"Comprehensive Care" Concept in Nursing: Systematic Review.
Alina Renghea, Miguel Angel Cuevas-Budhart, Hugo Yébenes-Revuelto and 2 others
PMID 36867778WHAT IT FOUND
Across 14 studies, nurses and patients described comprehensive care as needing to cover spiritual, psychological and social needs, not just the reason for admission.
But psychosocial and spiritual care is often left out, and family is rarely included in the care plan.
Key findings
01Nurses and patients defined comprehensive care as covering biophysiological, psychological, social and spiritual domains, not only the clinical reason for admission.
02The care plan is described as the main tool for delivering comprehensive care, but it is often not operational and is not used as often as it should be.
03Psychosocial care is frequently neglected, with the family not included in the patient's comprehensive care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only open-access articles in four languages were included, so relevant work behind paywalls or in other languages was missed. The 14 studies varied widely in design and population, mixing nurses' views, patients' views and family caregivers' views, which makes it hard to draw one firm conclusion. Most included studies were qualitative, so they describe experiences and meanings rather than measuring whether comprehensive care improves outcomes. Four of the 14 papers were rated low methodological quality. Brazil supplied 8 of the 14 studies, so the picture is heavily weighted to one country's healthcare system. The review reports no pooled effect sizes or outcome data, so it cannot say whether comprehensive care works, only how it is described.
The easy way to misread this
Do not read this as evidence that comprehensive care improves patient outcomes. The review synthesises how the concept is described and where it falls short in practice; it reports no measured clinical results, so it cannot support a claim that this approach works.