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Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study
University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
University of Skövde, (School of Life Sciences, Högskolevägen 1, 541 28 Skövde, Sweden.
University College of Borås, Institute of Health and Care Sciences, Allégatan 1, 501 90 Borås, Sweden.
Gothenburg University, Institute of Health and Care Sciences, The Sahlgrenska Academy , Box 457, 405 30 Gothenburg, Sweden.
2011 (English)In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, article id 534060Article in journal (Refereed) Published
Abstract [en]

Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT) was employed. Interviews were performed with patients (), recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

Place, publisher, year, edition, pages
2011. article id 534060
Keywords [en]
Critical incident technique, nurse behaviour, nurse-patient interaction, patient participation, patient responses
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-1924DOI: 10.1155/2011/534060OAI: oai:DiVA.org:hv-1924DiVA, id: diva2:275668
Available from: 2009-11-06 Created: 2009-11-06 Last updated: 2018-12-12Bibliographically 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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