Protecting Personhood: A Classic Grounded Theory
Main Article Content
Abstract
The importance of perceiving and considering patients as healthcare partners has been increasingly promoted. Healthcare systems around the world are now highly interested in patient engagement, participation, collaboration, and partnership. Healthcare professionals are advised that patients, as autonomous beings, should be active in and responsible for a portion of their own care. The study presented here focused on patients’ perceptions of interprofessional collaboration. It was conducted using the classic grounded theory methodology. The theory of protecting personhood emerged as the core concept of hospitalized patients, cared for by interprofessional healthcare teams. This theory encapsulates the process hospitalized patients go through to find balance in their sense of self, oscillating between personhood and patienthood in the unfamiliar hospital environment. The process consists of four stages: the stage of introspection, during which hospitalized patients become aware of their self as a person and as a patient; the stage of preservation, when patients find a balance between the sense of personhood and patienthood; the stage of rupture, wherein patients experience an imbalance between their sense of personhood and patienthood; and the stage of reconciliation, in which personhood is restored. The theory of protecting personhood offers insights into a better understanding of hospitalized patients’ experiences and strategies, revealing the importance of relationships, and the driving force of empowerment. This study is about patients’ perspectives of interprofessional healthcare teams. A grounded theory process allowed the emergence of patients’ concerns and expectations, leading to a substantive theory grounded in the patients’ data.
Downloads
Article Details
The Grounded Theory Review is an open access journal, which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author. This is in accordance with the international Budapest Open Access Initiative (BOAI) definition of open access.
References
Arnetz, J. E., Zhdanova, L., & Arnetz, B. B. (2016). Patient involvement: a new source of stress in health care work?. Health communication, 31(12), 1566-1572. https://doi.org/10.1080/10410236.2015.1052872
Berntsen, G., Chetty, M., Ako-Egbe, L., Yaron, S., Phan, P., Curran, C., & Lachman, P. (2022). Person-centred care systems: from theory to practice. International Society for Quality in Healthcare (ISQUA). https://isqua.org/media/ attachments/2022/10/03/person-centred-care-systems_- from-theory-to-practice.pdf
Calvès, A. E. (2009). Empowerment: The history of a key concept in contemporary development discourse. Revue Tiers Monde, 200(4), 735-749. https://doi.org/10.3917/ rtm.200.0735
Birks, M., & Mills, J. (2022). Grounded theory: A practical guide. Sage.
Charmaz, K. (2014). Constructing grounded theory. (2nd ed.). Sage.
Cheraghi, M. A., Esmaeili, M., & Salsali, M. (2017). Seeking Humanizing Care in Patient-Centered Care Process. Holistic Nursing Practice, 31(6), 359–368. https://doi.org/10.1097/hnp.0000000000000233
Canadian Interprofessional Health Collaborative (CIHC). (2010). A National Interprofessional Competency Framework. https://phabc.org/wp-content/uploads/2015/07/CIHC-National-Interprofessional-Competency-Framework.pdf
Crisp, N. (2012). Patient power needs to be built on strong intellectual foundations: An essay by Nigel Crisp. The BMJ, 345(e6177), Article e6177. https://doi.org/10.1136/ bmj.e6177
Fasanelli, R., D’Alterio, V., De Angelis, L., Piscitelli, A., & Aria, M. (2017). Humanisation of care pathways: training program evaluation among healthcare professionals. Electronic Journal of Applied Statistical Analysis, 10(2), 485–498. https://doi.org/10.3917/ rtm.200.0735
Friesen-Storms, J. H., Bours, G. J., van der Weijden, T., & Beurskens, A. J. (2015). Shared decision making in chronic care in the context of evidence based practice in nursing. International journal of nursing studies, 52(1), 393-402. https://doi.org/10.1016/j.ijnurstu.2014.06.012
Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare, 8, 33–37. https://doi.org/10.2147/JMDH.S72623
Giusti, A., Pukrittayakamee, P., Alarja, G., Farrant, L., Hunter, J., Mzimkulu, O., ... & Harding, R. (2022). Developing a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals. BMJ Global Health, 7(7), e008843. https://doi.org/10. 1136/bmjgh-2022-008843
Glaser, B. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Sociology Press.
