Registered Nurses' experiences of patient participation in hospital care: supporting and hindering factors patient participation in care.

Abstract

Promoting patient participation in care is an international priority identified by the World Health Organization and various national bodies around the world and an important aspect of person-centred care. The aim of this study was to describe Registered Nurses' experiences with patient participation in nursing care including their barriers and facilitators for participation. The study setting was a University Hospital in Sweden. Interviews were conducted with twenty Registered Nurses working at medical wards in 2013. Thematic data analysis was used to analyse the transcribed interview data. Twenty nurses from four wards in two hospitals were included. Five themes emerged from the analysis including listening to the patient, engaging the patient, relinquishing some responsibility, sharing power and partnering with patients. The core theme 'partnering with patients' was enacted when nurses listened to and engaged patients and when they relinquished responsibility and shared power with patients. In addition, hindering and facilitating factors to participation were identified, such as patients wanted to take on a passive role, lack of teamwork which participants understood would enhance interprofessional understanding and improve patient safety. Patient participation was hindered by medical jargon during the ward round, there was a risk of staff talking over patients' heads but sometimes inevitable having conversations at the patient's bedside. However, nurses preferred important decisions to be made away from bedside. It all came down to partnering with the patient and participants described how they made an effort to respect the patients' view and accept patient as a part of the care team. Identified hindering factors for participation were lack of teamwork, patients' taking on passive roles and communication during ward rounds having conversations at the patient's bedside. Nurses wished for a change but lacked strategies on how. Nurses preferred important decisions to be made away from bedside.