The Patient Experience: Partnering in Care

In the era of globalization, where science and technology are in the range of many people like nursing professionals it is very necessary to improve their process of work so that quality care of high standards can be given to the patients. New technologies in the health sector have enhanced the cost related to health care and people's expectations with the services that are offered. However, studies have also stated that there are various flaws in the safety and quality care of the patient. Unnecessary events badly affect the image of the health organization. Hence, it is necessary to pay attention to patient's satisfaction which is ultimately an indicator of quality care (Freitas et al., 2014).

While taking care of the patients, health professionals such as nurses take all the decisions by themselves and no input is asked from the patient who is under observation. This makes the healthcare professional dominant in their relationship. Participation of the patient recently has gained a lot of attention as this helps with ensuring that appropriate care is been given to them (Pomey et al., 2015). Partnering with the patient and his family can improve the experiences and outcomes of the treatment (Bookout, Staffileno& Budzinsky, 2016). Decision- making which is shared, therapeutical approaches, increasing expertise of patients and self- management are some approaches which are patient-centred and are designed with patient views (Pomey et al., 2015).

Aboriginal people face many difficult situations such as they are unwelcomed in hospitals, are short of transport facilities, are mostly separated and are given inflexible treatment options. Studies have also suggested that there is a communication gap caused by health providers to these people. Aboriginal staff is also very less in healthcare facilities (Durey et al., 2016). This is because of assumptions and stereotyping of their community. They fall short of their needs and expectations in healthcare facility (Mbuzi, Fulbrook & Jessup, 2017). The patient in our case is a 40-year-old female, who belongs to an Aboriginal community situated in Australia and she has to face various problems in the facility because of the nature and behaviour of the healthcare professionals such as doctors and nurses. Some studies have also mentioned that the life expectancy of indigenous women is very low that is around 9.7 years less than their male counterparts (Li, 2017).

The problems which are arising due to nurse behaviour and are affecting Aboriginal people can be eliminated if the nurse will follow these standards, such as the nurse should analyze and use the very best evidence that is available which comprises research findings so that safe and quality practice can be performed. The nurse should also treat all cultures and experiences respectfully, including reacting to the family and as well as to the community that will ultimately support Aboriginal people. The nurse should also follow ethical framework before taking any decision and should add to the improvement of quality and significant research. The nurse should also effectively communicate and should respect the patient's dignity, values, rights, culture and beliefs. The nurse should lead or participates in mutual practices. The nurse should also be accountable for the actions performed and decisions are taken. They should also enthusiastically engage with their occupation. Other than this, the nurse should also carry out assessments that are complete and is appropriate with the patient's culture. They should also avail to the resources which are available to them so that they can plan in a better way. Additionally, they should use data and pieces of evidence that are present for the development of preparations. The nurse should mutually build the nursing plan with the relevant person and should take their opinions, actions and goals into consideration. They should also document, analyze and change the plan with the accordance to give the outcome which the patient has agreed upon. They should offer inclusive quality and safe practice so that goals and results that are receptive to the nursing need of the patient are achieved (Nursing and Midwifery Board Ahpra, 2020).

Because of colonization in Australia, racism started. Aboriginal people are forced to live in reserves where their rights are restricted such as their right to hunt, marry or follow their traditions. They were also been segregated by the use of policies and guidelines and were not given any importance (Waterworth et al., 2015). The data suggests that all these factors have very badly affected these people and their physical and mental well- being. Aboriginal people have to face cultural barriers such as issues with trust and respect. They also fear the medical system and feel disempowered by professionals such as nurses and doctors. There are various barriers which could have inhibited the communication between an Aboriginal patient and the healthcare professional. The healthcare professionals are not having knowledge about the customs followed by Aboriginal people, their values, beliefs, lifestyles and also the necessity of land and family. Their experiences with racism also very majorly affect communication (Shahid et al., 2013). In addition to that, the inability of the health service provider to understand the non- verbal communication and symbols can also create problems and can act as barriers (Norouzinia et al., 2015). The main area for attention that a health service provider should look for is having proper communication in the hospital setting with the Aboriginal person. The healthcare professional needs to have empathetic contact with the Aboriginal patient. They should also respect and take into consideration the family structure of the Aboriginal patient. They should understand their life circumstances and culture plus have knowledge about non- verbal communication. The healthcare professional should also learn about the aboriginal patient history and community (Shahid et al., 2013). Employing more health workers from the Aboriginal community in the hospital settings and allowing them to take part in decision- making will likely to increase Aboriginal patient care in the healthcare facility and this will help in progress in this particular area (Wilson et al., 2016).

