Humanization of Care: Key Elements Identified by Patients, Caregivers, and Healthcare Providers. A Systematic Review

Abstract

Background Given the automatization of care and rationing of time and staff due to economic imperatives, often resulting in dehumanized care, the concept of 'humanization of care' has been increasingly discussed in the scientific literature. However, it is still an indistinct concept, lacking well-defined dimensions and to date no literature review has tried to capture it. Objectives The objectives of this systematic review were to identify the key elements of humanization of care by investigating stakeholders' (patients, patients' caregivers, healthcare providers) perspectives and to assess barriers and strategies for its implementation. Methods We carried out a systematic search of five electronic databases up to December 2017 as well as examining additional sources (e.g., gray literature). Search terms included "humanization/humanisation of care" and "dehumanization/ dehumanisation of care". We conducted a thematic synthesis of the extracted study findings to identify descriptive themes and produce key elements. Results Of 1327 records retrieved, 14 full-text articles were included in the review. Three main areas (relational, organizational, structural) and 30 key elements (e.g., relationship bonding, holistic approach, adequate working conditions) emerged. Several barriers to implementation of humanization of care exist in all areas. Conclusion Our systematic review and synthesis contributes to a deeper understanding of the concept of humanization of care. The proposed key elements are expected to serve as preliminary guidance for healthcare institutions aiming to overcome challenges in various forms and achieve humanized and efficient care. Future studies need to fully examine specific practices of humanized care and test quantitatively their effectiveness by examining psychosocial and health outcomes.

A Cross-Sectional Study of Empathy and Emotion Management: Key to a Work Environment for Humanized Care in Nursing

“…Professional practice in healthcare can be affected by dehumanization (Glebocka, 2019), which psychologically is due to patients losing their identity as individuals and no longer being perceived as active persons, but as being impaired, and the professional practice is performed mechanically, with lack of empathy, causing moral disengagement (Haque and Waytz, 2012). This depersonalization in providing healthcare has been associated with emotional exhaustion and stress (Murji et al, 2006;Parola et al, 2017;Molero et al, 2018;Busch et al, 2019), as well as environmental factors of nursing, such as staff ratios or patient care automation (Michelan and Spiri, 2018;Busch et al, 2019).…”

The experience of living with a chronic disease in pediatrics from the mothers’ narratives: The Clinical Interview on Parental Sense of Grip on the Disease

“…Healthcare systems are overloaded by the growth of the caring needs due to chronicity. New paradigms of research and intervention are required, aiming at fostering patients’ lay competencies and engagement and their active involvement in their caring needs (Borghi et al, 2016; Busch et al, 2019; Domecq et al, 2014; Forsythe et al, 2016; Freda et al, 2019; Grande et al, 2014; Graffigna and Vegni, 2017).…”

The Development and Validation of the Healthcare Professional Humanization Scale (HUMAS) for Nursing

“…Several different focuses and studies have reported the need to seek a consensus with respect to the term, the humanization of care, which would contribute systematically to its development in the field of health [2]. In this respect, previous studies have agreed that the humanization of care is built upon people’s needs in the care relationship [4,10,11,16], for which purpose healthcare professionals must be committed to their work [17,21,22,23], which is promoted if they possess certain characteristics [27,28,29,34,39,40,46].…”

“…The approach to and use of the term “humanization” is very much present in the area of care, and has even come to be defined as the humanization of care, arising in response to the perception of a society where healthcare is dehumanized or depersonalized [1,2,3,4]. This is a situation that, even though considered multifactorial [5], may be associated to a great extent with emotional exhaustion, burnout [6,7,8], stress [2] or other factors more closely associated with the workplace, such as staffing ratios or the automation of care [2,9].…”

“…However, in spite of its rapid introduction and acceptance in the healthcare environment, there is still no clear definition of the concept of the humanization of care, which makes it somewhat vague, and has caused it to be considered a passing fashion by many. In this sense, there are various approaches directed toward the definition of the humanization of care, such as the one that defines care centered on the patient (patient-centered care) [2,10,11,12], or person-concentrated care [2,4], which makes it extrapolatable to healthcare professionals themselves, in addition to patients [3,13,14]. However, it should not be forgotten that the humanization of care is also understood as providing services and technologies, human resources and materials, and infrastructure for offering attention and ensuring the comfort and wellbeing of health service users [15].…”