A dimensional analysis of patient-centered care.
BACKGROUND
Patient-centered care (PCC) is a poorly conceptualized phenomenon and can indicate anything from soothing room design, emotional support of patients, customization of meals, to support of patient decision making. This inconsistency across the clinical and research literature makes the application of PCC difficult.


OBJECTIVE
The objective of this study was to identify dimensions of PCC as found in the literature.


METHODS
A dimensional analysis of PCC was conducted from 69 clinical and research articles published from 2000 to 2006. Coding of the literature for the perspective, context, conditions, process, and consequences of PCC was completed. These codes were used to determine literature selected for inclusion, organize article content, and frame the delineation of PCC.


RESULTS
Alleviating vulnerabilities, consisting of both compromised physiological states and threats to individual identity, was constant throughout the literature. Therapeutic engagement was the process sustaining the patient during an illness episode that necessitated service use and involved allocating time, carrying out information practices, knowing the patient, and developing a relationship. This process occurs during nurse-patient interaction, sustained during successive interactions, and reinforced by the information practices of a particular setting.


CONCLUSIONS
The interaction between nurse and patient is central to the effective study and application of PCC. Appropriate use of PCC can improve study outcomes and measurements by clarifying the variables involved, and PCC holds great promise to frame patient outcome and satisfaction research by analyzing how and with what effect nurses alleviate patient vulnerability. Moreover, consideration of information practices as a critical supporting structure of nurse-patient interaction can be explored.
Hobbs
Jennifer Lynn
JL
School of Nursing, University of Pennsylvania, Philadelphia, USA. Jennifer.Hobbs@va.gov
D003659:Decision Making, Organizational; D017598:Efficiency, Organizational; D006301:Health Services Needs and Demand; D006801:Humans; D007374:Interior Design and Furnishings; D007389:Internal-External Control; D016294:Models, Nursing; D017146:Models, Organizational; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D009736:Nursing Process; D015399:Nursing Research / Q000458:organization & administration*; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D018802:Patient-Centered Care / Q000458:organization & administration*; D011209:Power, Psychological; D012648:Self Care; D012944:Social Support; D012962:Sociology, Medical; D017749:Total Quality Management / Q000458:organization & administration; D035862:Vulnerable Populations