Patient participation in municipal elderly care from the perspective of nurses and occupational therapists

Lidström-Holmqvist, Kajsa; James, Inger

doi:10.1002/nop2.302

Cited by 6 publications

(11 citation statements)

References 34 publications

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“…A clinical implication to counteract this and create a feeling of home is to work on how home-based care is provided and that the older person's home needs to be considered as a private space where home-based care staff are guests and not as a public workplace. This clinical implication is in line with earlier suggestions stating the need for handing over the power from home-based care staff to the older adult, not only in decision-making, but throughout the ageing process, to emphasise autonomy and a sense of control [27]. Our results do also have implications for staff in nursing homes.…”

Section: Discussionsupporting

confidence: 91%

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

Spang

Holmefur

Hermansson

et al. 2022

Scandinavian Caring Sciences

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Background: Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health.Aim: This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place. Materials and Methods:A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis. Results:The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives. Discussion and Conclusion:The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.

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Section: Discussionsupporting

confidence: 91%

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

Spang

Holmefur

Hermansson

et al. 2022

Scandinavian Caring Sciences

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“…(2018), patients temporally re‐constructed their identity and how they were socially connected with the health personnel during their rehabilitation process. These findings were not a continuum, as described by Holmqvist and James (2019), which ranged from patients complying with the health personnel's wishes to all power being transferred to the patient. However, dialogue and power exchange between the patients and the health professionals (Aasen et al., 2012a) took place throughout the rehabilitation process.…”

Section: Discussionmentioning

confidence: 83%

“…From a patient's point of view, the meanings of goal‐setting situations have been identified as ‘trust in the rehabilitation situation, professionals, oneself, and relatives;’ ‘respectful presence;’ ‘confusing awareness;’ ‘disturbing pain;’ and ‘fear of unpredictability’ (Alanko et al., 2019). Patient participation in rehabilitation is described, based on the perspectives of nurses and occupational therapists, as a continuum that ranges from patients complying with the professional's instructions to the idea that all power is transferred to the patient (Holmqvist & James, 2019). According to Scheel‐Sailer (2017), patients with acquired spinal cord injury had a reduced ability to participate in decision‐making in the early phase of the rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

From open to locked doors – From dependent to independent: Patient narratives of participation in their rehabilitation processes

Aasen

Nilsen

Dahlborg

et al. 2021

Journal of Clinical Nursing

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Aims and objectives The present study aimed to explore patients' experiences of participating in their rehabilitation process in the context of specialised rehabilitation in Norway. Background The rights of patients to participate in their care and treatment is an ideology that underlines newer international and Norwegian public documents. However, there is a gap between policy statements and clinical practice, and a discrepancy between patients' and professionals' statements about patient participation in rehabilitation. Design A qualitative approach with a narrative design. Methods Eleven patients were individually interviewed to tell their stories about the rehabilitation processes. We utilised narrative analysis with a three‐dimensional space narrative structure including temporality, sociality and spatiality. This study followed the COREQ checklist. Results The analysis identified two throughout plots: ‘person‐centred culture’ and ‘time’, and three plots which constructed how the patients participate in change through the rehabilitation process: (a) dependent—‘open doors’; (b) motivation from within; and (c) independence—‘locked doors’. Conclusions Patient participation in rehabilitation was dependent on person‐centred cultures in the unit and on different aspects of time. The dialogue and the power balance between the patients and the health personnel changed as the rehabilitation progressed. Motivation for rehabilitation had to come from within patients. The paternalistic ideology did not seem to dominate the specialised rehabilitation unit in the present study. Relevance to clinical practice This study gives new insight into how patients participate in change in the rehabilitation process. This can be valuable for healthcare professionals and governments. Insight into how the lack of person‐centred focus can harm the rehabilitation process, and a deeper understanding of the meaning of time in the rehabilitation process is essential. These results may provide a stimulus for discussions on how patients might participate in their rehabilitation process.

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“…The lack of a common understanding of patient participation (Castro et al, 2016) may cause healthcare providers to perceive that they are facilitating it while still operating in a traditional work frame. Policy documents in developed countries widely emphasise patient‐centred care, while the health services largely focus on productivity and efficiency (Holmqvist & James, 2019). This may be prominent within busy haemodialysis units designed for efficiency (Andersen‐Hollekim, Kvangarsnes, Landstad, Talseth‐Palmer, & Hole, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…If the main focus is on production, professionals may not acknowledge patients’ experiential knowledge of illness. Hence, person‐centred care via seeing and treating patients individually may clash with efficiency requirements (Holmqvist & James, 2019; Vandenberg et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Narratives of patient participation in haemodialysis

Andersen‐Hollekim

Solbjør

Kvangarsnes

et al. 2020

Journal of Clinical Nursing

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Aim and objective To explore how working‐age adults experience patient participation in hospital haemodialysis. Background End‐stage kidney disease is a progressive, chronic condition imposing patients with high treatment burdens and low health‐related quality of life. Patients face multiple medical decisions related to living with kidney failure. Given their frequent interaction with health services, patient participation may be of special value. Design Qualitative design with a narrative approach. Methods In 2018, eleven patients aged 35–64 years undergoing hospital haemodialysis participated in individual interviews. All interviews were analysed using a narrative approach. Reporting followed the Consolidated criteria for Reporting Qualitative Research guidelines. Findings The patients’ narratives of participation comprised three themes following their healthcare trajectory: Informed, but not involved in treatment choices; Duality of care and control; and Frail trust reflecting collaborative deficiencies. The patients received good information about dialysis, but were not involved in choice of treatment modality. Professional work, as well as the nature of treatment, contributed to restricted patient autonomy. Patients’ trust suffered from collaborative deficiency generating delays in their treatment trajectories, and patients extended their responsibility into the coordination of transitions as a way of coping with these issues. Conclusions The study identified challenges related to patient involvement and interdisciplinary collaboration. Involving patients through dialogue and acknowledging their experiences, preferences and lifestyles may strengthen the mutual patient–professional understanding of treatment. Despite increased focus on seamless trajectories, patients face obstacles regarding interdisciplinary collaboration and coordination of health services. Relevance to clinical practice The findings indicate a want of individually customised care for people requiring dialysis. Patients need to be involved in the choice of treatment modality as well as decisions related to the current treatment. Information must include potential consequences of the different treatment modalities. Health services need to strengthen collaboration in order to secure treatment continuity and patient involvement.

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Patient participation in municipal elderly care from the perspective of nurses and occupational therapists

Cited by 6 publications

References 34 publications

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

From open to locked doors – From dependent to independent: Patient narratives of participation in their rehabilitation processes

Narratives of patient participation in haemodialysis

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