Nurses’ Perceptions of Person-Centered Care in Inpatient Care Units in Saudi Arabia

Abstract

Problems previously identified in the implementation of person-centered care in Saudi Arabia include communication barriers, work environment factors, and cultural discordance between patients and nurses. Some have questioned whether Western person-centered care concepts are even applicable in a non-Western setting. In a nation where the majority of nurses are international migrant workers, better understanding is needed of what person-centered care means to nurses and how they manage to enact it in practice. This qualitative descriptive study aimed to explore nurse perceptions of person-centered care in inpatient units in Saudi Arabia and identify what nurses regard as facilitators and barriers to person-centered care. One-on-one semi-structured interviews were conducted via Zoom with 21 nurses working in two hospitals in Riyadh City, Saudi Arabia. One was a Magnet hospital. Interviewees included both Saudi-born and expatriate nurses. Qualitative analysis was then conducted recursively in a process combining both inductive and deductive elements. Regardless of cultural background and place of work, nurses described extensive efforts to provide individualized, empathic, developmentally appropriate, culturally sensitive care enabling patients and families to access information and participate in decisions. Perceptions of person-centered care aligned with established definitions. However, nurses did not separate descriptions of care from challenges encountered at the patient, organizational, and regional levels, including staffing and supplies shortages, gaps in regional care coordination, inadequate translation services, cultural beliefs limiting certain nurse-patient interactions, hostility toward foreign-born staff, and occasional violence. Differences were found between the Magnet and the non-Magnet setting. Nurses reported confronting these challenges through creativity, patience, knowledge, time, teamwork, and emotional self-regulation. The findings suggest that nurses’ understanding of person-centered care should be characterized more accurately as "situation"-responsive care – a process of doing one’s best to achieve professional nursing values while contending with the difficult realities that define the context of care. The results of this research can help inform Saudi healthcare managers and policymakers to design programs that will limit the challenges nurses face as they endeavor to provide respectful, attentive, individualized, and responsive care.