A Concept Analysis on

Patient-Centered Care

BSN 1 – D

Submitted to: Mrs. Marianne G. Sotelo

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 TABLE OF CONTENTS

COVER PAGE………………………………………………………………………………………..……i

TABLE OF CONTENTS……………………………………………………………………………….…ii

INTRODUCTION………………………………………………………………………………………….1

DEFINITION OF PATIENT-CENTERED CARE............................................................................1

CONCEPT COMPARISON………………………………………………...……………………………2

LITERATURE REVIEW.................................................................................................................4

DEFINING ATTRIBUTES………………………………………………………………………………..5

ANTECEDENT AND CONSEQUENCE………………………………………………………………..7

EMPIRICAL REFERENTS………………………………………………………………………………8

MODEL CASES…………………………………………………………………………………………..8

ALTERNATIVE CASES………………………………………………………………………………….9

CONCLUSION…………………………………………………………………………………………..10

LIST OF GROUP MEMBERS…………………………………………………………………………11

REFERENCES…………………………………………………………………………………………..12

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INTRODUCTION

Patient-centered care has been significant in the world of nursing practice. There is a need
for a comprehensible and common understanding of the purpose of the concept to support in the
advancement of various effective strategies and to implement the application and provision of a
structural guide of these approaches for essential and proper caring of patients. Patient-Centered
Approach to Nursing was developed by Faye G. Abdellah which she intended to provide a
roadmap beyond the conventional care of the patients with their health needs, whether ill or well
(Santana, et al., 2017). According to Abdellah, nursing is based on an art and science that mold
the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire
and ability to help people, sick or well, cope with their needs. It has been a prime concern to
nursing practice and knowledge to provide relevant and correct information about patient-
centered care. This enables nurses to cultivate themselves and develop policies that could
possibly affect practice for a consistent knowledge base (Ortiz, 2018).
This paper covers nine sections: (1) Definition of Patient-Centered Care, (2) Concept
Comparison, (3) Literature Review, (4) Defining Attributes, (5) Antecedent and Consequence, (6)
Empirical Referents, (7) Model Cases, (8) Alternative Cases, and (9) Conclusion.

DEFINITION OF PATIENT-CENTERED CARE

Every patient's personal experiences, foundations, and way of living has resulted in his or
her various values, preferences, and desired health outcomes. From the traditional model wherein
a care provider endorses the same treatment to most patients sharing the same conditions or
diagnoses, the connection between both the providers and the patients, which is included in the
patient-centered care, is transformed into a patient-provider partnership in which there are options
depending on the patient's unique concerns, preferences, and values (Solomon, nd.).
Patient-centered care is a practice of providing care to patients (and their families) in a
meaningful and important manner to individual patient. This involves listening, advising and
engaging them in their care (Oneview, 2015). Patient-centered care (PCC) has primarily
approached health care. The approach underscores health relationships among patients and
medicinal services experts, recognizes patients' preferences and values, promotes flexibility in
the arrangement of human services, and seeks to move past the customary paternalistic way to
deal with social insurance. The PCC approach therefore recognizes the beliefs and values of a
patient in addition to the physical aspects of health care towards wellbeing. One of its advantages
includes its emphasis to enhance patient satisfaction; notwithstanding, recently, concerns have
been raised with regards to the impacts of the PCC on the evidence-based care approach, as the
two approaches are seen as fundamentally unrelated instead of corresponding. It also gives
considerations to nurses’ commitment to PCC and in the enhancement of service delivery
(Delaney, 2018).

According to NEJM Catalyst (2017), the primary goal and benefit of patient-centered care
is to improve individual health outcomes, not just population health outcomes, although population
outcomes may also improve. Not only do patients benefit, but providers and health care systems
benefit as well, through:

• Improved satisfaction scores among patients and their families.

• Enhanced reputation of providers among health care consumers.
• Better morale and productivity among clinicians and ancillary staff.

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 • Improved resource allocation.
• Reduced expenses and increased financial margins throughout the continuum of
care.

Patient-centered approach to nursing which was developed by Faye G. Abdellah

inductively from her practice is considered a human needs theory. Created to assist with nursing
education, this theory is most applicable to nurses’ education. Guiding care of patients in the
hospital is its intention; it also has relevance for nursing care in community settings. As Abdellah
stated, nursing depends on an art and science that form the attitudes, intellectual competencies,
and technical skills of the individual nurse into the desire and capability to help people, sick or
well, cope with their health needs.

