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Value discrepancies between nurses and patients : a survey study

Liesbeth Van Humbeeck (UGent) , Simon Malfait (UGent) , Els Holvoet (UGent) , Dirk Vogelaers (UGent) , Michel De Pauw (UGent) , Nele Van Den Noortgate (UGent) and Wim Van Biesen (UGent)
(2020) NURSING ETHICS. 27(4). p.1044-1055
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Abstract
Background: Patient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients' and nurses' perspective seems crucial. Aim: To explore how patients and their nurses perceive the importance and enactment of values in their healthcare. Research design: An observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and empowerment) as described in the taxonomy of Bastemeijer et al. Participants and research context: The survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium. Ethical considerations: This study was approved by the ethical committee of the Ghent University Hospital (B670201836799). Findings: (1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients. Discussion: Our findings challenge nurses' overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs. Conclusion: Our findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients.
Keywords
DECISION-MAKING, CENTERED CARE, PARTICIPATION, PREFERENCES, INVOLVEMENT, PERSPECTIVES, EMPOWERMENT, KNOWLEDGE, AUTONOMY, Hospital, nurses, patient-centered care, patients, prioritization, quantitative, survey, values

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MLA
Van Humbeeck, Liesbeth, et al. “Value Discrepancies between Nurses and Patients : A Survey Study.” NURSING ETHICS, vol. 27, no. 4, 2020, pp. 1044–55, doi:10.1177/0969733020906595.
APA
Van Humbeeck, L., Malfait, S., Holvoet, E., Vogelaers, D., De Pauw, M., Van Den Noortgate, N., & Van Biesen, W. (2020). Value discrepancies between nurses and patients : a survey study. NURSING ETHICS, 27(4), 1044–1055. https://doi.org/10.1177/0969733020906595
Chicago author-date
Van Humbeeck, Liesbeth, Simon Malfait, Els Holvoet, Dirk Vogelaers, Michel De Pauw, Nele Van Den Noortgate, and Wim Van Biesen. 2020. “Value Discrepancies between Nurses and Patients : A Survey Study.” NURSING ETHICS 27 (4): 1044–55. https://doi.org/10.1177/0969733020906595.
Chicago author-date (all authors)
Van Humbeeck, Liesbeth, Simon Malfait, Els Holvoet, Dirk Vogelaers, Michel De Pauw, Nele Van Den Noortgate, and Wim Van Biesen. 2020. “Value Discrepancies between Nurses and Patients : A Survey Study.” NURSING ETHICS 27 (4): 1044–1055. doi:10.1177/0969733020906595.
Vancouver
1.
Van Humbeeck L, Malfait S, Holvoet E, Vogelaers D, De Pauw M, Van Den Noortgate N, et al. Value discrepancies between nurses and patients : a survey study. NURSING ETHICS. 2020;27(4):1044–55.
IEEE
[1]
L. Van Humbeeck et al., “Value discrepancies between nurses and patients : a survey study,” NURSING ETHICS, vol. 27, no. 4, pp. 1044–1055, 2020.
@article{8670475,
  abstract     = {Background: Patient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients' and nurses' perspective seems crucial. Aim: To explore how patients and their nurses perceive the importance and enactment of values in their healthcare. Research design: An observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and empowerment) as described in the taxonomy of Bastemeijer et al. Participants and research context: The survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium. Ethical considerations: This study was approved by the ethical committee of the Ghent University Hospital (B670201836799). Findings: (1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients. Discussion: Our findings challenge nurses' overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs. Conclusion: Our findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients.},
  articleno    = {0969733020906595},
  author       = {Van Humbeeck, Liesbeth and Malfait, Simon and Holvoet, Els and Vogelaers, Dirk and De Pauw, Michel and Van Den Noortgate, Nele and Van Biesen, Wim},
  issn         = {0969-7330},
  journal      = {NURSING ETHICS},
  keywords     = {DECISION-MAKING,CENTERED CARE,PARTICIPATION,PREFERENCES,INVOLVEMENT,PERSPECTIVES,EMPOWERMENT,KNOWLEDGE,AUTONOMY,Hospital,nurses,patient-centered care,patients,prioritization,quantitative,survey,values},
  language     = {eng},
  number       = {4},
  pages        = {0969733020906595:1044--0969733020906595:1055},
  title        = {Value discrepancies between nurses and patients : a survey study},
  url          = {http://dx.doi.org/10.1177/0969733020906595},
  volume       = {27},
  year         = {2020},
}

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