Patient neglect in healthcare institutions: a systematic review and conceptual model

Abstract

BackgroundPatient neglect is an issue of increasing public concern in Europe and North America, yet remains poorly understood. This is the first systematic review on the nature, frequency and causes of patient neglect as distinct from patient safety topics such as medical error.MethodThe Pubmed, Science Direct, and Medline databases were searched in order to identify research studies investigating patient neglect. Ten articles and four government reports met the inclusion criteria of reporting primary data on the occurrence or causes of patient neglect. Qualitative and quantitative data extraction investigated (1) the definition of patient neglect, (2) the forms of behaviour associated with neglect, (3) the reported frequency of neglect, and (4) the causes of neglect.ResultsPatient neglect is found to have two aspects. First, procedure neglect, which refers to failures of healthcare staff to achieve objective standards of care. Second, caring neglect, which refers to behaviours that lead patients and observers to believe that staff have uncaring attitudes. The perceived frequency of neglectful behaviour varies by observer. Patients and their family members are more likely to report neglect than healthcare staff, and nurses are more likely to report on the neglectful behaviours of other nurses than on their own behaviour. The causes of patient neglect frequently relate to organisational factors (e.g. high workloads that constrain the behaviours of healthcare staff, burnout), and the relationship between carers and patients.ConclusionA social psychology-based conceptual model is developed to explain the occurrence and nature of patient neglect. This model will facilitate investigations of i) differences between patients and healthcare staff in how they perceive neglect, ii) the association with patient neglect and health outcomes, iii) the relative importance of system and organisational factors in causing neglect, and iv) the design of interventions and health policy to reduce patient neglect.

An exploration of the perceptions of caring held by students entering nursing programmes in the United Kingdom: A longitudinal qualitative study phase 1

“…This is particularly pertinent in the UK where recently there have been reports highlighting poor standards of care (Francis, 2010). Similarly reports of patient neglect in Europe and America include examples of failures by healthcare staff and uncaring attitudes and behaviours (Reader and Gillespie, 2013). In the light of this, the public could be forgiven for believing that healthcare workers, including nurses, have lost sight of the meaning of caring in the workplace.…”

Not another Complaint!

“…Thirdly, complaints often concentrate on problems in interactions with healthcare staff [3], leading to the focus of the complaint being subjective (e.g. compassion and dignity) [12]. Lastly, patient complaints will be made without awareness of the wider system pressures influencing care.…”

The Health-Care Needs Among Older Persons in an Indonesian Urban Setting

“…Reader and Gillespie identified several factors contributing to the inappropriate attitude among health-care professionals while providing care to older persons and one of the most prominent factors was high workloads that make health-care professionals feel burnout [43]. In Indonesia, for example, the ratio between the numbers of physicians to total population is different from one province to others.…”