To meet the care needs of the rapidly ageing patient populations, the cultivation of a compassionate patient-centred healthcare culture has become central in the value-based healthcare discourse. A participatory music practice, ‘Meaningful Music in Healthcare’ employs a person-centred approach to music-making in Dutch hospitals. A grounded theory analysis on ethnographically collected data suggests that music-making serves as a social change agent and cultural resource for catalysing compassionate contact between healthcare professionals and patients. Processes of experiential growth and shared values in music-making and healthcare help to enrich care relationships and allow the emotional dimension of nurses’ professional performance to be explored.
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One approach to nursing is to value person-centred care as the preferred way of caring. Undergraduate nursing education may include specific courses that facilitate the development of person-centred care in students but it is not known which learning experiences students report as influential in this respect or which components of the courses contribute.The aims of this empirical study is to describe the perceived learning experiences gained during a one-semester course and their impact on the development of person-centred care in undergraduate nursing students, and to gain insight into which course components contributed to this development. In: In: International Practice Development Journal 8 (1)
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As a result of the COVID-19 measures, many people experienced social isolation and a lack of meaningful contact, especially vulnerable elderly people. For a specific group of musicians specialized in person-centred artistically-led participatory practices in healthcare settings, this sparked the exploration of migrating their live practice online, by making use of video-calling technology. From a ‘lifelong learning’ perspective—which considers musicians as being capable of responding to societal change by creating new, meaningful artistic practices—such a sudden migration from offline to online, under the exceptional circumstances at the beginning of the COVID-19 pandemic, created an instant challenge for the musicians to demonstrate their flexibility and adaptability. On the other hand, the limits caused by the conditions and immediacy of this response, combined with a feeling of diminished humanness in virtual interaction, seemed to jeopardize the person-centred values that the work of this group is built upon.This article explores this issue by expanding on the musicians’ flexibility towards personcentredness and their attempts to safeguard these values when they suddenly switch from a ‘physical’ to ‘virtual’ space.
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Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational cohort study included 132 nurses who rated pain behaviour in 75 patients. The majority of nurses indicated that BPS and CPOT reflect background and procedural pain-specific features (63–72 and 87–80%, respectively). All BPS and CPOT items loaded on one latent variable (≥0.70), except for compliance ventilator and vocalisation for CPOT (0.69 and 0.64, respectively). Internal consistency also met the criterion of ≥0.70 in ventilated and non-ventilated patients for both scales, except for non-ventilated patients observed by BPS (0.67). Intraclass correlation coefficients (ICCs) of total scores were sufficient (≥0.70), but decreased when patients had facial burns. In general, the scales were fast to administer and easy to understand. Cut-off scores for BPS and CPOT were 4 and 1, respectively. In conclusion, both scales seem valid, reliable, and useful for the measurement of acute pain in ICU patients with burns, including patients with facial burns. Cut-off scores associated with BPS and CPOT for the burn population allow professionals to connect total scores to person-centred treatment protocols.
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Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands. Methodology & Methods A collective case study methodology was used. Seventy-five hours of observation, interview and documentary data was gathered over six weeks. Alternative strategies of communication were developed to enable the co-creation of dialogue between participants and researcher. For example, a participant who could not talk used intentionally created artwork to share her ideas with the researcher. Findings Participants' daily experiences were characterised by struggling against the constraints of the residential setting: having to wait, having unmet needs, experiencing vulnerability and uncertainty. Participants' communication difficulties exacerbated these constraints. Their experiences of struggling were sometimes ameliorated by significant social contact with family or particular staff members, and engaging in enjoyable activities. Occasionally the experiences of enjoying the here-and-now, and being 'seen' as a person by the other, would create beautiful moments in which truly person centred engagement would occur. These moments were neither articulated nor recorded, and were thus invisible after they had occurred. Similarly, the experiences of struggling against the constraints were neither acknowledged nor recorded. Significant experiences in the lives of these four residents were therefore invisible to others. The unifying theme representing the participants' daily experiences was: That which goes unsaid. Discussion It was necessary to develop communication strategies which would by-pass the researcher's assumptions and enable participants to introduce their own ideas and opinions. This ongoing process of co-creation of dialogue required work from, and trust between, participants and researcher. What is new? Expressly seeking the views of residents with communication difficulties Successfully using process consent with participants in this situation Using intentionally created artwork during data gathering in this context What has regional, national or international relevance? The findings indicate that people with communication difficulties may not receive optimal care in residential settings in the Netherlands. Methods are described which could be used by practitioners in their everyday work, and which show facilitators or practice developers how they can help carers to engage in more effective communication with this kind of resident. Additionally, this research contributes to the international discussion about ethical participation of vulnerable people in research.
