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Chapter 2: Literature Review
patient as central to the care relationship and the patient has a personality shaped by
their life experiences. However, Dewing (2004) argued that these frameworks need
further development in order to make them meaningful for older people and for the
nurses working with them.
In order to advance the use of these frameworks in practice, various prerequisites to
PCC have more recently been presented in the literature. McCormack (2001) stated
that getting close to the patient and building a relationship with them is the vital step
required for achievement of PCC. McCormack and McCance (2006) added that a
PCC approach to care delivery requires prerequisites such as professionally
competent staff, developed interpersonal skills, commitment to the job, clarification
of values and beliefs, and knowing the self. The care environment needs an
appropriate skill mix, a shared decision-making system, effective staff relationships,
potential for innovation and risk taking, and supportive organisational systems.
There are currently no published research reports that examine whether or not these
prerequisites do in fact lead to PCC. In one mixed-method study Hunter and Levett-
Jones (2010) found that delivering person-centred care remains a challenge for
nurses working in residential care in Australia. Operationalising and understanding
one of its key ingredients, i.e. autonomy, may help to eradicate part of the challenge.
Their aim was to provide a contemporary description of the practice of nurses caring
for older people in residential care. Data were collected via purposive
questionnaires, document analysis and semi-structured interviews from 48 clinical
registered nurses and 16 nurses managers across six long-stay care facilities for older
people. There was a balanced mix of two rural, two metropolitan and two regional
facilities in the study sample and these included both profit and not-for-profit
facilities. The questionnaires yielded a low response rate of 56% from the nursing
sample (86 were distributed and 48 returned) while a high 76% response rate was
achieved with the nurse manager sample (21 distributed and 16 returned). Hunter
and Levett-Jones (2010) found that while nurses have moved to a more person-
centred approach to care they are not using any person-centred frameworks. The
researchers state that observations would have further enhanced the research
findings.