Patient-centered care (PCC) was developed in the 1950s by Carl R. Roger, an American humanist psychologist in what he referred to as client-centered therapy [1-3]. Today, PCC is widely recognized and acknowledged as a core value in medical practice [4, 5]. This has led to positive outcomes that include a reduction in malpractice complaints, improved patients satisfaction, improved consultation time, patient’s emotional state, and medication adherence [6-8]. In addition, Newell & Jordan  reported that PCC is an essential and fundamental ethics in promoting quality healthcare. This is in the understanding that patients are fundamentally human, leading to the promotion of the concept of PCC even with personhood, but not without its complexities . Historically, the concept of PCC has been explored through theoretical proposals and practical approach since the earliest Geneva conference that followed a process that allowed the acquisition of experience concurrently [11-13]. In essence, the experience is a crucial aspect of the identity and existence of any institution that connotes the value of delineating institutional journeys, evaluating and recognizing PCC development.
PCC concept is a comprehensive approach to healthcare service delivery [14, 15]. This innovative concept in policy and practice moving to a conceptual optimal routine clinical practice is pivotal [16-19].
In developed countries such as the United Kingdom, United States of America, Australia, and Germany, among others, PCC has been in paper through policies leading to this statement, “liberating the NHS: No decision about me without me” [20, 21]. Even though the trend of this concept is clear in research and theoretical conceptualization, it is, however, fuzzy, elusive, and even poorly implemented in medical practice [22-24]. Since its inception, several studies on PCC such as [8, 12, 25-28] have described the various dimensions and models of PCC to show its importance in the healthcare system. In addition, several research findings on the challenges experienced in realizing and practicing PCC have been presented in , among others. The results of these findings also reveal that PCC has been taken for granted by healthcare providers and other stakeholders in primary health care.
Implementation of the PCC concept is a necessity in order to achieve sustainable healthcare coverage for all in Nigeria, where it has been accepted for incorporation into the existing healthcare system. This means that it is feasible at the grassroots level of the healthcare system provided that the stakeholders work in collaboration with the nurses in its implementation and practice. Thus, the aim of this study was to explore the perception of nurses on PCC.
The impact of perception on PCC
There has been an increased need for PCC globally since its identification by the Institute of medicine of United States of America National Academies of Science as the leading contributor in the provision of quality PHC . PCC is aimed at understanding the illness experiences from the patient’s viewpoint. The International Alliance of Patients Organization (IAPO) declared that PCC as a service is based on placing the patient at the center and around the patient’s needs .
In professional nursing circles, PCC is perceived to be an awareness of the importance of patient healthcare culture, family and friend’s involvement, incorporation of values of love and respect, and communication in all facets of patient’s care leading to accountability to the patient [32, 33]. In South Africa, PCC is endorsed in the second amendment Act No 3 of 2003, which states that all South African citizens have a right to effective quality healthcare free from harm . The South African PCC has established on an eight-point “Batho Pele” principle that introduces a concept to service delivery putting people first, and the stated values of public service in the Republic of South Africa .
The role of nurses in delivering PCC in public hospitals and other healthcare facilities has become an imperative study for researchers since it is necessary to evaluate the knowledge and understanding of the nurses. In the findings by Terry in , nurses were found to be enthusiastic about sharing their perceptions with regards to PCC and what they perceived it to encompass. It is interesting to note that the perception of humane treatment was evident from the nurses. The components of human emotional aspects such as psychological, social, spiritual, and emotional aspects that greatly influence an individual’s health was presented. For instance, the awareness of the patient’s cultural background and how to integrate the culture of a patient into the management of a patient and treatment plan were seen to be associated with PCC.
Therefore, in order to effectively render PCC, the nurses have to demonstrate cultural awareness . Culture is known to be multifaceted and dynamic, making it an important subject for the health practitioner’s especially nurses, to understand for quality and effective healthcare service in the PHC [37-39]. To improve healthcare outcomes in PCC model, there has to be a demonstrated aptitude for cultural competence . However, there are many challenges and barriers, but none is more influential than institutional and cultural-based on individual ethnocentrism . This is responsible for the current socialization of young healthcare professionals leading to the perpetuation of negative attitudes, stereotype behavior towards vulnerable and culturally diverse populations .
The involvement of the family in crucial patient’s health decisions is a vital component of PCC and has been evident in research findings presented in [43, 44]. The similarities and differences have been identified in order to define and describe the level of family involvement in delivering PCC. In a systematic review of nine different models and frameworks in which PCC was defined, family and friend’s involvement was found to be 60 % [45, 46]. The values of love and respect for patients were seen to be the other aspects of PCC. This is seen as incorporating a holistic PCC when interacting with patients and family members. Dowling in , reports that nurses perceive love in nursing as going beyond the traditional duty of patient care and the willingness and commitment to the good of a patient before themselves. In , it was found that treatment with love and respect among patients included aspects of listening and trusting in a patient. This makes the patients feel valued besides having a sense of control of their own healthcare process, thus helping in their recovery efforts. The display of these values of love, respect, and dignity was seen as integral to PCC and was perceived so by the nurses.
One way of expressing perception is through verbal and non-verbal communication. Nurses should be aware of the different methods of communication that should be adopted when handling patients. In , it is reported that communication skills form a fundamental component of PCC. Evidence has demonstrated the impact of PCC in healthcare. These include patient satisfaction, adherence to recommended treatment, and management of chronic diseases [50, 51]. However, PCC lacks clear measurement tools to clearly show its effectiveness as presented in .