Patient Centered Care: Behind the Theory

Deanna Bassette

Chamberlain College of Nursing

Nursing 501 Theoretical Basis for Advanced Nursing Practice

June 3rd, 2018

Introduction

Working in the field of nursing requires individuals to set aside personal issues and focus on helping others. Nursing, fundamentally, is a profession rooted in caring—defined as feeling or showing concern for or kindness to others (Caring, n.d.). Over the years, many theorists have developed various viewpoints and theories on the essence of caring in nursing and its benefits for patients. These theories have been integrated into theoretical frameworks, creating comprehensive models that guide nursing practices. One notable framework is the Person-centered Nursing Framework (PCN), which aims to elevate the standard of care provided to patients globally (McCance, McCormack, & Dewing, 2011). This essay will discuss the PCN framework, its appraisal, its application in family nurse practitioner (FNP) practice, and a summary of its significance.

Overview of Patient Centered Care Model

Patient-centered care is an enduring concept in healthcare. Patient-centeredness is defined as “a standing or status bestowed upon one human being by others, in the context of relationship and social being. It implies recognition, respect, and trust” (McCance, McCormack, & Dewing, 2011, p. 1). McCormack identifies four core concepts: being in relation, being in a social world, being in place, and being with self. These concepts highlight the importance of holistic care, where the patient’s social, emotional, and physical needs are addressed within the context of their environment and relationships.

The PCN framework emphasizes the importance of understanding the patient’s experience and perspective. It advocates for a collaborative approach, where healthcare providers and patients work together to achieve optimal health outcomes. This model contrasts with traditional healthcare models that often prioritize the disease or condition over the patient’s individual needs and preferences.

Appraisal of the Patient Centered Care Model

The PCN framework has garnered widespread support for its holistic approach to patient care. It aligns with the core values of nursing, emphasizing empathy, respect, and partnership. Studies have shown that patient-centered care leads to improved patient satisfaction, better health outcomes, and enhanced patient engagement in their care (Epstein et al., 2005). Moreover, this model promotes better communication between patients and healthcare providers, fostering a therapeutic relationship built on trust and mutual respect.

Despite its advantages, the PCN framework faces several challenges. Implementing patient-centered care requires significant changes in healthcare systems, including training for healthcare providers, adjustments in clinical practices, and policy changes. Additionally, it demands more time and resources, which can be a barrier in busy healthcare settings with limited staffing and funding.

Research by Luxford, Safran, and Delbanco (2011) indicates that while many healthcare organizations recognize the value of patient-centered care, practical implementation often lags due to these challenges. There is a need for ongoing education, support, and resources to ensure that patient-centered care is not only understood but also effectively integrated into everyday practice.

Application of the Patient Centered Care Model as a Family Nurse Practitioner

As a Family Nurse Practitioner (FNP), the principles of the PCN framework are invaluable. FNPs are in a unique position to provide comprehensive, continuous care to patients across the lifespan. The PCN framework guides FNPs to consider the whole person rather than just the disease, fostering a more holistic approach to healthcare.

For example, in managing chronic conditions such as diabetes, an FNP using the PCN framework would not only focus on controlling blood sugar levels but also address the patient’s lifestyle, emotional well-being, and social support systems. This might involve collaborating with dietitians, social workers, and mental health professionals to create a comprehensive care plan tailored to the patient’s unique needs and circumstances.

Furthermore, the PCN framework encourages FNPs to actively involve patients in their care. This includes shared decision-making, where patients are educated about their conditions and treatment options, and their preferences and values are considered in developing the care plan. This collaborative approach empowers patients, leading to better adherence to treatment plans and improved health outcomes (Barry & Edgman-Levitan, 2012).

Conclusion

In conclusion, the Person-centered Nursing Framework (PCN) represents a significant shift in healthcare, emphasizing holistic, empathetic, and collaborative care. This model aligns with the core values of nursing, promoting better patient outcomes, satisfaction, and engagement. However, its implementation requires addressing several challenges, including the need for systemic changes and additional resources.

For Family Nurse Practitioners, the PCN framework provides a valuable guide for delivering comprehensive, patient-centered care. By focusing on the whole person and involving patients in their care, FNPs can significantly enhance the quality of care they provide, ultimately leading to better health outcomes and patient satisfaction.

References

• Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781. https://doi.org/10.1056/NEJMp1109283
• Caring. (n.d.). In Merriam-Webster’s online dictionary. Retrieved from https://www.merriam-webster.com/dictionary/caring
• Epstein, R. M., Fiscella, K., Lesser, C. S., & Stange, K. C. (2005). Why the nation needs a policy push on patient-centered health care. Health Affairs, 24(Suppl1), W555-W558. https://doi.org/10.1377/hlthaff.w5.555
• Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience. International Journal for Quality in Health Care, 23(5), 510-515. https://doi.org/10.1093/intqhc/mzr024
• McCance, T., McCormack, B., & Dewing, J. (2011). An exploration of person-centredness in practice. Online Journal of Issues in Nursing, 16(2), 1. https://doi.org/10.3912/OJIN.Vol16No02Man01

4o