Glaser, B. (2012). Literature Review. In V. B. Martin & A. Gynnild (Eds). Grounded theory: The philosophy, method, and work of Barney
Glaser (pp.266-269). BrownWalker Press.
Gulbrandsen, P., Clayman, M. L., Beach, M. C., Han, P. K., Boss, E. F., Ofstad, E. H., & Elwyn, G. (2016). Shared decision-making as an existential journey: aiming for restored autonomous capacity. Patient Education and Counseling, 99(9), 1505–1510. https://doi.org/10.1016/j. pec.2016.07.014
Holmström, I., & Röing, M. (2010). The relation between patient-centeredness and patient empowerment: a discussion on concepts. Patient education and counseling, 79(2), 167-172. https://doi.org/10.1016/j.pec.2009.08.008
Hôpitaux Universitaires Genève (HUG). (2019). Vision 2020: Plan Stratégique 2015-2020. https://www.hug-ge.ch/sites/interhug/files/documents/plan-strategique.pdf
Intstitute for Patient-and Family-Centered Care (IPFCC) (2017). Advancing the practice of patient-and family-centered care in hospitals: How to get started. Intstitute for Patient-and Family-Centered Care.
Karazivan, P., Dumez, V., Flora, L., Pomey, M.-P., Del Grande, C., Ghadiri, D. P., … Lebel, P. (2015). The patient-as-partner approach in health care: a conceptual framework for a necessary transition. Academic Medicine, 90(4), 437–441. https://doi.org/10.1097/acm.0000000000000603
Kitson, A. L., Harvey, G., Gifford, W., Hunter, S. C., Kelly, J., Cummings, G. G., ... & Wilson, P. (2021). How nursing leaders promote evidence‐based practice implementation at point‐of‐care: A four‐country exploratory study. Journal of advanced nursing, 77(5), 2447-2457. https://doi.org/10. 1111/jan.14773
Kitson, A. L. (2018). The fundamentals of care framework as a point-of-care nursing theory. Nursing Research, 67(2), 99-107.
Kitwood, T. (2011). Dementia reconsidered: The person comes first. In J. Katz, S. Peace, & S. Spurr, Adult Lives: A Life Course Perspective (pp. 89-99). Bristol University Press
Knapp, G. (1988). Die 4 affektiven Bereiche der Primärbeziehung: Aufgehobenheit, Versorgtheit, Vertrauen, Anerkennung. In Narzißmus und Primärbeziehung (pp. 125–232). Springer.
Langberg, E. M., Dyhr, L., & Davidsen, A. S. (2019). Development of the concept of patient-centredness–A systematic review. Patient education and counseling, 102(7), 1228-1236. https://doi.org/10.1016/j.pec.2019.02.023
Larsson, I. E., Sahlsten, M. J., Sjöström, B., Lindencrona, C. S., & Plos, K. A. (2007). Patient participation in nursing care from a patient perspective: a Grounded Theory study. Scandinavian journal of caring sciences, 21(3), 313-320. https://doi.org/10.1111/j.1471-6712.2007.00471.x
McCormack, B., & McCance, T. (Eds). (2016). Person-centred practice in nursing and health care: theory and practice (2nd ed.). John Wiley & Sons.
