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Abstract
Abstract
Aim: To describe and understand patients’ experiences as a means to conceptualize and evaluate outpatient person-centered care (PCC) in nurse-led rheumatoid arthritis (RA) clinics.
Methods: Persons with RA were interviewed about how they experienced their nurse-led outpatient care and about the meaning of living with persistent RA. Interviews were analyzed by qualitative content analysis and hermeneutic
phenomenology. Based on these results, existing PCC frameworks and hypothetical logical reasoning, a conceptual framework for nurse-led outpatient PCC was developed and used to operationalize a PCC instrument for outpatient
care in rheumatology (PCCoc/rheum). Acceptability and content validity of the PCCoc/rheum were evaluated, and its measurement properties were tested according to Rasch measurement theory (RMT).
Results: The experience of nurse-led outpatient care was expressed as social environment, professional approach and value-adding measures, all relating to the degree of PCC. Living with persistent RA was revealed as an existence dominated by painful symptoms and treatment, radical changes and limitations in life, a continual struggle to cope with life and to master the illness, and a dependency on those who are close by and the world around. Results also pointed to the need for a stronger PCC approach. An outpatient framework was conceptualized with five related domains, and was used to develop the PCCoc/rheum, which showed good acceptability and content
validity. RMT supported the accordance between the PCCoc/rheum and the conceptual framework, and its measurement properties were generally supported.
Conclusions: Experiences of persons with RA support a central role for PCC. The conceptual framework and the PCCoc/rheum have potentials to improve implementation and evaluation of outpatient PCC and contribute to quality
of care from a PCC perspective in nurse-led rheumatoid arthritis clinics.
Aim: To describe and understand patients’ experiences as a means to conceptualize and evaluate outpatient person-centered care (PCC) in nurse-led rheumatoid arthritis (RA) clinics.
Methods: Persons with RA were interviewed about how they experienced their nurse-led outpatient care and about the meaning of living with persistent RA. Interviews were analyzed by qualitative content analysis and hermeneutic
phenomenology. Based on these results, existing PCC frameworks and hypothetical logical reasoning, a conceptual framework for nurse-led outpatient PCC was developed and used to operationalize a PCC instrument for outpatient
care in rheumatology (PCCoc/rheum). Acceptability and content validity of the PCCoc/rheum were evaluated, and its measurement properties were tested according to Rasch measurement theory (RMT).
Results: The experience of nurse-led outpatient care was expressed as social environment, professional approach and value-adding measures, all relating to the degree of PCC. Living with persistent RA was revealed as an existence dominated by painful symptoms and treatment, radical changes and limitations in life, a continual struggle to cope with life and to master the illness, and a dependency on those who are close by and the world around. Results also pointed to the need for a stronger PCC approach. An outpatient framework was conceptualized with five related domains, and was used to develop the PCCoc/rheum, which showed good acceptability and content
validity. RMT supported the accordance between the PCCoc/rheum and the conceptual framework, and its measurement properties were generally supported.
Conclusions: Experiences of persons with RA support a central role for PCC. The conceptual framework and the PCCoc/rheum have potentials to improve implementation and evaluation of outpatient PCC and contribute to quality
of care from a PCC perspective in nurse-led rheumatoid arthritis clinics.
| Translated title of the contribution | Personcentrerad vård på sjuksköterskemottagningar inom reumatologisk öppenvård: Från upplevelse till mätning |
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| Original language | English |
| Qualification | Doctor |
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| Supervisors/Advisors |
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| Award date | 2017 Sept 1 |
| Place of Publication | Lund |
| Publisher | |
| ISBN (Print) | 978-91-7619-501-7 |
| Publication status | Published - 2017 |
Bibliographical note
Defence detailsDate: 2017-09-01
Time: 09:00
Place: City Hall, Helsingborg
External reviewer(s)
Name: Danielson, Ella
Title: professor em
Affiliation: Göteborg
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ISSN: 1652-8220
Lund University, Faculty of Medicine Doctoral Dissertation Series 2017:118
Subject classification (UKÄ)
- Medical and Health Sciences
Fingerprint
Dive into the research topics of 'Person-centered care in nurse-led outpatient rheumatology clinics. From experience to measurement.'. Together they form a unique fingerprint.Research output
- 2 Article
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Living with persistent rheumatoid arthritis: A BARFOT study
Bala, S. V., Samuelson, K., Hagell, P., Fridlund, B., Forslind, K., Svensson, B. & Thomé, B., 2017, In: Journal of Clinical Nursing. 26, 17-18, p. 2646-2656Research output: Contribution to journal › Article › peer-review
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The Experience of Care at Nurse-Led Rheumatology Clinics.
Bala, S.-V., Samuelson, K., Hagell, P., Svensson, B., Fridlund, B. & Hesselgard, K., 2012, In: Musculoskeletal Care. 17, 1, p. 202-211Research output: Contribution to journal › Article › peer-review