Person-centred care during treatment with nasal esketamine - a qualitative study

鼻用艾司氯胺酮治疗期间以人为本的护理——一项定性研究

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Abstract

BACKGROUND: Patients suffering from treatment-resistant depression may be treated with nasal esketamine. The treatment requires administration in a healthcare facility and monitoring by a nurse. Existing research has mainly focused on the clinical effect of nasal esketamine, while less is known about patients' experiences of treatment. A person-centred framework provides valuable insights into care and treatment. By using person-centredeness, the patient turns into a respected contributor in the delivery of care, enabling improved outcomes, better use of resources, reduced costs and increased satisfaction with care. Thus, the aim was to explore patients' experiences of treatment with nasal esketamine utilizing the person-centred nursing framework by McCormack and McCance. METHODS: The study had a qualitative design with an abductive approach. Twenty patients with treatment-resistant depression who had received at least eight treatments of nasal esketamine were interviewed. A thematic analysis was conducted, based on the four constructs of PCC: prerequisites, care environment, person-centred process and expected outcomes. The analysis generated 11 subthemes, reflecting the contextuality of the PCC nursing framework. RESULTS: The results highlighted the importance of working in a person-centred manner to achieve increased patient satisfaction and treatment outcomes. Patients highlighted the importance of relationships with competent and engaged nurses and a supportive care environment for treatment outcomes. The physical care environment influenced patients' well-being, and organizational aspects, such as continuity of staff, flexibility, and being allowed a private space, were also crucial during esketamine treatment. These aspects fostered feelings of security and contributed to achieving the desired outcome. CONCLUSION: This study identified that key aspects of PCC; competent nurses and respect for the patient, comfort and personalization of the care environment, support and involvement are important in ensuring patient satisfaction, quality and ultimately the desired treatment outcomes in esketamine treatment. By adopting a person-centred approach, nurses can increase patient well-being and the quality of care in nasal esketamine treatment. CLINICAL TRIAL NUMBER: Not applicable.

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