How Context Shapes Person-Centred Fundamental Care Through Nurse-Patient Relationships: Validation of the FoC Intelligence Modelling Tool and Predictive Pathway Analysis.
Regina Allande-Cussó, Maria Alejandra Pinero de Plaza, Alison Kitson and 3 others
PMID 41216894WHAT IT FOUND
A Spanish-language survey of 1053 hospitalised patients validated a tool measuring how care context and nurse-patient relationships shape integrated care.
Better contextual support predicted stronger relationships, which in turn strongly predicted care integration, confirming the nurse-patient bond as the key mediator.
Key findings
01The Spanish version of the FoC-IMT tool demonstrated strong reliability and validity in measuring patient perceptions of care context and integration.
02Statistical modelling showed that improvements in the care context predicted stronger nurse-patient relationships, which then strongly predicted better integration of care.
03The nurse-patient relationship acted as a mediator, meaning the quality of the environment influences care integration primarily through the strength of the interpersonal connection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design prevents determining causality; it shows associations but not that changes in context directly cause changes in relationship or integration over time. The study was conducted only in Spain, so the tool's validity and the specific findings may not apply to other cultural or healthcare contexts without further adaptation. Data was collected via nurse-administered interviews, which may introduce social desirability bias, as patients might report more positive experiences to please the interviewer.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the strong predictive relationship between context and care integration as proof that changing the physical or organisational environment alone will improve care integration. The study shows that the nurse-patient relationship is the necessary mediator; without strengthening this interpersonal bond, improvements in context may not translate into better integrated care.