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Patient participation in nursing care: an interpretation by Swedish registered nurses.
The Sahlgrenska Academy at Göteborg University, Institute of Health Care Pedagogics.
University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
Department of Health and Welfare, Stockholm.
Sahlgrenska Academy at Go¨ teborg University, Faculty of Health and Caring Sciences, Institute of Health.
2005 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 1, p. 35-42Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: The aim of this study was to clarify Registered Nurses' understanding of patient participation in nursing care. Objectives were to investigate ward nurses' interpretation of the elements of patient participation and its implementation. BACKGROUND: One goal of health care is patient participation. Registered Nurses must encourage the participation of their patients in nursing care situations. A right for patients to make their own informed choices is laid down in Swedish laws and national and local directives. The concept of patient participation can be interpreted differently and is thus difficult to implement and evaluate. Current nursing literature provides little clarity of the elements and processes of patient participation and conceptual definitions differ. DESIGN AND METHODS: A qualitative approach was applied and the Grounded Theory method used. Thirty-one Registered Swedish Nurses described the meaning of patient participation and its implementation in nursing care. Seven focus group interviews with nurses providing inpatient somatic care were carried out in five hospitals in west Sweden. RESULTS: Four properties, describing nurses' approaches and procedures, constitute patient participation. The properties are: interpersonal procedure, therapeutic approach, focus on resources, opportunities for influence. These properties were considered crucial for patient participation in a nursing care context. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: The results clarify the concept of patient participation from a nursing perspective. A comprehensive description of important factors for patient participation could be made on the basis of nursing experience. This comprehensive description can be used in nursing care practice and its evaluation. The developed categories can be used in nursing care documentation of how patient participation is realized.

Place, publisher, year, edition, pages
2005. Vol. 14, no 1, p. 35-42
Keywords [en]
concept, nursing care, nurse–patient relationship, patient participation
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-1782DOI: 10.1111/j.1365-2702.2004.00957.xPubMedID: 15656846OAI: oai:DiVA.org:hv-1782DiVA, id: diva2:242046
Available from: 2009-10-06 Created: 2009-10-02 Last updated: 2020-04-01Bibliographically approved
In thesis
1. Patient och medaktör: Studier av patientdelaktighet och hur sådan stimuleras och hindras
Open this publication in new window or tab >>Patient och medaktör: Studier av patientdelaktighet och hur sådan stimuleras och hindras
2008 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Patient and co-actor : Studies of patient participation and how this is stimulated and hindered
Abstract [en]

Original title: Patient och medaktör. Studier av patientdelaktighet och hur sådan stimuleras och hindras. Title in English: Patient and Co-actor. Studies of patient participation and how this is stimulated and hindered. Language: Swedish with summary in English. Keywords: behaviour, Co-actor, Critical Incident Technique, barriers, focus group, Grounded Theory, nurse-patient relationships, nursing, patient participation. ISBN: 978-91-628-7410-0 The overall aim of this thesis was to contribute to the development of knowledge of what could strengthen patients’ participation in their own care by clarifying the phenomenon patient participation and describe how it is stimulated or hindered, respectively. Data collection were obtained from focus groups (13); with patients (26) and with nurses (31) and interviews; with patients (17) within inpatient somatic care at five hospitals in West Sweden. This thesis includes four papers. Grounded Theory has been described and used to explore the meaning of patient participation in nursing care from a patient point of view. “Insight through consideration” was generated from four interrelated categories: Obliging atmosphere, Emotional response, Concordance and Rights. Grounded Theory has also been used to clarify Registered Nurses’ understanding of patient participation in nursing care. Four properties emerged: Interpersonal procedure, Therapeutic approach, Focus on resources and Opportunities for influence. A thematic content analysis has been described and used to explore barriers for patient participation in nursing care with a special focus on adult patients identified as: Facing own inability, Meeting ignorance, Meeting a paternalistic attitude and Sensing structural barriers. A qualitative approach, using the Critical Incident Technique has been described and used to identify incidents and nurses’ behaviours that influence patients’ participation in nursing care based on patients’ experiences from inpatient somatic care, identified as: Regarded as a person, Engaged through information, Acknowledged as competent, Abandoned without backup, Belittled verbally, Ignored without influence. This thesis has clarified the fact that patient participation is something that needs to be worked on and further developed in health and medical care. This requires nurses as well as leaders at all levels to become aware of the rights and expectations patients have. To achieve optimum patient participation, patients need to be encouraged and supported by knowledgeable and dedicated nurses in order to increase their own control. In order to improve patient participation, traditional structures as well as attitudes of the caregivers need to be questioned and replaced.

Place, publisher, year, edition, pages
Göteborg: Institutionen för vårdvetenskap och hälsa, Göteborgs Universitet, Sahlgrenska Akademin vid Göteborgs Universitet, 2008. p. 67
Keywords
Co-actor, Critical Incident Technique, barriers, focus group, Grounded Theory, nurse-patient relationships, nursing, patient participation
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-1911 (URN)978-91-628-7410-0 (ISBN)
Public defence
Hörsal 2119, Arvid Wallgrens backe, hus 2., Göteborg (English)
Supervisors
Note

Doctor of Philosophy (Health Care Sciences)

Available from: 2010-03-03 Created: 2009-11-06 Last updated: 2020-04-01Bibliographically approved

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