Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Core Process of Client Centered Care - Identifying Concerns and Needs

a) Initiate discussion or strategies (i.e. focus groups and surveys) in order to understand the client’s perspective regarding his/her health and quality of life. Nurses may ask:

  • What is this situation like for you?
  • What is most important to you?
  • What are your goals?
  • What does quality of life mean for you?
  • How involved do you want to be?
  • What would you like to know about?
  • What gives you strength to carry on?
  • What has worked for you before?
  • Who in your family or friends would help you?
  • How will you know that you will be able to manage on your own?

b) Seek to clarify the hopes, wishes, preferences, strengths, needs, and concerns of the client, from his/her perspective. Nurses may ask:

  • What do you hope happens?
  • What do you see down the road?
  • What are your concerns?
  • What do you need/expect from your health care team?

c) Seek to build the client’s capacity (ability to reach independence) based on the client’s goals.

d) Clarify the client’s wishes and follow his/her lead in determining the involvement of others in their health care. Nurses may ask:

  • Who do you want to involve in your care?
  • Who else should be involved in this meeting/project?
  • What is important to you?
  • Who would you like to make decisions for you, if you were unable to make them for yourself?

e) Represent the client’s/community’s perspective of health, goals in life, as well as their concerns when making recommendations to others (i.e. the health care team, project team, community group, etc).

f) Follow the client’s lead when providing information or teaching that the client wants with respect to his/her health/illness situation. Teach the client in a way that is relevant to his/her personal reality. This is based on the premise that the nurse trusts that clients will seek relevant information according to their own readiness.

g) Document the client’s/community’s perspective with regard to health and quality of life, goals, wishes, choices regarding information, and concerns.

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