Developing a Holistic Model for Patient-Centered Nursing Care Delivery

Thesis Abstract

The increasing complexity of healthcare needs and the emphasis on quality patient outcomes underscore the necessity for a comprehensive model that encapsulates holistic, patient-centered nursing care. Despite significant advancements in clinical protocols, there remains a limited integrative framework that addresses the multidimensional aspects of patient well-being, including physical, emotional, social, and spiritual dimensions, within nursing practice. This study aims to develop a robust, evidence-based holistic model for patient-centered nursing care delivery that can inform practice, education, and policy. The research employs a mixed-methods sequential exploratory design. The study population comprises registered nurses working in tertiary hospitals and patients receiving inpatient care within a metropolitan region. A purposive sampling technique will be used to recruit 200 nurses and 300 patients for quantitative data collection, supported by qualitative interviews with 20 nurses and 20 patients selected through maximum variation sampling. Data collection instruments include standardized questionnaires for nurses and patients—such as the Person-Centered Care Assessment Tool (P-CAT) and the Holistic Nursing Care Scale—augmented by semi-structured interview guides. The instruments' validity and reliability will be established through pilot testing and Cronbach’s alpha analysis, with expert panel review ensuring content validity. Quantitative data will be analyzed using descriptive statistics, multiple regression analysis, and Structural Equation Modeling (SEM) to identify relationships between variables and to validate the proposed model’s constructs. Qualitative data will undergo thematic analysis using NVivo software, guided by Creswell’s methodological framework, to explore nurses' and patients' perspectives on holistic care components, facilitators, and barriers. The integration of findings aims to produce a comprehensive, theoretically grounded model that encapsulates key dimensions and processes of delivering holistic, patient-centered nursing care. The anticipated results are expected to delineate critical factors influencing the implementation of holistic care, such as communication, shared decision-making, cultural competence, and emotional support, and to establish the interconnectedness of these variables within a conceptual framework. The model validated through SEM is projected to demonstrate good fit indices (e.g., CFI > 0.90, RMSEA < 0.08), confirming its theoretical and practical relevance. It is also expected that qualitative insights will enrich the model by highlighting contextual and personal factors affecting care delivery, thus offering a nuanced understanding that complements quantitative findings. This study contributes to nursing science by developing a comprehensive, empirically validated framework that integrates diverse components of holistic, patient-centered care within a structured model. It advances existing theories such as the Watson’s Theory of Human Caring and the Leininger’s Culture Care Diversity and Universality Theory by synthesizing their principles into an operational model for practice enhancement. Policymakers and healthcare administrators can utilize the model as a blueprint for designing nursing interventions, training programs, and care protocols aimed at optimizing patient outcomes and satisfaction through holistic approaches. The study concludes that implementing a structured, evidence-based holistic model can transform nursing practice by fostering a more personalized, compassionate, and effective care environment. It recommends that healthcare institutions adopt this model into nursing education curricula, clinical guidelines, and quality assurance programs. Future research should focus on longitudinal assessments of model application effects, as well as adaptation across different healthcare settings and populations. The findings of this research hold significant implications for advancing holistic nursing care worldwide, emphasizing the need for continued integration of multidimensional patient needs into care delivery processes.