The theory also helps to identify nursing responsibilities.

• Effective communication between patient and caregiver. Information is accurate,

timely, and appropriate.
• Do everything possible to alleviate patients’ pain and make them feel comfortable.
• Provide emotional support and alleviate fears and anxiety.
• Involve family and friends in every phase of the patients’ care.
• Ensure a smooth transition and continuity from one focus of care to another.
• Guarantee every member of the community has access to the care.

Patient-Centered Approaches to Nursing

Abdellah’s theory state’s that nursing is the use of the problem solving approach with key
nursing problems related to health needs of people.

Health is a dynamic pattern of functioning whereby there is a continued interaction with

internal and external forces that results in the optimum use of necessary resources that serve to
minimize vulnerabilities (Lampkin, 2015).

CONCEPT COMPARISON (Use of Concept of Patient-Centered Care in Dentistry)

Patient-centered care (PCC) has become the cornerstone in the delivery of healthcare. It
is an approach that involves the patients in decision-making about their health in order for them
to receive healthcare while dignity and respect are being taken into account. This concept,
however, is not only limited to the nursing profession but also to a number of other fields. This
includes the application of the concept in general dental practice.
The perspective of dentistry to patient-centered care emphasizes a holistic and
humanitarian approach coupled with good quality general care. A qualitative study conducted by
Scambler, S., Gupta, A., & Asimakopoulou, K. (2015) asserts that the concept, when applied to
the field of dentistry, falls into six broad themes which are: First, individualized care where the
patients are the focus of care along with ensuring that all of their clinical oral health needs are
satisfied. Next is care in the best interests of the patient which is concerned in providing quality
competent care by a dental practitioner with appropriate technical expertise for the specific needs
of the patient. Succeeding this is humanity which is centered on the clinician’s attitude towards
the patient. Following this is holistic care where every aspect of the patient is considered. Then,
patient involvement where balanced decision-making between the patient and a dental
practitioner is incorporated. Lastly, political construction which regards PCC as a marketing tool.

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 In the United Kingdom, quality care within dental services has been an aspiration, but
designing an effective method has been a problem. In 2006, a new system which aimed to
improve patient access, promote prevention and deliver quality was introduced but the system
failed to deliver on its key objective. In 2014, “Improving Oral Health – A Call to Action” was
launched which aimed to developing a long-term strategic plan for dentistry in the UK. A Dental
Quality and Outcomes Framework (DQOF) was developed to measure quality but is still being
evaluated. The quality measure is based around three dimensions: Clinical Effectiveness, Patient
Experience and Safety (Mills et al., 2014).
The perspective of Dentistry with PCC shares a lot of similar views with Nursing on the
concept. Delaney (2017) suggests that there should be an “emphasis on the partnerships in health
between patients and healthcare professionals”. In the same fashion, dental practitioners allow
their patients to decide from a set of choices made available to them. Both perspectives highlight
the need for patients to feel involved in the treatment process. Professionals involved in both
nursing and dentistry should acknowledge the patient’s preferences and values that would
influence the appropriate treatment that will be utilized (Scambler, S., Gupta, A., & Asimakopoulou,
K., 2015). That is to say that they should be given the ability to make informed choices based on
what clinicians are able to recommend the treatment that they need. Delaney (2017) also stresses
the importance of PCC as an approach for enhanced patient satisfaction and patient self-care.
The utilization of PCC in nursing increases patient’s confidence to healthcare professionals and
drastically lowers healthcare costs. A study by Bertakis and Azari (2011) found that those patients
who received more patient-centered care have seen a significant reduction to number of specialty-
care visits, hospitalizations, and diagnostic services, as were total health-care charges and
specialty-care charges. Likewise, PCC in dentistry results in patient satisfaction where
compliance with treatment recommendations, improve clinical outcomes, and better
postoperative experience correlates to high patient satisfaction, hence, resulting in cost
containment.
Williams (2010) stated that no proper agreement or consensus was established despite
the fact that Patient-Centered Care has become the cornerstone in the delivery of healthcare.
This means that it may differ from one professional to another and from one organization to
another. As such, Patient-Centered Care for Nursing may vary from that of Dentistry.
Patient-Centered Care for Nursing occurs when processes are directed toward reducing
or eliminating patient vulnerabilities. Therapeutic engagement of the patient happens when the
vulnerabilities are being addressed. The development of trust on the interaction between the
nurse and patient is very crucial in engaging the patient. According to Williams (2010), “When
therapeutic engagement is successful, the patient receives effective care, needs are met, and
suffering is lessened.”
Ben Natan (2017) presented dimensions on Patient-Centered Care which include respect,
dignity, information sharing and collaborations. According to Steiger and Balog (2010), other
definitions are delivery of respectful and responsible care, which considers each patient's
preferences, needs and personal values, and ensures that personal values of each patient will be
at the base of all patient-related therapeutic decisions. Delivery of PCC means that professionals
work together with the patient to develop a program achieved by having a mutual consent. Smith-
Stonner (2011) stated that relevant laws and regulations are discussed and mutually agreed by
the medical personnel, patient and the patient’s family.
Meanwhile, Patient-Centered Care for Dentistry has six broad themes as stated by
Scambler et al. (2015). First, individualized care where the patient is the center of care and
ensuring that all clinical oral health needs were met. Second, care in the best interest of the patient,
which is about the provision of care that met the clinical needs of the patient. Next is humanity