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Background: Patient involvement in interprofessional education (IPE) is a new approach in fostering person-centeredness and collaborative competencies in undergraduate students. We developed the Patient As a Person (PAP-)module to facilitate students in learning from experts by experience (EBEs) living with chronic conditions, in an interprofessional setting. This study aimed to explore the experiences of undergraduate students, EBEs and facilitators with the PAP-module and formulate recommendations on the design and organization of patient involvement in IPE. Methods: We collected data from students, EBEs and facilitators, through eight semi-structured focus group interviews and two individual interviews (N = 51). The interviews took place at Maastricht University, Zuyd University of Applied Sciences and Regional Training Center Leeuwenborgh. Conventional content analysis revealed key themes. Results: Students reported that learning from EBEs in an interprofessional setting yielded a more comprehensive approach and made them empathize with EBEs. Facilitators found it challenging to address multiple demands from students from different backgrounds and diverse EBEs. EBEs were motivated to improve the personcentredness of health care and welcomed a renewed sense of purpose. Conclusions: This study yielded six recommendations: (a) students from various disciplines visit an EBE to foster a comprehensive approach, (b) groups of at least two students visit EBEs, (c) students may need aftercare for which facilitators should be receptive, (d) EBEs need clear instruction on their roles, (e) multiple EBEs in one session create diversity in perspectives and (f) training programmes and peer-to-peer sessions for facilitators help them to interact with diverse students and EBEs.
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Lifelong learning is necessary for nurses and caregivers to provide good, person-centred care. To facilitate such learning and embed it into regular working processes, learning communities of practice are considered promising. However, there is little insight into how learning networks contribute to learning exactly and what factors of success can be found. The study is part of a ZonMw-funded research project ‘LeerSaam Noord’ in the Netherlands, which aims to strengthen the professionalization of the nursing workforce and promote person-centred care. We describe what learning in learning communities looks like in four different healthcare contexts during the start-up phase of the research project. A thematic analysis of eleven patient case-discussions in these learning communities took place. In addition, quantitative measurements on learning climate, reciprocity behavior, and perceptions of professional attitude and autonomy, were used to underpin findings. Reflective questioning and discussing professional dilemma's i.e. patient cases in which conflicting interests between the patient and the professional emerge, are of importance for successful learning.
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The ageing of people with intellectual disabilities, with associated morbidity like dementia, calls for new types of care. Person-centered methods may support care staff in providing this, an example being Dementia Care Mapping (DCM). DCM has been shown to be feasible in ID-care. We examined the experiences of ID-professionals in using DCM. We performed a mixed-methods study, using quantitative data from care staff (N = 136) and qualitative data (focus-groups, individual interviews) from care staff, group home managers and DCM-in-intellectual disabilities mappers (N = 53). ageing, dementia, Dementia Care Mapping, intellectual disability, mixed-methods, personcentred care
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Over the last two decades, much work has been done for developing person-centred approaches in social and health services in order to deliver better treatment and care for older people. Communication is pivotal in person-centred care and services. Communication skills are necessary to understand the needs and wishes of the older people and their families and be able to decide for the best person-centred care. Competences of the communicator role are maintaining relationships and effective communication, empowerment and coaching.
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The concept of Smart Healthy Age-Friendly Environments (SHAFE) emphasises the comprehensive person-centred experience as essential to promoting living environments. SHAFE takes an interdisciplinary approach, conceptualising complete and multidisciplinary solutions for an inclusive society. From this approach, we promote participation, health, and well-being experiences by finding the best possible combinations of social, physical, and digital solutions in the community. This initiative emerged bottom-up in Europe from the dream and conviction that innovation can improve health equity, foster caring communities, and sustainable development. Smart, adaptable, and inclusive solutions can promote and support independence and autonomy throughout the lifespan, regardless of age, gender, disabilities, cultural differences, and personal choices, as well as promote happier and fairer living places.
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