Four focus groups were conducted to explore acute care nurses' experiences empowering patients and the facilitators and barriers they encountered during the process. Thirty-four nurses employed at four hospitals in the Midwestern United States participated in the study between February and April 2015. Facilitators of empowerment included establishing a therapeutic relationship, fostering communication, providing education, respecting patient autonomy, engaging support systems, and lifting spirit/giving hope. Barriers included conflicting information about plans of care, lack of time, fear and anxiety over unfamiliar environments and routines, ineffective or inadequate support systems, lack of/low accountability, and killing the soul. Nurses also described innovative strategies they used to overcome the barriers. The development of future inpatient empowerment interventions needs to focus on the innovative strategies nurses used to overcome barriers in addition to considering the facilitators and barriers to empowerment that nurses identified.

The articulation of what patients actually experience in the hospital setting contributes to improve nursing practice by offering insight into what is important to the patient and how best to engage with them in their care. The constraints that patients reported facing related to their healthcare engagement should be used to inform the delivery of future engagement interventions in the acute care setting.

Background Conceptual clarity for the term patient engagement is growing. However, there is variability in patient engagement in healthcare, which could be due to the absence of models to guide practice or a myriad of organisational, nurse and patient factors. The recently developed ‘Interactive Care Model’ provides guidance on how to genuinely promote individualised patient engagement. An understanding of how to action this model in nursing is required. Aims The aim of this scoping review was to examine actions in the published scientific literature that align with the Interactive Care Model, in the context of nursing care of hospitalised patients. Data sources In 2018, searches of CINAHL, Cochrane Library, MEDLINE and PsycInfo were undertaken, for literature published between 2008 and 2018. This was followed by citation tracking. Review methods Two researchers screened and selected studies using prespecified criteria. Data were charted into a pre‐established tool and collated and summarised using numerical summaries and deductive content analysis. For content analysis, categories were generated from the ‘Interactive Care Model’. Findings Forty‐three studies were included in the review, 33 noninterventional and 10 interventional studies. Publications on the topic are increasing in number over time, with most conducted in Europe with patient or nurse participants. Forty‐two actions were found in the literature that aligned with the ‘Interactive Care Model’. The actions uncovered differed between intervention and noninterventional studies; in interventional studies actions were formalised. Conclusions This review provides an overview of actions that promote patient engagement and could inform implementation of the Interactive Care Model and the design and testing of patient engagement interventions to support the model. There are opportunities to explore latter phases of the Interactive Care Model to foster patient engagement in self‐management and to motivate patients’ management of healthcare beyond hospitalisation. Further, there is a need to rigorously evaluate patient engagement interventions.

To identify, critically appraise, and summarize instruments that measure patients' preferences for engagement in healthcare. Design: Psychometric systematic literature review. Data sources: PubMed, Embase, CINAHL, and PsycINFO were searched from inception to March 2019. Review methods: Three reviewers independently evaluated the 'methodological quality' and the 'measurement properties' of the included instruments using The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and Terwee's quality criteria. Each instrument was given a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) score. The review was registered at PROSPERO (registry number CRD42018109253). Results: A total of 16 studies evaluating 8 instruments measuring patients' preferences for engagement in healthcare were included. All instruments were downgraded for their 'methodological quality' or 'measurement properties', or a combination of both. Common concerns were lack of theoretical basis, absence of patient input during development, incorrect usage and reporting of validity measures, and absence of a priori hypotheses to test validity. Conclusions: There were no identified instruments that demonstrated adequate evidence for all measurement properties. The Patient Preferences for Patient Participation Scale (4Ps) and 10item Decisional Engagement Scale (DES-10) had the highest overall GRADE scores; however, each had some underlying developmental or methodological issues. Impact: Assessing how patients prefer to engage in their care is a critical first step to truly individualize engagement interventions to meet patient expectations. Systematic reviews of measures of patient experience with engagement in healthcare have been undertaken but none are available on measures of patient preferences for engagement. The results highlight the need to further develop and test instruments that measure patients' preferences for engagement in healthcare within a framework for consumerism. Involving the consumer in the instrument development process will ensure that engagement strategies utilized by healthcare providers are relevant and individualized to consumer preferences.

This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies ( N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse–patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.