Older patients’ participation in team meetings—A phenomenological study from the nurses’ perspective (original) (raw)

2013, International Journal of Qualitative Studies on Health and Well-Being

Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM) to which the patient has been invited. The aim of this study is to highlight nurses' experiences of older patients' participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients' vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: ''the need for a guide,'' ''patient participation challenged by structures,'' and ''creating space for the whole human being.'' In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.

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It made me feel human"-a phenomenological study of older patients' experiences of participating in a team meeting

International journal of qualitative studies on health and well-being, 2013

This study focused on older patients participating in a team meeting (TM) in a hospital ward in Sweden. A process had taken place on the ward, in which the traditional round had developed into a TM and understanding what participating in a TM means for the older patient is necessary for the development of care that facilitates older patient's participation. The aim of this study was to describe the caring, as experienced by the older patients on a ward for older persons, with a specific focus on the team meeting. A reflective lifeworld research (RLR) design was used. Fifteen patients, 12 women and three men (mean age of 82 years) were interviewed while they were hospitalized in a hospital ward for older people. In the essential meaning of the phenomenon, the TM is described as being a part of a wider context of both caring and life. The need for hospitalization is an emotional struggle to overcome vulnerability and regain everyday freedom. The way in which the professionals are able to confirm vulnerability and create a caring relationship affects both the struggle for well-being and the possibilities for maintaining dignity. The essence is further explicated through its constituents; Vulnerability limits life; Life is left in the hands of someone else; Life is a whole and Space for existence. The result raises concern about how the care needs to be adjusted to older people's needs as lived bodies. The encounter between the carer and the patient needs to be developed in order to get away from the view of the patient as object. An expanded vision may open up for existential dimensions of what brings meaning to life. One way, as described by the patients, is via the patient's life stories, through which the patients can be seen as a whole human being.

Exploring the meaning of participation in nursing care : the old persons' perspective in the community

2008

It is evident in the literature that there is no clear definition of the term participation. Researchers that deal with this issue mention that it is a term that is used with the same meaning as patient collaboration, patient involvement, patient partnership (Ashworth et al, 1992; Cahill, 1998) and even self help. This study aims to uncover the meaning of participation in nursing care for old persons living in the community. The Husserlian phenomenological approach was chosen to investigate the phenomenon. Twenty three old persons living in the community were recruited through four open day care centres in both urban and rural Greece. Unstructured interviews were performed in order to obtain their views and experiences regarding the issue under investigation. Collaizzi's method of data analysis was employed to analyse the data. Furthermore, phenomenological research is suggested to be an efficient way of getting to know other people's reality in order to plan future care and...

Ambiguous participation in older hospitalized patients: gaining influence through active and passive approaches-a qualitative study

BMC nursing, 2016

Patient participation is required by law in Norway and in several western countries. Current participation ideology is based on individualism, which may conflict with the older generation's commonly held values of solidarity and community. Hence, different values and ideologies may come in conflict when older patients receive treatment and rehabilitation in geriatric wards. Participation is a guiding principle in rehabilitation. Criteria for admission of older patients to geriatric wards are complex health problems, acute illness and/or acute physical and/or cognitive functional failure. The ideal is an active and engaged patient. The aim of the study was to describe the difficulties experienced by older patients on acute geriatric wards when involving themselves with their own treatment and care. In this qualitative study older patients were interviewed during hospitalization in geriatric wards and asked to tell about their experiences with participation. Data analysis was cond...

Patient participation in nursing care from a patient perspective: a Grounded Theory study

Scandinavian Journal of Caring Sciences, 2007

Patient participation in nursing care from a patient perspective: a Grounded Theory study The study's rationale: Patients' active participation in their own care is expected to contribute to increased motivation to improve their own condition, better treatment results and greater satisfaction with received care. Knowledge of patients' understanding of participation is of great importance for nurses in their efforts to meet patient expectations and for quality of nursing care. Aim: The aim was to explore the meaning of patient participation in nursing care from a patient point of view. Methodological design and justification: Six tape-recorded focus group interviews with 26 Swedish informants described opinions on and experiences of patient participation. The informants consisted of patients in somatic inpatient care as well as discharged patients from such a setting. The Grounded Theory method was used and the data were analysed using constant comparative analysis. Ethical issues and approval: The ethics of scientific work was followed. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Gö teborg University approved the study. Findings: The patients emphasised the importance of collaboration to improve participation. The core category, Insight through consideration, was generated from four inter-related categories: (i) Obliging atmosphere; (ii) Emotional response; (iii) Concordance; and (iv) Rights and their 15 subcategories. Conclusions: The meaning structures of patient participation in nursing care revealed from a patient point of view, seemed to mainly consist of not only external factors presented by the institutions -by the professionals -but also internal patient factors. The patients' view of participation should be considered to a greater degree in nursing practice and education, as should also further development of nursing care policy programmes, evaluation and quality assurance criteria. For further development, studies are needed in similar and other settings.

Moving from Participation towards Partnership in Nursing Care

Iris Publishers LLC, 2019

Background: Meeting with health care gets short before and after the operation. The difficulty at the day surgery is that preparation and information take place in close proximity to the operation. Health professionals must not only take care of the child during the medical visit, but also of the accompanying parent, too. Parents' participation in the perioperative care, sometimes unable to attend. Aim: This study aims to investigate how parental involvement in the perioperative a process can be facilitated. Method: A qualitative design based on observations and interviews with semi structured questions with open answers. Results: The results conveyed involvement in the child's perioperative process in diverse ways and to a different depth. This is highlighted in the theme Allowed with the under themes Security and Being accepted. However, the theme Exclusion with the under-theme Rejection revealed a non-caring approach where no caring relation could be established. Quotes from the transcribed material are used to highlight the results. Conclusion: The study's findings confirm earlier studies in the perspective that information is of central importance in enabling parents to be involved in the perioperative process. The results showed that parents' involvement in the perioperative process is a prerequisite for creating safety in the child and reducing concerns in connection with the operation. Parental involvement may be hindered by a conventional approach that does not include the child's perspective.

Patient participation in hospital care: Nursing staffs' point of view

International Journal of Nursing Practice, 2014

The aim was to investigate nursing staff’s perceptions related to patient participation and the parameters affecting it during nursing care. A cross-sectional study with both a quantitative and qualitative orientation was conducted. The sample consisted of all nursing staff working in medical and surgical wards in three Greek hospitals. A questionnaire was developed and the data were analysed with exploratory factor analysis, whereas content analysis was used for qualitative data. Nursing staff perceived participation as the process of information giving to patients, communication of symptoms by patients and compliance with the staff’s orders. ‘Information providing’ and ‘ability to influence and responsibility’ were significant aspects of the content of participation, whereas the parameters affecting participation were related to patients, nursing staff and the care context. These results support patient engagement in dialogue and shared decisionmaking, while highlighting the need to implement participation systematically and stimulate changes in nursing care organization.

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