Patient Participation in Nursing Care: A Focused Ethnography
MetadataShow full item record
Patient-centred care has been recognised internationally as a way patients can participate in their nursing care to potentially improve their safety, yet widespread understanding of patient participation and ways to promote it is lacking. Further, nurses’ behaviours sometimes conflict with their reported support for patient participation. The aim of this study was to understand patient participation in nursing care in medical wards and the barriers to and facilitators of patient participation. This study was a focused ethnography. Two hospitals participated in the study. Site 1 was located in Queensland and catered for public patients, while Site 2 was located in Victoria and catered for private patients. The setting for this study was four medical wards, two from each hospital. Patients and nurses were observed in practice and participated in semi-structured interviews. Observational field notes were analysed using both deductive and inductive content analysis. Interviews were transcribed and analysed using inductive content analysis. Deductive analysis of observations of practice showed that the most frequent types of participation were in the categories ‘having dialogue with health care staff’ and ‘sharing knowledge’. Patients participated less frequently in the categories ‘partaking in planning’ and ‘managing self-care’. Inductive analysis of field notes demonstrated that nurses exerted control over care, evident in the category ‘maintaining control of work’. Findings from 20 patient interviews, revealed four categories. In the category ‘valuing participation’ patients spoke about wanting to participate and seeing it as beneficial. The categories ‘exchanging intelligence’ and ‘on the lookout’, were ways patients reported participating in care. The final category ‘power imbalance’, revealed patients’ difficulty in enacting participation.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Item Access Status
In order to comply with copyright the 4 journal articles have not been published here.
Patient participation in health care
Patients as partners in health care
Nurse and patient