Barriers and enablers to the implementation of person-centred care in an Indonesian hospital: a qualitative study
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Introduction: Person-centred care (PCC) is increasingly considered as one of the criteria standards for delivering healthcare in hospitals. Registered nurses are increasingly expected to provide PCC in daily practice. However, although the hospital commits to enhancing and improving PCC, implementing this approach into practice has faced barriers and enablers. As the implementation of PCC is still at an early stage of development, it is well-recognised that the need to identify barriers and enablers is essential. This study aims to explore these barriers and enablers to implementing PCC in Indonesian hospitals.
Methods: This study employed a qualitative exploratory study conducted from July 2023 to September 2023 at a public hospital in Pekanbaru, Riau Province. It applied semi-structured interviews to collect data on barriers and enablers to implement PCC from 2 managers and 12 nurses from the medical ward. All participants were selected using a purposive sampling technique. Data collected from interviews were transcribed and then thematically analysed.
Results: Three barriers-related themes emerged, namely time constraints and workload, lack of resources, and communication challenges. Furthermore, three enablers themes also emerged, including leadership, commitment, and sufficient monitoring and supervision.
Conclusions: The study results lead hospital managers and policymakers to overcome existing barriers using adaptive planning and strategies and to improve enablers with well-trained professionals and strong leadership to deliver a PCC approach into practice. The implications to practice are that healthcare organisations must continue their support to decrease the barriers and optimise professional care in healthcare facilities to improve healthcare services.
Bekele, W.B. and Ago, F.Y. (2022) ‘Sample size for interview in qualitative research in social sciences: A guide to novice authors’, Research in Educational Policy and Management, 4(1), pp. 42–50. Available at: https://doi.org/10.46303/repam.2022.3.
Clarke, V., Braun, V. and Hayfield, N. (2015) ‘Thematic analysis’, in J.A. Smith (ed.) Qualitative psychology: A practical guide to research methods. London: Sage Publications Ltd, pp. 222–248.
Dewi, W.N. et al. (2014) ‘Person‐centred care in the Indonesian healthcare system’, International Journal of Nursing Practice, 20(6), pp. 616–622. Available at: https://doi.org/10.1111/ijn.12213.
Dewi, W.N. and Safri, M. (2020) ‘Understanding of person-centred care consept: medical –surgical nurses perspective’, Proceeding the 2nd Andalas International Nursing Conference, Sciendo [Preprint].
Ferreira, T.D.M. et al. (2022) ‘The influence of nursing leadership styles on the outcomes of patients, professionals and institutions: An integrative review’, Journal of Nursing Management, 30(4), pp. 936–953. Available at: https://doi.org/10.1111/jonm.13592.
Hennink, M. and Kaiser, B.N. (2022) ‘Sample sizes for saturation in qualitative research: A systematic review of empirical tests’, Social Science & Medicine, 292, p. 114523. Available at: https://doi.org/10.1016/j.socscimed.2021.114523.
Huang, C. et al. (2020) ‘The impact of person‐centred care on job productivity, job satisfaction and organisational commitment among employees in long‐term care facilities’, Journal of Clinical Nursing, 29(15–16), pp. 2967–2978. Available at: https://doi.org/10.1111/jocn.15342.
Institute of Medicine (2021) Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academic Press.
Johnsen, A.T. et al. (2022) ‘Perceptions of person‐centred care in two large university hospitals: A cross‐sectional survey among healthcare professionals’, Scandinavian Journal of Caring Sciences, 36(3), pp. 791–802. Available at: https://doi.org/10.1111/scs.13014.
de Jong, Y. et al. (2021) 'Person-centredPerson care provision and care planning in chronic kidney disease: Which outcomes matter? A systematic review and thematic synthesis of qualitative studies’, BMC Nephrology, 22(1), pp. 1–16. Available at: https://doi.org/10.1186/s12882-021-02489-6.
Kong, E., Kim, Hyang and Kim, Hyejin (2022) ‘Nursing home staff’s perceptions of barriers and needs in implementing person‐centred care for people living with dementia: A qualitative study’, Journal of Clinical Nursing, 31, pp. 1–11. Available at: https://doi.org/10.1111/jocn.15729.
