title: Nurses' understanding of patient-centred care in Bhutan.
abstract: OBJECTIVE
  The purpose of the study was to explore nurses' perceptions and understanding of patient-centred care (PCC) in Bhutan.
  
  
  BACKGROUND
  Nurses' perceptions and understanding of PCC in Bhutan are unknown.
  
  
  METHODS
  A non-probability convenience sample was taken and a mixed method (quantitative and qualitative descriptive) used. Survey questionnaires were administered to 87 Bhutanese nurses in three types of hospitals--the National Referral Hospital, the regional referral hospital and the district hospital. Descriptive statistics including frequency distribution, mean and standard deviation (SD) were used for analysis. Spearman's correlation coefficients were used to investigate relationships between demographic variables.
  
  
  RESULTS
  The nursing labour force in Bhutan knows which behaviours are considered necessary for practising PCC. The mean (SD) rating of behaviours considered critical for practising PCC was 4.29 (0.22), five being the highest score. Bhutanese nurses described PCC, according to qualitative descriptive analysis, as being based on individual patient assessment (22/87 or 25% of respondents), using a holistic model of care (38/87 or 44%) that was based on evidence (38/87 or 44%). A higher level of education (79/87 or 91%) was found to be the main factor that would facilitate the development of PCC, while inadequate staffing, in terms of insufficient numbers of staff and lack of advanced practitioners (56/87 or 64%), was revealed as the main factor that hinders development of PCC.
  
  
  CONCLUSIONS
  Bhutanese nurses believed certain behaviours were critical to PCC. Reform of higher nursing education, putting an emphasis on PCC, would improve nursing practice and increase its scope.
authors.affiliation: Jigme Dorji Wangchuk National Referral Hospital, Ministry of Health, Royal Government of Bhutan, Thimphu.
authors.forename: Rinchen
authors.initials: R
authors.lastname: Pelzang
authors.forename: Beverley
authors.initials: B
authors.lastname: Wood
authors.forename: Simon
authors.initials: S
authors.lastname: Black
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001631:Bhutan; D032882:Comprehension; D003906:Developing Countries; D004509:Education, Nursing, Continuing; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D018802:Patient-Centered Care / Q000458:organization & administration*; D036301:Qualitative Research; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires