The integration of a person-centered approach in palliative care

被引:20
作者
Lavoie, Mireille [1 ]
Blondeau, Danielle [1 ]
Martineau, Isabelle [2 ]
机构
[1] Univ Laval, Fac Sci Infirmieres, Ctr Rech Ctr Hosp Univ Quebec Hotel Dieu Quebec, Quebec City, PQ G1V 0A6, Canada
[2] Maison Michel Sarrazin, Quebec City, PQ, Canada
关键词
Palliative care; Autonomy; Person-centered approach; Humanbecoming; QUALITY-OF-LIFE; TERMINALLY-ILL; AUTONOMY; DIGNITY; CANCER; MODEL; END;
D O I
10.1017/S1478951512000855
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: The philosophy underlying palliative care places the respect of patients and their autonomy at the heart of clinical practice. A study was conducted at a palliative care facility to document changes that occurred after the integration of a person-centered approach focusing on human freedom (which is linked to autonomy): the humanbecoming school of thought. It aimed to describe changes observed in the beliefs and practices of healthcare providers, the concept and respect of autonomy by healthcare providers, care and respect of autonomy experienced by patients' relatives, and consideration of patients' wishes through their documentation. Method: The method adopted consisted of a pre-project - process - post-project descriptive qualitative design and was inspired by teaching-learning and mentoring models. Data were collected from 51 healthcare providers and 10 relatives through semistructured interviews and from the medical records of 30 patients during the pre- and post-project phases. They were analyzed and compared at the end of the study. The process phase consisted of offering training sessions and mentoring, encouraging the involvement of healthcare providers, and cocreating integration and care tools. Results: While the analysis exposed some discrepancies with the language of the approach and differences between nurses and other healthcare providers, it revealed, above all, similarities in the changes observed between the different sources of data. The focus moved from being task-centered to being person-centered; the affirmation of the priority of respecting patients' choices, desires, and needs; a presence shifting from being available to true listening; the affirmation of following the ever-changing rhythm of the patient; and a notion of respect of autonomy now including the other. Significance of results: In line with the philosophy of palliative care, the project demonstrated that the integration of the humanbecoming approach can result in changes that contribute to the development of a more person-centered practice.
引用
收藏
页码:453 / 464
页数:12
相关论文
共 51 条
  • [1] Research sensitivities to palliative care patients
    Addington-Hall, J
    [J]. EUROPEAN JOURNAL OF CANCER CARE, 2002, 11 (03) : 220 - 224
  • [2] [Anonymous], 2001, Crossing the Quality Chasm: A New Health System for the 21st Century
  • [3] Existential issues in palliative care -: Interviews with cancer patients
    Bolmsjö, I
    [J]. JOURNAL OF PALLIATIVE CARE, 2000, 16 (02) : 20 - 24
  • [4] Striving for balance: Palliative care patients' experiences of making everyday choices
    Bottorff, JL
    Steele, R
    Davies, B
    Garossino, C
    Porterfield, P
    Shaw, M
    [J]. JOURNAL OF PALLIATIVE CARE, 1998, 14 (01) : 7 - 17
  • [5] Research evaluating human becoming in practice
    Bournes, DA
    [J]. NURSING SCIENCE QUARTERLY, 2002, 15 (03) : 190 - 195
  • [6] Human becoming and 80/20:: An innovative professional development model for nurses
    Bournes, Debra A.
    Ferguson-Pare, Mary
    [J]. NURSING SCIENCE QUARTERLY, 2007, 20 (03) : 237 - 253
  • [7] Buckley Jenny, 2004, Nurs Stand, V19, P33
  • [8] *CAN HOSP PALL CAR, 2002, MOD GUID HOSP PALL C
  • [9] Canadian Nurses Association:, 2012, HOSP PALL CAR NURS C
  • [10] Living with a terminal illness: patients' priorities
    Carter, H
    MacLeod, R
    Brander, P
    McPherson, K
    [J]. JOURNAL OF ADVANCED NURSING, 2004, 45 (06) : 611 - 620