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which is focused on the interaction of the clinician and the patient. After that is holistic care which
is tailored to a particular patient’s needs. Following is patient involvement where decision-making
should be balanced between the clinician and the patient. Lastly, political construction wherein
PCC is regarded as a rebranding work that already takes place in the form of good practice.

LITERATURE REVIEW

Everything about the process is a manifestation of a greater scale. The records of

Pennsylvania State University (2016) stated that under difficult cases, the continuous exposure
to suffering, to needy people, where the needs and suffering have to be translated into solved
problems, are reckoned up as the output of the medical team. Patient centered-care is, hence,
conceived to be something beyond the bounds of customer service alone. It incorporates the on-
going hospital initiatives and the nature of specific positions. It involves the development of
relationships and care plans between staff and patients. In other words, patient centered-care
encompasses the reciprocal nature of all relationships through patient and staff collaboration. In
fact, studies show that when healthcare administrators, providers, patients and families work in
partnership, the quality and safety of health care rises, costs decrease, and provider and patient
satisfaction increases.
The concepts of ‘patient-centered care’ are co-related and emerging. According to
Goodrich and Cornwell (2011), the core elements are education and shared knowledge,
involvement of family and friends, collaboration and team management, sensitivity to nonmedical
and spiritual dimensions of care, respect for patient needs and preferences and the free flow and
accessibility of information. Similarly, Carrier (2015), as cited from the work of Robb and Seddon,
indicated the dimensions of care quality brought by common concepts which are informing and
involving patients, eliciting and respecting patient preferences, engaging patients in the care
process, treating patients with dignity, designing care processes to suit patient needs, ready
access to health information and continuity of care.
Within the clinical consultation, patient centered care is the interaction between the
clinician and the patient. It refers to the clinician’s behavioral skills to customize care to the specific
needs and circumstances of each individual, that is, to modify care to respond to the person, not
the person to the care (National Diabetes Education Program, 2007). It encourages clinicians to
think about ways of integrating patients’ perceptions into consultations (Kinmonth, 1998). The
focus of the patient centered consultation is on the partnership between patients, families and
providers (National Diabetes Education Program, 2007), with acknowledgement of the patient’s
treatment and life goals (National Asthma Council Australia, 2007).
Epstein and Street Jr. (2011) stated that patient-centered care is a quality of personal,
professional, and organizational relationships. Thus, efforts to promote patient-centered care
should consider patient-centeredness of patients (and their families), clinicians, and health
systems. Helping patients to be more active in consultations changes centuries of physician-
dominated dialogues to those that engage patients as active participants. Training physicians to
be more mindful, informative, and empathic transforms their role from one characterized by
authority to one that has the goals of partnership, solidarity, empathy, and collaboration. Their
article identified several shortcomings of current approaches to measuring patient-centered care,
many of which resulted from confusion between its associated philosophy, behaviors, and
outcomes. Firstly, philosophically, patient-centered care is an approach to care and perceived as
the right thing to do. Second, many of the measures confound behaviors with outcomes, leading
to confusing results. Consider a situation in which a patient is satisfied with her physician’s

