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Essential Aspects Of Care (1)

Introduction

In the everyday care of patients, we are involved in interactions and interventions that assist and enable our patients to achieve the satisfactory outcomes that are essential to their recovery and well-being. The patient and significant others are encouraged to play an active part in the care process. In caring for the patient/client, the involvement and participation of family members and friends contributes to the understanding of their needs and expectations. The active participation of patients and their relatives in care makes the relationship between them and health care professionals much more of a partnership.

In the drive to improve the quality of care and patient experience, and to demonstrate its commitment to the nursing, midwifery and health visiting strategy (Making a Difference, DoH, 1999), the Department of Health has added to its wide ranging publications ‘The Essence of Care’ (Department of Health, 2001). The Essence of Care was developed through the active participation of practitioners and users of services. Its purpose is to support quality improvement and facilitate contributions to clinical governance at local level. The toolkit focuses on core and essential aspects of care, and provides a basis for advancing best practice in areas that are crucial to the quality of care. The eight fundamental aspects of care it addresses are: Personal and Oral Hygiene, Privacy and Dignity, Food and Nutrition, Safety of people with Mental Health needs, Record Keeping, Principle of Self Care, Pressure Ulcers and Continence and Bladder and Bowel Care. Not all of these will be covered in this section of our resource but it will be worth looking up the toolkit to extend your knowledge on what is offered here.

In this resource, the theme 'Essential aspects of care' is chosen to represent those aspects of care that are fundamental to the holistic care of the individual, in both health and illness, and even in birth and in death. They are thought of as essential to personal safety, comfort, and a sense of well-being, and embrace the dimensions of personal, physiological, psychological, social, and spiritual needs. The delivery of the essential aspects of care require different levels of skills and competence together with sensitivity and respect. Although caring exists in all cultures, the interpretation and relevance of culturally acceptable care are viewed according to the beliefs, values, social norms and taboos prevalent in that culture (see Holland and Hogg, 2001; MacLachlan, 1997). Our effort to understand and acknowledge the care needs of clients from the cultural perspective reduces barriers and enhances effectiveness.

The essential aspects of care introduced here are:

Before we examine these essential aspects of care, we perhaps ought to briefly visit some of the fundamental principles that may be general considerations when caring for others but assume greater significance in the cross-cultural context of care. The values we hold are an integral part of us, and determine how we think, feel and behave in respect to ourselves and towards others. In professional practice, we become aware of the accentuation of these values, and the associated personal and professional conflicts that may arise as a consequence of our own experiences. Values and philosophies are assimilated and become internalised by us through the socialisation process. Values have cultural determinants, and are influenced by religious beliefs and life experiences. When caring for people who are not of the same ethnic/cultural background as ourselves, we need to be aware of and sensitive to the values of others. In addition we all need to be cognisant of our cultural relativism or ethnocentric positions. Some of the values that are important to explore are concerned with dignity, trust, confidentiality, privacy, modesty, respect, truth and justice. Cultures vary in their philosophical worldviews that shape their visions and actions. Professional cultures are no different.

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