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Abstract

Introduzione: L'implementazione dei modelli patient centred care può essere minata dalla percezione intra-professionale di barriere che non sempre vengono riconosciute. Infatti, in letteratura sono molto scarse le descrizioni di tali barriere. Per questo motivo, l'obiettivo principale di questo studio è indagare nel contesto italiano le barriere che ostacolano l'implementazione di un nuovo modello organizzativo patient centred care (Synergy Model), secondo la prospettiva intra-professionale infermieristica.

Metodo: Lo studio segue un disegno con metodo misto sequenziale. La prima fase ha un disegno qualitativo e la seconda fase un disegno quantitativo, osservazionale e trasversale e mono-centrico (unico ospedale nord Italia). Nella fase qualitativa sono stati coinvolti 9 infermieri, mentre nella fase quantitativa 117 infermieri.

Risultati: Sono state condotte 9 interviste nella prima fase. I 3 temi principali, risultati dall'analisi tematica sono: (a) lavoro improprio, (b) in¬concludenza attivití  lavorative e (c) scarso valore aggiunto. Nella seconda fase, 117 infermieri hanno risposto ad un questionario creato ad hoc (21 item). Il questionario risulta avere una buona validití  di facciata e di contenuto. Tramite l'analisi fattoriale esplorativa (EFA) sono stati identificati i seguenti domini: (a) organizzazione lavorativa (X=3,21±0,64), (b) competenza infermieristica (X=3,14±0,30), (c) crescita professionale (X=3,48±0,74), che descrivono le barriere percepite dal personale infermieristico all'implementazione di modelli assistenziali patient centred care.Le barriere indagate dovranno esser prese in considerazione per pianificare interventi formativi ed organizzativi. La creazione del questionario e la sua validití  saranno utili per avere nel tempo la misurazione di tali barriere. La presa di coscienza di queste barriere rientra nella logica di creare una cultura organizzativa in salute, sensibile alla personalizzazione delle cure.

Parole Chiave: Metodo misto; Modelli assistenziali; Nursing; Personalizzazione dell'assistenza abstract

Mixed method sequential study on the barriers underpinning a new patient centred care model implementation: the nurses' perspectives

Introduction: The patient centred care models implementation could be undermined by the intra-professional perception of barriers. Moreover, the literature has paid little attention in describing those one. For this reason, the aim of this study is to describe the main barriers underpinning the implementation of patient centred care models.

Method: This study follows the Mixed-Methods Sequential Explanatory method. Phase one has a qualitative design. Phase two has a quantitative, observational, cross-sectional and mono-centric design. The phase 1 involved nine nurses, while 117 nurses were enrolled for the phase 2.

Results: Nine interviews were conducted in phase one. Three main themes were carried out by the thematic analysis: (a) improper work, (b) inconclusiveness of working activities, (c) poor added value. In phase two, 117 nurses answered to a questionnaire created ad hoc (21 items). The questionnaire showed good face and content validity. The Exploratory Factorial Analysis (EFA) showed three dimensions: (a) working organization (X=3,21±0,64), (b) nursing competence (X=3,14±0,30), and (c) professional improvement (X=3,48±0,74), which described the nurses' perceived barriers to implement a new patient centred model.

Conclusion: The described barriers should be considered to design educational and organizational interventions. The development and the validity of the questionnaire used in this study will be useful to measure those barriers over the time. The awareness related to those barriers is in line with the purpose of enhancing the overall organizational health, particularly focused on personalization of care delivery.

Key words: Mixed methods; Nursing Models; Nursing; Patient-Centered Care

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Come citare
Dellafiore, F., Nania, T., Bruscagin, M., Pittella, F., Ripamonti, S. C., Barello, S., Graffigna, G., & Caruso, R. (2019). Studio con metodo misto sequenziale sulle barriere che ostacolano l’implemen tazione di un nuovo modello organizzativo patient centred care: la prospettiva infermieristica. PROFESSIONI INFERMIERISTICHE, 72(3). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/661
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