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listening skills, yet her chronic disease control worsens. Third, it is commonly assumed that the
patient is the best judge of whether an interaction is patient centered. Finally, patients’ and
physicians’ perceptions of a clinical encounter differ, and each differs somewhat from the
assessments of communication experts using sophisticated coding of audio-recorded clinical
encounters.
Heyman and Congress (2018), in their book of Health and Social Work: Practice, Policy,
and Research, mentioned how patient-centered inpatient unit consistently demonstrated a shorter
average length of stay and increased satisfactory rates. Other benefits associated with patient-
centered care include decreased mortality, decreased emergency department return visits, fewer
medication errors, lower infection rates, higher functional status, improved clinical care, and
improved liability claims experience. In application to patients with chronic conditions, studies
show that the approach contributed to the improvement of disease management, increase of
patient engagement and task orientation, as well as, anxiety reduction. Moreover, it can also
increase efficiency through fewer diagnostic tests and unnecessary referrals, and reduce hospital
attendance rates. Accordingly, patient-centered care approach has been a contributory factor in
long-term outcomes in cardiac patients—considering it as a component of preventative care.
In addition, there is a link between patient satisfaction and employee satisfaction. That
being so, it is reflected in the fundamental philosophy of patient centered care. Recognizing
nutrition is an integral part of health (as well as a source of comfort, and familiarity) conforms with
organizational culture which encourages staff to be sensitive to a patient’s needs.

DEFINING ATTRIBUTES

Walker and Avant’s approach to concept analysis requires defining the attributes of the
selected concept which shows the essence of the concept, eventually establishing its
distinctiveness to any other similar or related ones (Walker & Avant, 2011 as cited in Garnett et
al., 2017). In detail, Morgan and Yoder (2011) discussed that the method identifies the key
characteristics that are relatively common and most frequently occurring as associated with the
concept. Furthermore, emerging themes that suggest similar ideas were condensed into a single,
general attribute.
In Faye Glenn Abdellah’s Theory, she explained that nursing as a comprehensive service
includes the following: recognizing the nursing problems of the patient, deciding the appropriate
course of action to take in terms of relevant nursing principles, providing continuous care to relieve
pain and discomfort and provide immediate security of the individual, adjusting the total nursing
care plan to meet the patient’s individual needs, helping the individual to become more self
directing in obtaining or maintaining a healthy state of mind and body, instructing nursing
personnel and family to help the individual to do for himself that which he can within his limitations,
helping the individual to adjust his limitations and emotional problems, working with allied health
professions in planning for optimum health on local, state, national, and international levels, and
carrying out continuous evaluation and research to improve nursing techniques and to develop
new techniques to meet the health needs of people(Abdellah, 1968).
Further literature search has revealed that patient-centered care focuses on the interactive
relationship between the patient, folks, physician, and hospital staff. In line with this, the
researchers of Harvard Medical School, on behalf of Picker Institute and The Commonwealth
Fund, came up with Picker’s Eight Principles of Patient-Centered Care through extensive and
careful research.

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Respect for patients’ values, preferences and expressed needs
Patients should always be involved in decision-making because they have their own
values and preferences. Their decisions and cultural values should be respected.
Coordination and integration of care
It is a given that patients will feel vulnerable and powerless in the face of illness. To
alleviate those negative feelings, proper coordination of care such as coordination of clinical care,
ancillary and support services, and front-line patient care can reduce the patient’s vulnerability.
Information and education
Patients should be well-informed about their condition. To inform them, hospitals can focus
on three kinds of communication such as Information on clinical status, progress and prognosis,
processes of care, and facilitate autonomy, self-care and health promotion.
Physical comfort
The level of physical comfort patients report has a significant impact on their experience
which includes pain management, assistance with activities and daily living needs, and hospital
surroundings and environment.
Emotional support and alleviation of fear and anxiety
Fear and anxiety associated with illness can be as debilitating as the physical effects
where caregivers should pay particular attention to anxiety over physical status, treatment and
prognosis; anxiety over the impact of the illness on themselves and family; anxiety over the
financial impact of illness.
Involvement of family and friends
Providing accommodations for family and friends, family and close friends in decision
making, supporting family members as caregivers, and recognizing the needs of family and
friends are dimensions of family involvement in patient-centered care.
Continuity and transition
Patients expressed concern about their ability to care for themselves after discharge
where patients will be needing understandable, detailed information regarding medications,
physical limitations, dietary needs, etc., ongoing treatment and services after discharge,
information about access to clinical, social, physical and financial support on a continuing basis.
Access to care
Patients need to know they can access care when it is needed, such as access to the
location of hospitals, clinics and physician offices, availability of transportation, ease of scheduling
appointments, availability of appointments when needed, accessibility to specialists or specialty
services when a referral is made, and clear instructions provided on when and how to get referrals.

