COMMENTARY

Barriers to Patient-Centered Care

Tom G. Bartol, NP

Disclosures

May 09, 2014

Barriers to Patient-Centered Care: A Thematic Analysis Study

Esmaeili M, Ali Cheraghi M, Salsali M
Int J Nurs Knowl. 2014;25:2-8

Study Summary

This qualitative research from Iran seeks to explore nurses' attitudes toward the barriers to achieving patient-centered care in a critical care setting. Using thematic analysis, 21 critical care nurses (16 women and 5 men) affiliated with Tehran University were interviewed about barriers to patient centered-care, factors affecting patient-centered care, and the reasons for lack of quality and ideal care by nurses. Probing questions were then used to clarify responses.

The mean age of the nurses in the study was 33.6 years, and their mean length of work experience was 10.4 years. Three themes were identified: lack of common understanding of teamwork, individual barriers, and organizational barriers.

Lack of understanding of teamwork. The essence of this theme was a lack of team coordination and patient centrality. Nursing care cannot be provided in isolation and must be provided with other healthcare team members. Some stated that other team members "pursue their own interests against the patient's preferences." The role of the nurse often limited what they could do to maintain patient-centered care.

Personal barriers. A theme of lack of motivation was partly explained by the hard work, low pay, and other problems of the workplace. Nurses identified a desire for unconditional caring but found barriers in the workplace. Some identified a lack of a holistic view as a barrier, wanting focus on the whole patient, not just on the problem at hand.

Organizational barriers. The final theme was organizational barriers. Staffing problems, problems with relationships between doctors and nurses, and lack of support and encouragement limited the effective delivery of patient-centered care.

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