Activities Patients and Nurses Undertake to Promote Patient Participation

Purpose: To describe and understand activities patients and nurses undertake to enact patient participation in nursing care. Design: This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse–patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014. Methods: Field notes were collected and were analyzed both inductively and deductively. Findings: Nurse–patient interactions promoted patient participation through dialogue and knowledge sharing. Less evident was patient involvement in planning or self-care. Nurses exerted control over patient care, which influenced the extent of patient participation. Conclusions: Patient participation appears to be difficult to enact. Nurses’ controlling approach, influenced by organizational issues, was in conflict with a patient-centered approach to care. Nurse–patient communication is one aspect of patient-centered care enacted more frequently. Clinical Relevance: Nurses may benefit from strategies at the individual and organizational level to enhance their patient-centered practices. Fostering nurses’ communication may enhance patient-centered practices in hospitals.