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ANTECEDENT AND CONSEQUENCE

Antecedents are events that must occur prior to the manifestation of a concept, and
consequences are events that occur as a result of it. Identifying antecedents and consequences
can shed light on the context in which a concept is generally used (Walker & Avant, 2011).
Antecedent
Caregivers will not be able to give effective patient-centered care successfully without
these antecedents. Various proof exists which recognizes that the health care climate of an
inpatient is the primary determining element of influence on the ability of nurses to supply care
that is centered to the person. The healthcare environment, physical and cultural, dictates the
framework for nursing care and either promote or restrain the capability for care to be personalized
for each patient. Vision and commitment, organizational attitudes and behaviors, and shared
governance are the antecedents that make person-centered care with the healthcare
environment.
Consequence
The concept of patient-centered care has received increased attention in recent years and
is now considered an essential aspiration of high-quality health care systems (Greene, Tuzzio, &
Cherkin, 2012). Patient-centered care results in improved care processes and health outcomes,
including survival.
Within healthcare, quality care has been defined by the Institute of Medicine as “care that
is safe, effective, timely, efficient, equitable and patient-centred”. Patient-centered care is defined
as care that is respectful of and responsive to individual patient preferences, needs and values,
and ensuring that patient's values guide all clinical decisions.
In this concept, patient's health is influenced by communication that their perception is that
their visit is patient-centered. Thus, communication plays an integral role in service quality--in fact,
in all service professions including health care professions. An effective communication will
facilitate the ability for patient and clinician to find common ground. Usage of communication in
this improves health status and efficiency of care by reducing diagnostic tests and referrals.
However, communication failures between clinicians are often viewed as the primary cause of
errors and adverse events in health care.
Furthermore, the Patients for Patient safety program believes that safety will be improved
if patients are placed at the center of care. Patients are considered "essential partners" as to
bringing quality, making healthcare safer and reducing admissions.
Newell et al. (2015) stated in his journal, entitled "The patient experience of patient-
centered communication with nurses in the hospital setting: a qualitative systematic review
protocol", that 'methods which focus on including the patient and their information in real-time are
considered by many to be crucial to the advancement of improved health outcomes and reduced
costs that are required of health care to be sustainable'. Hence, nurse-patient interaction, given
emphasis in patient-centered care, is a core component of nursing science and high-quality
nursing care.

