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Patients perceptions of barriers for participation in nursing care
University West, Department of Nursing, Health and Culture, Division of Nursing.
University of Skövde,School of Life Sciences.
University College of Borås.
Göteborg University, The Sahlgrenska Academy,Institute of Health and Care Sciences.
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 575-582Article in journal (Refereed) Published
Abstract [en]

Background: In many Western countries as in Sweden, patients have legal right to participate in own care individually adjusted to each patient's wishes and abilities. There are still few empirical studies of patients' perceptions of barriers for participation. Accordingly, there is a need to identify what may prevent patients from playing an active role in own nursing care. Such knowledge is highly valuable for the nursing profession when it comes to implementation of individual patient participation. Aim and objective: To explore barriers for patient participation in nursing care with a special focus on adult patients with experience of inpatient physical care. Methodological design and justification: Data were collected through 6 focus groups with 26 Swedish informants recruited from physical inpatient care as well as discharged patients from such a setting. A content analysis with qualitative approach of the tape-recorded interview material was made. Ethical issues and approval: The ethics of scientific work was adhered to. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study. Results: The barriers for patient participation were identified as four categories: Facing own inability, meeting lack of empathy, meeting a paternalistic attitude and sensing structural barriers, and their 10 underlying subcategories. Conclusions: Our study contributes knowledge and understanding of patients' experiences ofbarriers for participation. The findings point to remaining structures and nurse attitudes that are of disadvantage for patients' participation. The findings may increase the understanding of patient participation and may serve as an incentive in practice and nursing education to meet and eliminate these barriers, in quality assurance of care, work organization and further research. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science

Place, publisher, year, edition, pages
2011. Vol. 25, no 3, p. 575-582
Keywords [en]
Focus groups, barriers, hindrance, nursing care, patient participation
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-1922DOI: 10.1111/j.1471-6712.2010.00866.xOAI: oai:DiVA.org:hv-1922DiVA, id: diva2:275665
Available from: 2009-11-06 Created: 2009-11-06 Last updated: 2017-12-12Bibliographically 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: 2018-12-12Bibliographically approved

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