Martin, G. P., & Finn, R. (2011). Patients as team members: opportunities, challenges and paradoxes of including patients in multi‐professional healthcare teams. Sociology of health & illness, 33(7), 1050-1065. https://doi.org/10. 1111j.1467-9566.2011.01356.x
N'Goran, A. A., Pasquier, J., Deruaz-Luyet, A., Burnand, B., Haller, D. M., Neuner-Jehle, S., Zeller, A., Streit, S., Herzig, L., & Bodenmann, P. (2018). Factors associated with health literacy in multimorbid patients in primary care: a cross-sectional study in Switzerland. BMJ open, 8(2), e018281. https://doi.org/10.1136/bmjopen-2017-018281
Ocloo, J., & Matthews, R. (2016). From tokenism to empowerment: progressing patient and public involvement in healthcare improvement. BMJ Quality & Safety, 25(8), 626–632. http://dx.doi.org/10.1136/bmjqs-2015-004839
Oxelmark, L., Ulin, K., Chaboyer, W., Bucknall, T., & Ringdal, M. (2018). Registered Nurses’ experiences of patient participation in hospital care: supporting and hindering factors patient participation in care. Scandinavian journal of caring sciences, 32(2), 612-621. https://doi.org/10.1111/scs.12486
Paterson, J. G., & Zderad, L. T. (1988). Humanistic nursing. National League for Nursing
Peplau, H. E. (1992). Interpersonal relations: A theoretical framework for application in nursing practice. Nursing Science Quarterly, 5(1), 13–18. https://doi.org/10.1177/089431849200500106
Phillips, R. L., Short, A., Kenning, A., Dugdale, P., Nugus, P., McGowan, R., & Greenfield, D. (2015). Achieving patient‐centred care: the potential and challenge of the patient‐as‐professional role. Health Expectations, 18(6), 2616-2628.
Phillips, L., & Scheffmann-Petersen, M. (2020). Minding the Gap Between the Policy and Practice of Patient-Centeredness: Cocreating a Model for Tensional Dialogue in the “Active Patient Support” Program. Qualitative Health Research, 30(9), 1419-1430. https://doi.org/10.1177/ 104973232091385
Scott, D. A., & Grant, S. M. (2018). A meta-ethnography of the facilitators and barriers to successful implementation of patient complaints processes in health-care settings. Health Expectations, 21(2), 508–517. https://doi.org/10.1111/hex.12645
Swiss Confederation. Federal Act on Reserach Involving Human Beings [Human Research Act, HRA]. (2014).
Swiss Medical Sciences Association (2020). Update of the ASSM Interprofessional Charter. Bulletin des médecins suisses, 101(39), 1220-1221. https://doi.org/10.4414/bms.2020.19214
Thibault, G. E. (2019). Humanism in medicine: What does it mean and why is it more important than ever? Academic Medicine, 94(8), 1074 1077. https://doi.org/10.1097/ACM.0000000000002796
Thórarinsdóttir, K., & Kristjánsson, K. (2014). Patients’ perspectives on person-centred participation in health care: A framework analysis. Nursing Ethics, 21(2), 129–147. https://doi.org/10.1177/0969733013490593
Thórarinsdóttir K, Kristjánsson K, Gunnarsdóttir TJ, Björnsdóttir K. (2019). Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain: An Ethnographic Study. Qualitative Health Research, 29(4):471-483. doi:10.1177/1049732318770628
Verres, R. (1999). Heidelberger Lesebuch Medizinische Psychologie. Vandenhoeck & Ruprecht.
Watson, J. (2018). Unitary caring science: Philosophy and praxis of nursing. University Press of Colorado.
World Health Organization (WHO). (2013). Exploring patient participation in reducing health-care-related safety risks. World Health Organization. https://apps.who.int/iris/handle/10665/326442
World Health Organization (WHO). (2017). Patient safety: making health care safer. Health Organization. https://apps.who.int/iris/handle/10665/255507
Wilcock, P. M., Stewart Brown, G. C., Bateson, J., Carver, J., & Machin, S. (2003). Using patient stories to inspire quality improvement within the NHS Modernization Agency collaborative programmes. Journal of Clinical Nursing, 12(3), 422–430. https://doi.org/10.1046/j.1365-2702.2003.00780.x
Wolf, J. A. (2018). To Care is Human: The factors influencing human experience in healthcare today. The Beryl Institute.
Zimmermann, L., Konrad, A., Müller, C., Rundel, M., & Körner, M. (2014). Patient perspectives of patient-centeredness in medical rehabilitation. Patient Education and Counseling, 96(1), 98-105. https://doi.org/10.1016/j.pec.2014.04.015
Zoffmann V, Harder I, Kirkevold M. A Person-Centered Communication and Reflection Model: Sharing Decision-Making in Chronic Care. Qualitative Health Research. 2008;18(5):670-685. doi:10.1177/1049732307311008