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EMPIRICAL REFERENTS

Empirical referents are ways in which to show or measure the existence of a concept
(Walker & Avant, 2011). Measuring PCC from the view of the person receiving care is imperative
in assessing and improving individualized care at the bedside. ICS (Individualized Care Scale)
and P-CIS (Patient-Centered Inpatient Scale) are ways of evaluating its antecedent (Morgan &
Yoder, 2011).
ICS is a 38-itemed bipartite self-administered instrument used to measure patient’s view
on individualized care. It is based on ICS-A and ICS-B with 19-item Likert type scale. ICS-A
examines patients’ views on how nursing interventions have supported the patient’s
characteristics toward clinical situations caused by hospital stay, the individual’s personal life
situation, and their decisional control over care. ICS-B on the other hand examines how the
patients perceive their care situations as individuals which are subdivided into their clinical and
personal life situation, and their decisional control over care (Berg et al., 2010).
The Patient-Centered Inpatient Scale (P-CIS) is a 20-item instrument developed to
capture the client’s experience of “personal identity threat” in the health care setting (Morgan &
Yoder, 2011). Coyle and Williams (2010) developed a tool to assess person-centeredness in
health care and tested it with a sample of hospital health care recipients (n = 97). The tool
measures recipient experiences of care and contains 20 items in five dimensions: personalization,
empowerment, information, approachability/availability, and respectfulness. The utility of the tool
was studied in an Australian sample of older patients in subacute care (n = 78). An ability to detect
variation in frequency scores of the items was found, even though validity or reliability estimates
were not presented. Strengths of the tool relate to it being short and concrete, and applicable to
various settings. Potential weaknesses include unclear psychometric properties as estimates of
validity and reliability are yet to be presented. Also, it cannot be ascertained if and how a
systematic procedure guided by theory and statistics aided in the item selection process. Thus,
the tool would benefit from further exploration (Edvardsson, 2010).
These have been used to measure the concept of PCC in primary acute care settings in
Sweden, Finland, Australia, and Canada. None of these instruments have been used in a post–
acute health care setting in the United States; therefore, further testing is needed to build on
findings from these international studies and to strengthen the implementation and practice of
PCC in the United States. (Morgan & Yoder, 2011).

MODEL CASES

Walker and Avant (as cited in Garnett et al., 2017) explained that the model case serves
as a concrete illustration or real-world situation where the concept along with its defined attributes
is incorporated and demonstrated.
Student A is a 16-year-old student at a certain high school. On a Monday, she visited the clinic
while complaining of stomach pain. Nurse X warmly greeted Student A upon seeing her in the
school clinic. Nurse X, then, asked her what was wrong after Student A expressed her discomfort.
Nurse X offered Student A Aceite de Manzanilla and explained that this liniment could ease her
pain by applying it onto her abdominal area. Nurse X further assessed the patient’s condition by
inquiring about her diet, food preferences, study habits and current lifestyle. Student A expressed
her situation where she lives alone in a boarding house and that she does not really cook for
herself due to her hectic schedule accompanied by the high demands of schoolwork. She would

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also often skip meals and only eat SkyFlakes crackers or any other biscuits whenever she felt
hungry. Furthermore, she conveyed her loneliness due to the fact that her parents live away from
her. As she was expressing how homesick she was, Student A began to cry on her bedside. She
revealed that praying to God and meditating helped her overcome this sadness all the time, which
is why she was able to survive for this long. Nurse X continued to listen to Student A intently while
patting her back. asked her whether she wanted to relax and pray. Student A said yes, and Nurse
X offered to light the scented candle near the crucifix in the clinic. Student A prayed while lying
down as the scent of lavender surrounded the room. Nurse X also gave apples for Student A to
fill her empty stomach and advised Student A to buy meals during break time in school so that
she would not suffer from chronic stomach pains. After that, Nurse X suggested contacting her
parents to inform them of her situation as well as to have a little chat with her. Student A agreed
and decided to rest for a while inside the clinic. As Student A is about to leave the school clinic,
Nurse X made sure that she should return if ever the pain persists.
The above situation illustrates the critical attributes of patient-centered care. The mere
availability of the clinic and the school nurse provided easy access to care. Moreover, Student
A’s physical comfort was immediately addressed by the nurse when the liniment was offered and
rubbed onto the external surface. The fact that Nurse X stayed by Student A’s side the whole time
and listened to her sentiments was a source of emotional support. Apart from that, coordination
and integration of care manifested when the patient independently went to the school clinic -
suggesting his willingness to recover - and responded to the queries in a comprehensive and
truthful manner to which allowed Nurse X to implement an individualized care derived from the
student’s accounts. Upon identification of the student’s health concern and its corresponding
cause, the advice of Nurse X to buy and eat balanced meals during recess showed continuity and
transition. In line with that, Student A was educated and informed of the importance of healthy
eating habits in disease prevention as well by adding a thought that if the advice is not heeded
so, future complications may arise. Student A’s preferences like praying and meditation were
recognized and respected by Nurse X and allowed the patient to do such. Lastly, the family of
Student A was involved in the care in two instances: (1) keeping the parents updated on their
child’s state, and (2) providing support to the patient by allowing her to talk with her family on the
phone. Furthermore, Nurse X approached Student A from a comprehensive perspective, evident
by the commitment to identify and prioritize the patient’s situation as Student A received care that
was coordinated with her physical, mental, social and emotional needs.

