the occurrence of a concept. Hagan and Donovan (2013) discussed tools such as the Health Care Climate Questionnaire and the Schmidt Perception of Nursing Care Survey to measure patient-centered care. Morgan and Yoder (2011) utilized additional tools, including the Person-Centered Climate Questionnaire (PCQ), the Patient Satisfaction with Nursing Care Questionnaire (PSNCQQ), the Patient-Centered Inpatient Scale (P-CIS), and the Functional Independence Measurement (FIM), to measure various aspects of patient-centered care.

Model Case

A model case exemplifies all the defining attributes of a concept. Lusk and Fater (2013) described a case involving a woman with stage IV ovarian cancer. Despite a poor prognosis and limited treatment options, the patient was given comprehensive information about radiation, surgery, and hospice care. The nurse considered the patient’s cultural and religious background, preferences, and knowledge of hospice. Through active listening and providing ample time for decision-making, the nurse ensured that the patient was fully informed and involved in her care. This approach exemplifies patient-centered care, where the patient’s needs, values, and preferences are respected and supported.

Alternative Cases

A contrary case illustrates the opposite of the concept. Hagan and Donovan (2013) described Anne, a cancer patient whose symptoms worsened due to chemotherapy. Lacking support and communication from her healthcare provider, Anne felt unable to achieve a “normal life.” Miscommunication and a lack of trust prevented her from participating effectively in her care, resulting in suboptimal outcomes.

A borderline case involves attributes that differ in some way. An NP overseeing an infant care outpatient clinic implemented strategies to improve appointment attendance among low-income, teen mothers. By making same-day reminder calls and offering transportation assistance, the clinic saw improved attendance and better health outcomes (Hagan & Donovan, 2013).

Conclusion

Nursing is centered on holistic patient care, focusing on empowering patients to participate actively in their healthcare decisions. By promoting patient autonomy, confidence, and awareness of their treatment options, nurses can help patients achieve their desired health outcomes. Respect and support are fundamental to enhancing healthcare outcomes, and open communication is key to fostering patient autonomy (Ruben & Tinetti, 2012). With a collaborative approach to healthcare planning, optimal outcomes can be achieved.

References

Dabney, B. W., & Tzeng, H. (2013). Service Quality and Patient-Centered Care. MEDSURG Nursing, 22(6), 359-364.

Hagan, T. L., & Donovan, H. S. (2013). Self-Advocacy and Cancer: A Concept Analysis. Journal of Advanced Nursing, 69(10), 2345-2359. doi:10.1111/jan.12084

Lusk, J. M., & Fater, K. (2013). A Concept Analysis of Patient-Centered Care. Nursing Forum, 48(2), 89-97. doi:10.1111/nuf.12019

Morgan, S., & Yoder, L. H. (2011). A Concept Analysis of Person-Centered Care. Journal of Holistic Nursing, 1-10. doi:10.1177/0898010111412189

Ruben, D. B., & Tinetti, M. E. (2012). Goal-Oriented Patient Care — An Alternative Health Outcomes Paradigm. The New England Journal of Medicine, 366, 777-779. doi:10.1056/NEJMp1113631

Scott, A. (2010). Quality lessons. Patient-Centered Care Vital to Outcomes, Cost. Modern Healthcare, 40(46), 22.

Sitzman, K. L., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists: A creative beginning. (2nd ed.). Sudbury, MA: Jones and Bartlett.