Participation of the patient in taking decisions in healthcare is not new but has become a necessity which is political in most countries. Moreover, their involvements have caused improvement in controlling rheumatic diseases and diabetes (Vahdat et al., 2014). Patients now play an active role in taking personal decisions of their health, delivery of the healthcare, in making policies and guidelines of clinical practices. This wave which will be known as patient revolution will be very active and help in the involvement of patients in research which is health-related. It is also important to acknowledge that experienced patient's families, caregivers as they contain a wholesome knowledge from experiencing and living a medical condition. By valuing and understanding this knowledge which is experienced-based, the study design of the research, it's setting, conducting of trial and analysis of outcomes can be influenced in a positive way. Patients can also challenge the assumptions made by healthcare professionals, can bring research into line with the requirements of the patients and can in addition to that increases the transparency and faith in research. It will moreover guide research that will have a greater impact on patient care. This approach will be a movement towards pragmatic and simple trails which will reflect the reasonable care of the patient. While a lot has to be learned in this direction some studies have shown that engagement of the patients in research has promising results which will untimely benefit the patient (Duffett, 2017). Other importance of partnering with the patient is that it will be considered as an indication of taking on good values and moral which will be a manifestation of accountability and equity in the healthcare system. This will also gain the approval of the public and their confidence. It will plus escort towards more correct and economical services which will enhance the outcomes of the health, patient's satisfaction and quality of life. Making sure that the patient has all the relevant information regarding their treatment and diagnosis is important for giving them quality care and save services (Vahdat et al., 2014).

In conclusion, it can be said that in the era of globalization, as science and technologies are blooming, care is directed towards patient experiences. The care given by healthcare professionals like nurses and doctors is of supreme quality. But with that, many flaws of the system are detected in giving patient quality care and providing them with safety. Because of these errors, patient satisfaction cannot be reached. Some examples of problems are: healthcare professionals do not undertake the advice of patients while making a treatment plan or nurses show dominant behaviour while taking care of them. For overcoming situations like these, the involvement of the patient and his family must be considered. They can help in decision making and self- management. The case of 40 years of Aboriginal women is taken here. As she belongs to a community which is looked down, she might have faced multiple issues within the healthcare facility. Those problems can be: feeling like an unwelcomed person, not providing her with a flexible treatment option, having to face discrimination and stereotyping. These reasons act as barriers to quality patient care. If a registered nurse would follow the guidelines of NMBA then all these difficulties can be sorted out. If healthcare professionals give respect and give importance to Aboriginal people values and beliefs then the patient experience can be improved too. Partnering with them will also help in increasing satisfaction and ultimately the quality of life.

References for The Patient Experience: Partnering in Care

Bookout, M. L., Staffileno, B. A., & Budzinsky, C. M. (2016). Partnering with a patient and family advisory council to improve patient care experiences with pain management. The Journal of Nursing Administration46(4), 181–186. https://doi.org/10.1097/NNA.0000000000000328

Duffett L. (2017). Patient engagement: What partnering with patient in research is all about. Thrombosis Research150, 113–120. https://doi.org/10.1016/j.thromres.2016.10.029

Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., &Bessarab, D. (2016).Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research16, 224.https://doi.org/10.1186/s12913-016-1497-0

Freitas, J. S., Silva, A. E., Minamisava, R., Bezerra, A. L., & Sousa, M. R. (2014). Quality of nursing care and satisfaction of patients attended at a teaching hospital. Revista Latino-Americana de Enfermagem22(3), 454–460. https://doi.org/10.1590/0104-1169.3241.2437

Li, J.L. (2017). Cultural barriers lead to inequitable healthcare access for Aboriginal Australians and Torres Strait Islanders. Chinese Nursing Research, 4(4), 207- 210.

Mbuzi, V., Fulbrook, P., & Jessup, M. (2017). Indigenous peoples' experiences and perceptions of hospitalisation for acute care: A metasynthesis of qualitative studies. International Journal of Nursing Studies71, 39–49. https://doi.org/10.1016/j.ijnurstu.2017.03.003

Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2015). Communication barriers perceived by nurses and patients. Global Journal of Health Science8(6), 65–74. https://doi.org/10.5539/gjhs.v8n6p65

Nursing and Midwifery Board Ahpra.(2020). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Pomey, M. P., Ghadiri, D. P., Karazivan, P., Fernandez, N., & Clavel, N. (2015). Patients as partners: A qualitative study of patients' engagement in their health care. PloS One10(4), e0122499. https://doi.org/10.1371/journal.pone.0122499

Shahid, S., Durey, A., Bessarab, D., Aoun, S. M., & Thompson, S. C. (2013). Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: The perspective of service providers. BMC Health Services Research13, 460. https://doi.org/10.1186/1472-6963-13-460

Shahid, S., Finn, L. D., & Thompson, S. C. (2009). Barriers to participation of Aboriginal people in cancer care: Communication in the hospital setting. The Medical Journal of Australia190(10), 574–579.

Vahdat, S., Hamzehgardeshi, L., Hessam, S. & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: A review. Iranian Red Crescent Medical Journal16(1), e12454. https://doi.org/10.5812/ircmj.12454

Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors influencing the health behaviour of indigenous Australians: Perspectives from support people. PloS One10(11), e0142323. https://doi.org/10.1371/journal.pone.0142323

Wilson, A. M., Kelly, J., Magarey, A., Jones, M., & Mackean, T. (2016). Working at the interface in Aboriginal and Torres Strait Islander health: Focusing on the individual health professional and their organisation as a means to address health equity. International Journal for Equity in Health15(1), 187. https://doi.org/10.1186/s12939-016-0476-8

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