ALTERNATIVE CASES

Borderline Case
According to Kadivar et al., (2018), a borderline case contains most of the critical attributes
of the concept but not all of them.
Ms. T, is an 87-year-old woman who can take care of her personal needs if she does not
have a backache or sore feet. She has a good relationship with her young son, and asks for his
help when she cannot do her self-care. One time she could not get out of bed and her son was
not there. She asked another patient for help and fell on the ground. Her nurse was informed and
said, "What you did was wrong and you should have informed us." The patient insisted that she
had done the right thing decisively with self-respect, and after her son arrived, she told him that
she believed she was right.
Analysis

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 This is a borderline case because it does not represent all the key attributes of patient-
centered care but it does relate to the concept. There is involvement of family and demonstration
of human dignity.
Contrary Case
According to Walker & Avant (2011), a contrary case does not illustrate the intended
concept.
Nurse A is a nurse who worked in the pedia ward of a hospital. She does not create an
interpersonal relationship with the patient or the patient's family. She does not believe that patients
should have a right to make decisions regarding their illness because she believes that it is only
the medical personnel’s job. She only works as a nurse for the sake of her salary and nothing
else. One morning when a 9-year-old girl suffering from thalassemia was admitted to the hospital
for her first blood transfusion, she did not even explain anything to the girl and her mother. She
believed that it is not necessary to reinforce knowledge and educate the patient. In the afternoon
when the girl's father decided to visit, the nurse forbade because she believes that only one folk
is allowed with the patient. The nurse does not let anyone from the family decide for the patient,
rather she's the one who decides for them. She's the one who chose which hematologist should
look after the patient. She does not ask what or how the family and the patient feels about this.
Analysis
This is a contrary case because it demonstrates the complete opposite of the nursing
concept. When it is a patient-centered care, one must acknowledge and respect the patient's
preference and needs, inform and educate the patient, and involve the family and friends of the
patient.

CONCLUSION

Throughout the years, a fundamental paradigm shift had occurred that changed the
nursing practice from the traditional model that is deficient of diversity to the current model of
individualized care. This transition introduced the concept of patient-centered care in which each
client is viewed as unique and receive medical service in his or her own way. Arised from
Abdellah’s Patient-Centered Approaches To Nursing, patient-centered care is considered as the
forefront of modern-nursing. In this concept analysis, we can condense patient-centered care into
this simple explanation: it is holistic and in-depth in terms of service, and it considers the
preference of the patient. Not only are the physical disease or illness are considered to be treated
by the nurse, but there are a variety of factors being considered in this concept such as the
patient’s family, religion, and general preferences.
In the Philippine setting, due to the lack of nurses in the country, this affects the ratio of
nurses to patients, especially in public hospitals. There is the struggle of providing patient-
centered care in this specific context since there is a ratio of one nurse to one ward, and the
limited amount of resources. This means that not all the preferences of the patient will be catered.
More attention is given to dealing with the illness due to the workload of one nurse. For patient-
centered care, it can be assumed that regardless of the hectic situation, it is still a challenge for
Filipino nurses - especially in the public hospital environment, to cater to the needs of the patient
while being resourceful due to the limited amount of equipment and materials in the hospital. It is
a culmination of skillfulness, resourcefulness, and compassion when it comes to dealing with
numerous patients on a daily basis.

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LIST OF GROUP MEMBERS

Asuncion, Keziah Gwyneth P.

Belita, Beatrice A.

Belinario, Jessyl Kate Gail T.

Botante, Maria Patricia M.

De Justo, Ma. Pamela Andrea D.

De la Cruz, Jespher G.

Diana, Ma. Prestige Leudouel J.

Dumpit, Marie Therese T.

Ferrandiz, Paul Martin D.

Flores, Elyka Zea N.

Garillos, Estelle Jan N.

Lanado, Ella Jean C.

Loquiano, Zymon L.

Neyra, Tisha Jane A.

Parcon, Neschille Joy A.

Precioso, Jan Karl A.

Ricaforte, Lady Kathrina O.

Sumague, Josephine A.

Tan, Jannine Goson J.

Tomboc, Cris Vinz C.

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