Being taken seriously. Person-centredness and person-centred climate as experienced by patients and significant others when the patient is assessed as non-urgent by the Swedish Ambulance Service

Background: The experience of person-centredness and person-centred climate is poorly understood in the context of being assessed as non-urgent and, in many cases, left at home by the Ambulance Service.
Aim: The overall objective of this thesis was to explore experiences of person-centredness and the person-centred climate among patients and significant others when patients were assessed as non-urgent by the Swedish Ambulance Service.
Methods: Both an inductive and deductive approach has been used in combination with qualitative and quantitative research methods.
The study group consisted of I) 12 patients and II) 111 patients who were considered non-urgent and thus recommended for triage and non-conveyance by the Ambulance Service as well as III) 11 significant others and IV) 100 significant others of patients considered non-urgent and therefore not conveyed to the Accident and Emergency Department. Interviews were performed and analysed by means of phenomenological hermeneutics developed by Lindseth and Norberg. The instruments used for data collection were the Person-centred Climate Questionnaire, Patient/Family version. In addition, questions from the inductive studies were tested for construct validity.
Results: The meaning of person-centredness among the patients was a strong wish to be taken seriously. The climate was perceived as highly person-centred. Being taken seriously resulted in feelings of trust and being an active
partner in the decision-making process. In contrast, a sense of being rejected and insulted arose when not taken seriously. Eight aspects of person-centredness were established psycho¬metrically with a one-factor solution covering 79.9 % of the variance. The patients reported the climate as person-centred. Significant others wished to be de-burdened from their caring responsibilities and not abandoned in the present situation. The single most important factor for achieving this was ensuring that the patient was taken
seriously. The significant others reported that the psychosocial climate was person-centred. Eight aspects of person-centredness and being de-burdened were established psychometrically with a onefactor solution explaining 58.8 % of the variance.
Conclusion: It is possible to achieve a person-centred climate within in the Ambulance Service irrespective of time and location, due to the fact that person-centredness mainly concerns taking patients seriously and providing a moment of de-burdening for significant others.