Receiving person-centred care in a hospital-A qualitative study of socially marginalised patients' experiences of social nursing

Abstract

Background: Socially marginalised people are at a substantially increased risk of diseases and typically have several contacts with the healthcare system. Health professionals at hospitals often lack the knowledge, skills, confidence, and time to provide relevant care for socially marginalised patients. Danish hospitals have implemented a social nursing initiative consisting of social nurses with specialised knowledge about marginalisation to support socially marginalised patients. Limited research into patients' perceptions of social nursing has been undertaken.

Objective: To explore patients' experiences with the in-hospital social nursing initiative.

Design: A qualitative study was conducted using a phenomenological hermeneutical approach.

Setting: Odense University Hospital, Denmark.

Participants: Patients aged 18 years and older who had been in contact with a social nurse during hospital admission were purposely sampled. Data saturation was reached when 15 participants were recruited.

Methods: In-depth patient interviews were conducted from November 2021 to April 2022 using a semi-structured interview guide. The interviews were transcribed verbatim and analysed using systematic text condensation. NVivo 12 software was employed for the analysis. Patient representatives were involved to validate the analysis and interpretations.

Results: Three themes were identified: (1) an equal and trusting relationship, (2) receiving person-centred care, and (3) coherence in the patient trajectory. The results show that when patients have established a relationship with a social nurse, they are willing to let her into their lives and share personal information. Patients also experience person-centred care and coherence in their trajectory when a social nurse participated in their treatment and care.

Conclusion: The findings indicate that the social nursing initiative bridges the gap between socially marginalised patients and healthcare services.

Keywords: health inequities; holistic nursing; patient participation; patient-centred care; qualitative research; sense of coherence; social marginalisation.