Lee, J.Y., Yang, E. and Lee, K.H. (2023) ‘Experiences of implementing person-centered care for individuals living with dementia among nursing staff within collaborative practices: A meta-synthesis’, International Journal of Nursing Studies, 138, p. 104426. Available at: https://doi.org/10.1016/j.ijnurstu.2022.104426.
Li, Y. and Zhang, S. (2022) ‘Qualitative data analysis’, in Applied Research Methods in Urban and Regional Planning, pp. 149–165.
Lloyd, B., Elkins, M. and Innes, L. (2018) ‘Barriers and enablers of patient and family centred care in an Australian acute care hospital: Perspectives of health managers’, Patient Experience Journal, 5(3), pp. 55–64. Available at: https://doi.org/10.35680/2372-0247.1270.
Maeda, A. and Socha-Dietrich, K. (2021) Skills for the future health workforce: Preparing health professionals for people-centred care.
Martín-Sanz, M.B. et al. (2022) ‘Person-centred care in individuals with stroke: a qualitative study using in-depth interviews’, Annals of Medicine, 54(1), pp. 2167–2180. Available at: https://doi.org/10.1080/07853890.2022.2105393.
Marulappa, N. et al. (2022) ‘How to implement person-centred care and support for dementia in outpatient and home/community settings: Scoping review’, BMC Health Services Research, 22(1), p. 541. Available at: https://doi.org/10.1186/s12913-022-07875-w.
McCormack, B., Dewing, J. and McCance, T. (2011) ‘Developing person-centred care: Addressing contextual challenges through practice development.’, Online journal of issues in nursing, 16(2).
Nkrumah, J. and Abekah-Nkrumah, G. (2019) ‘Facilitators and barriers of patient-centered care at the organisational-level: a study of three district hospitals in the central region of Ghana’, BMC Health Services Research, 19(1), pp. 1–11. Available at: https://doi.org/10.1186/s12913-019-4748-z.
Oppert, M.L., O’Keeffe, V.J. and Duong, D. (2018) ‘Knowledge, facilitators and barriers to the practice of person-centred care in aged care workers: A qualitative study’, Geriatric Nursing, 39(6), pp. 683–688. Available at: https://doi.org/10.1016/j.gerinurse.2018.05.004.
Peel, K.L. (2020) ‘A beginner’s guide to applied educational research using thematic analysis’, Practical Assessment, Research, and Evaluation, 25(1), p. 2.
Petersson, Å. et al. (2023) ‘Following a standardised pathway: Healthcare professionals’ perspectives on person‐centred care within ERAS for patients with colorectal cancer’, Journal of Clinical Nursing, 32(13–14), pp. 4070–4080. Available at: https://doi.org/10.1111/jocn.16562.
Potthoff, S., Hempeler, C. and Scholten, M. (2023) ‘Research ethics in qualitative health research’, International Journal of Qualitative Methods, 22, p. 16094069231189336. Available at: https://doi.org/10.1177/16094069231189335.
Ravitch, S. and Carl, N. (2016) Qualitative research: Bridging the conceptual, theoretical, and methodological. New York, NY: Sage Publications.
Richter, C. et al. (2022) ‘Factors influencing the implementation of person-centred care in nursing homes by practice development champions: A qualitative process evaluation of a cluster-randomised controlled trial (EPCentCare) using Normalization Process Theory’, BMC Nursing, 21(1), p. 182. Available at: https://doi.org/10.1186/s12912-022-00963-6.
Sutoto, S. (2022) Instrumen survey akreditasi KARS. Jakarta: Kementrian Kesehatan RI, KARS,.
Terry, G. and Kayes, N. (2020) ‘Person centered care in neurorehabilitation: A secondary analysis’, Disability and Rehabilitation, 42(16), pp. 2334–2343. Available at: https://doi.org/10.1080/09638288.2018.1561952.
Tiainen, M., Suominen, T. and Koivula, M. (2021) ‘Nursing professionals’ experiences of person‐centred practices in hospital settings’, Scandinavian Journal of Caring Sciences, 35(4), pp. 1104–1113. Available at: https://doi.org/10.1111/scs.12925.
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