Barriers to Patient-Centered Care: A Thematic Analysis Study Maryam Esmaeili, BSN, MSN, PhD Candidate, Mohammad Ali Cheraghi, BSN, MSN, PhD, and Mahvash Salsali, BSN, MSN, PhD Maryam Esmaeili is a PhD Candidate at the School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Mohammad Ali Cheraghi is an Associate Professor at the School of Nursing and Midwifery, Tehran University of Medical Sciences, Nursing and Midwifery Care Research Centre, Tehran, Iran; and Mahvash Salsali is a Professor at the School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Search terms: Barriers, nursing, patient-centered care, quality of care, thematic analysis Author contact: cheraghiali2000@yahoo.com, with a copy to the Editor: journal@nanda.org This study was one part of a PhD dissertation of the first author, financially supported by Tehran University of Medical Sciences. No conflict of interest has been declared by the authors. This research project has been approved by research ethics committee of the Tehran University of Medical Science. Author contributions: Maryam Esmaeili, Mohammad Ali Cheraghi, and Mahvash Salsali were responsible for the study design and data analysis. Maryam Esmaeili performed the data collection. Maryam Esmaeili, Mohammad Ali Cheraghi, and Mahvash Salsali made critical revisions to the paper for important intellectual content. PURPOSE: To explore nurses’ attitudes and experience toward the barriers to achieving patient-centered care in the critical care setting. METHODS: A qualitative exploratory design with thematic analysis approach was used to collect and analyze data, and identify barriers to patient-centered care. Data collection was based on in-depth semi-structured interviews. FINDINGS: Data analyses resulted in the identification of three themes: (a) lack of common understanding of teamwork, (b) individual barriers, and (c) organiza- tional barriers. CONCLUSION: This study goes beyond reporting problems with patient-centered care to try to understand why patients do not always receive high-quality care. IMPLICATION FOR NURSING PRACTICE: For achieving patient-centered care, not only nurses’ individual efforts in following up-to-date evidence-based practice and having a holistic view are necessary, but also team coordination, organiza- tional support, and elimination of nursing job problems. One of the major concerns in the nursing discipline is the development and application of appropriate solutions for quality improvement in nursing practice. It has an important role in the creation of new guidelines for provision of high- quality care and the development of quality indicators in practice (Institute of Medicine [IOM], 2001; Eijk, Faber, Shamma, Munneke, & Bloem, 2011). According to the IOM, quality in health care has been defined as providing safe, timely, effective, efficient, equitable, and patient-centered care (IOM, 2001). Many studies have identified core ele- ments of patient-centered care in nursing, medicine, and public health policy. For example, to assess the nursing relationship with the patient, continuity of care and atten- tion to patient preferences are taken into account (Bodenheimer, 2008; Hobbs, 2009; Rauta, Salantera, Nivalainen, & Junttila, 2012; Shaller, 2007). Patient- 2 © 2013 NANDA International, Inc. International Journal of Nursing Knowledge Volume 25, No. 1, February 2014