Activities Patients and Nurses Undertake to Promote Patient Participation

Abstract

Purpose: To describe and understand activities patients and nurses undertake to enact patient participation in nursing care.

Design: This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse-patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014.

Methods: Field notes were collected and were analyzed both inductively and deductively.

Findings: Nurse-patient interactions promoted patient participation through dialogue and knowledge sharing. Less evident was patient involvement in planning or self-care. Nurses exerted control over patient care, which influenced the extent of patient participation.

Conclusions: Patient participation appears to be difficult to enact. Nurses' controlling approach, influenced by organizational issues, was in conflict with a patient-centered approach to care. Nurse-patient communication is one aspect of patient-centered care enacted more frequently.

Clinical relevance: Nurses may benefit from strategies at the individual and organizational level to enhance their patient-centered practices. Fostering nurses' communication may enhance patient-centered practices in hospitals.

Keywords: Communication; nurse-patient relations; nursing care; organizational culture; patient participation; patient-centered care.