How patient participation is constructed in mental health care: a grounded theory study

Jørgensen, Kim; Rendtorff, Jacob Dahl; Holen, Mari

doi:10.1111/scs.12581

Cited by 50 publications

(38 citation statements)

References 25 publications

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“…Furthermore, that patient participation in forensic psychiatric care sometimes depends on nurses' views on patient crime, or that personal dislike of another origin may guide the professional is worrisome. This is also in line with descriptions of care as correction and discipline and underlines a previously described challenge in the construction of patient participation in mental health care, between ethical care and paternalism (18,28). Correctional, disciplinary and paternalistic care is dehumanising and counterproductive to patient participation and points at a need for improvement.…”

Section: Discussionsupporting

confidence: 85%

‘We try’ – how nurses work with patient participation in forensic psychiatric care

Magnusson

Axelsson

Lindroth

2019

Scandinavian Caring Sciences

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Rationale Patients in secure forensic psychiatric care have reduced autonomy because of the constraints imposed on them by compulsion laws. Thus, it is vital that nurses enable patient participation whenever possible. Patient participation, and it′s clinical use in forensic psychiatric care, is an understudied field. Aim To describe nurses’ experiences of their work with patient participation in forensic psychiatric care. Methods Managers at different secure forensic psychiatric institutions in the south of Sweden approved the study, and oral consent was retrieved from informants. Interviews guided by a semi‐structured interview guide were conducted with nine nurses from five different forensic psychiatric institutions and analysed with content analysis. Findings Nurses describe diverse understandings and abilities in an inflexible setting. This indicates that what participation is, and how to achieve it, is not the same for nurses as for patients. Moreover, patients have different abilities to participate, and the secure setting in itself is perceived as hindering participatory work. Still, participation is described as a crucial part of work that requires a caring relationship. Furthermore, nurses pronounce potentially excluding attitudes and strategies that may obstruct patient participation for all, and at the same time, they have a belief that improvement is possible. Conclusion Compulsory forensic psychiatric care is a complex care context that requires constant efforts from nurses to balance patients’ rights and needs with mandatory care. The very nature of this caring context appears to be a major obstacle when promoting patient participation. Nevertheless, nurses express that they do aim for patient participation, ‘they try’. From a patient's perspective, trying is not sufficient and a need for improvement is evident. The results can be of clinical interest in similar secure forensic psychiatric nursing settings, and a point of departure in future development of care striving for increased patient participation for all.

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Section: Discussionsupporting

confidence: 85%

‘We try’ – how nurses work with patient participation in forensic psychiatric care

Magnusson

Axelsson

Lindroth

2019

Scandinavian Caring Sciences

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“…Researchers, health care professionals, and patients have varying ideas about the meaning of patient participation in a behavioral health context. 22 Researchers cite multiple reasons to engage patients as research partners, such as improving capacity for PCOR among both researchers and patients 19 and developing better patient governance in research involving patients. 23 Patients are particularly well positioned to assist with research proposal development because they can identify topics that are meaningful and relevant to patients and their caregivers.…”

Section: Patients As Research Partnersmentioning

confidence: 99%

Patients as Agents in Behavioral Health Research and Service Provision: Recommendations to Support the Learning Health System

Galvin¹,

Petersen

Subbian

et al. 2019

Appl Clin Inform

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Authentic inclusion and engagement of behavioral health patients in their care delivery and in the process of scientific discovery are often challenged in the health care system. Consequently, there is a growing need to engage with and better serve the needs of behavioral health patients, particularly by leveraging health information technologies. In this work, we present rationale and strategies for improving patient engagement in this population in research and clinical care. First, we describe the potential for creating meaningful patient–investigator partnerships in behavioral health research to allow for cocreation of knowledge with patients. Second, in the context of behavioral health services, we explore the utility of sharing clinical notes to promote patients' agency in care delivery. Both lines of inquiry are centered in a Learning Health System model for behavioral health, where patients are agents in enhancing the therapeutic alliance and advancing the process of knowledge generation. Recommendations include genuinely democratizing the health care system and biomedical research enterprise through patient-centered information technologies such as patient portals. In research and technology development, we recommend seeking and tailoring behavioral health patients' involvement to their abilities, promoting patient input in data analysis plans, evaluating research and informatics initiatives for patients and clinicians, and sharing success and research findings with patients. In clinical practice, we recommend encouraging patients to read behavioral health notes on portals, engaging in proactive communication regarding note content, assessing outcomes including stress and anxiety in response to note content, and working with technology providers to support note-sharing governance and deployment.

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“…The report emphasizes that the population problem is about human dignity and not just numbers. The need to safeguard human well-being, education, and health, and the reduction of population growth, is about giving the individual a decent life, and this social sustainability is in turn linked to the sustainability of the ecosystem (Rendtorff 1997(Rendtorff , 1998(Rendtorff , 2002(Rendtorff , 2003(Rendtorff , 2008(Rendtorff , 2014cJørgensen and Rendtorff 2018;Jørgensen et al 2018;Rendtorff and Kemp (2019). Ensuring a stable social cohesion (social carrying capacity) expresses such a need for better conditions.…”

Section: The Principles As the Ethical Premise Of Sustainabilitymentioning

confidence: 99%

“…It can be said that the animals of late modernity have become much more part of industrial production and therefore may be subject to new abuses. Therefore, more awareness of ethical principles is required to protect the animal values and interests of animals (Rendtorff 1997(Rendtorff , 1998(Rendtorff , 2002(Rendtorff , 2003(Rendtorff , 2008(Rendtorff , 2014cJørgensen and Rendtorff 2018;Jørgensen et al 2018;Rendtorff and Kemp 2019).…”

Section: Society's Intervention In Animalsmentioning

confidence: 99%

“…The system develops according to its own essence (with a technical term; according to its genetic program for eidos). It applies to the ability of an ecosystem to maintain its identity as an organism, that is, to develop its health, harmony, and stability (Rendtorff 1997(Rendtorff , 1998(Rendtorff , 2002(Rendtorff , 2003(Rendtorff , 2008(Rendtorff , 2014cJørgensen and Rendtorff 2018;Jørgensen et al 2018;Rendtorff and Kemp 2019).…”

Section: Society's Intervention In Living Naturementioning

confidence: 99%

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Sustainability, Basic Ethical Principles, and Innovation

Rendtorff

2020

Handbook of Business Legitimacy

Self Cite

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In order to demonstrate the relation between sustainability, innovation, and business legitimacy, this chapter shows how a phenomenological body and principle ethics can be integrated into business ethics, philosophy of management, and organizational theory by discussing some philosophical, theological, and social science dimensions of environment and bioethics. The problem is how a body ethics and the concepts of autonomy, dignity, integrity, and vulnerability can make sense to the notion of "sustainable development" as the foundation of sustainable innovation that today forms the basis of international environmental policy. This is inspired by the concept of "ecoethical innovation." The chapter shows how, in an organizational theoretical perspective, environmental ethics can be regarded as a critique of previous anthropocentric ethics, which is necessary

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How patient participation is constructed in mental health care: a grounded theory study

Cited by 50 publications

References 25 publications

‘We try’ – how nurses work with patient participation in forensic psychiatric care

‘We try’ – how nurses work with patient participation in forensic psychiatric care

Patients as Agents in Behavioral Health Research and Service Provision: Recommendations to Support the Learning Health System

Sustainability, Basic Ethical Principles, and Innovation

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