University of Tasmania

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Patients' subjective experience of nurse-led clinics : a qualitative systematic review

posted on 2023-05-26, 03:08 authored by Jakimowicz, S
Aim To determine factors that impact the subjective experience of patients attending nurse-led clinics. Background As the number of nurse-led clinics increases in response to health system needs, evaluation has focused on clinical outcomes and cost. The experience of the patient has been less researched despite person-centred care being central to the health care political agenda for many years. Assessing patient experiences provides information of factors that impact the health care encounter that can inform policy and practice development. Design A systematic review of primary, qualitative literature was conducted using the methodology of meta-aggregation proposed by The Joanna Briggs Institute (JBI). Data Sources Published work from 1990 to the present date in English was located using databases CINAHL, PubMed, Medline and PsycINFO. Reference lists of all significant papers were searched and analysed. Review Methods Two reviewers assessed the retrieved papers for methodological quality using the System for the Unified Management, Assessment and Review of Information (JBI-SUMARI) software package. Results were synthesised using the metaaggregation method. The Qualitative Assessment Review Instrument (JBI-QARI) was utilized to critically appraise, extract data and aggregate findings in a rigorous and unbiased method. Results Eleven retrieved studies met all inclusion criteria and were incorporated in the review process. The papers described varied qualitative approaches: phenomenological-hermeneutic (6), exploratory or descriptive (3), and grounded theory (2). Nine categories were drawn from 46 key findings. Further analysis produced three synthesis statements titled: (i) establishment of a therapeutic relationship, (ii) effective communication, and (iii) clinical skills and collaboration. Conclusion Factors that influence patient experiences of nurse-led clinics should be addressed if such clinics are to continue to play a major role in the health care system. In order to improve patient experience of nurse-led clinics, nurses need to 'go back to basics' with regard to holistic nursing care. The concepts of the person-centred care model are key factors impacting patients' subjective experience of nurse-led health care. Further qualitative research is required to evaluate the person-centred care model in relation to clinical outcomes, clinical practice and educational programs for nursing students, novice and advanced practice nurses.


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