Factors That Influence Patient Involvement in Nursing Homes: Staff Experiences

Abstract

Aim:

The aim of this study was to identify the staff's experience with factors influencing patient involvement.

Background:

The focus of this study was care for frail, elderly patients in Norwegian nursing homes (NHSs). The background was an earlier quality development project where staff participated in a one-year systematic competence-building programme. Recommendations for patient involvement are part of the current legislation and ethical norms in Norway, but patients may not be able or have the opportunity to exercise their rights on every occasion.

Method:

Focus group interviews were conducted with a multidisciplinary team of professionals. Three groups were selected from different wards in one nursing home. Data were systematized and categorized before further analysis.

Results:

The results reveal the staff's descriptions of the attitudes and the environmental conditions that contribute to patient involvement. The competence-building programme raised consciousness among staff and contributed to a change in staff attitudes. Furthermore, the results also emphasize the importance of teamwork, continuity, structural conditions, time pressure, and cooperation with the next of kin when evaluating patient involvement.

Conclusion:

The findings of this study have the potential of contributing to the improvement of clinical practice in nursing homes.

Keywords

attitudes environmental conditions focus groups patient-centred care

References

Lov om pasientrettigheter av 2. juli 1999 nr. 63, (1999).

NOU (2005: 3). Fra stykkevis til helt. En sammenhengende helsetjeneste. Oslo: Statens forvaltningstjeneste. Informasjonsforvaltning.

Nurses ICo. The ICN Code of Ethics for Nurses. 2006.

Rights UDoH. UN Universal Declaration of Human Rights of 10 December 1948. 1948.

Levasseur

Richard

Gauvin

Raymond

. Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science & Medicine. 2010 71: 2141–9.

Norheim

Vinsnes

. Patient involvement in dementia care — opportunities and challenges. Norsk Tidsskrift for Sykepleieforskning. 2008; 10(4): 3–15.

Penney

Wellard

. Hearing what older consumers say about participation in their care. International Journal of Nursing Practice. 2007; 13: 61–8.

Zoffmann

Harder

Kirkevold

. A person-centered communication and reflection model: Sharing decision-making in chronic care. Qualitative Health Research. 2008; 18(5): 670–85.

Häggström

Mamhidir

A-G

Kihlgren

. Caregivers' strong committment to their relationship with older people. International Journal of Nursing Practice. 2010; 16: 99–105.

10.

Wilson

Davies

. Developing relationships in long term care environments: The contribution of staff. Journal of Clinical Nursing. 2009; 18: 1746–55.

11.

Bergland

Kirkevold

. Thriving in nursing homes in Norway: Contributing aspects described by residents. International Journal of Nursing Studies. 2006; 43: 681–91.

12.

Clarke

Hanson

Ross

. Seeing the person behind the patient: Enhancing the care of older people using a biographical approach. Journal of Clinical Nursing. 2003; 12: 697–706.

13.

Edvardsson

Winblad

Sandman

. Person-centred care of people with severe Alzheimer's disease: Current status and ways forward. The Lancet Neurology. 2008; 7(4): 362–7.

14.

McCormac

. A conceptual framework for person-centred practice with older people. International Journal of Nursing Practice. 2003; 9: 202–9.

15.

Norheim

Vinsnes

. Staff's attitudes towards hospitalised elderly patients with urinary incontinence. Vård i Norden. 2005; 25(1): 21–5.

16.

Rokeach

. Beliefs, Attitudes, and Values: A theory of Organization and Change. First ed. London: Jossey-Bass Inc.; 1972.

17.

Eagly

AHCS

. Attitude structure and function. 4th ed. Gilbert

DFS

Lindzey

, editor. Boston: McGaw-Hill; 1998. 269–322 p.

18.

Halvorsrud

Kirkevold

Diseth

Kalfoss

. Quality of life model: Predictors of quality of life among sick older adults. Research and Theory for Nursing Practice. 2010; 24(4): 241–59.

19.

Hertzberg

Ekman

S-L

. «We, not them and us?» Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing. 2000; 31(3): 614–22.

20.

Jonasson

L-L

Liss

P-E

Westerlind

Berterö

. Ethical values in caring encounters on a geriatric ward from the next of kin's perspective: An interview study. International Journal of Nursing Practice. 2010; 16: 20–6.

21.

Nilsen

. Opportunities for learning and knowledge creation in practice. Oslo: Handelshøyskolen BI; 2010.

22.

Bèlanger

Rodrìguez

. More than the sum of its parts? A qualitative research synthesis on multi-disciplinary primary care teams. Journal of Interprofessional Care. 2008; 22(6): 587–97.

23.

Kyrkjebø

Hage

. What we know and what they do: Nursing students' experiences of improvement knowledge in clinical practice. Nurse education today. 2005; 25: 167–75.

24.

Tonuma

Winbolt

. From rituals to reason: Creating an environment that allows us to nurse. International Journal of Nursing Practice. 2000; 6(4): 214.

25.

Robinson

Gallagher

. Culture change impacts quality of life for nursing home residents. Topics in Clinical Nutrition. 2008; 23(2): 120–30.

26.

Vabø

. Organisering for velferd: Hjemmetjenesten i en styringsideologisk brytningstid. Oslo: Norsk institutt for forskning om oppvekst, velferd og aldring; 2007.

27.

Kitzinger

. Introducing focus groups. British Medical Journal. 1995; 311: 299–302.

28.

Krueger

MA. Focus Groups. A practical Guide for Applied Research. London, New Dehli: Saga Publications, INC; 2000.

29.

Bloor

. Focus groups in social research. London: Sage; 2001. VII, 110 s. p.

30.

Morgan

. Focus groups as qualitative research. Thousand Oaks, Calif.: Sage Publications; 1997. VIII, 80 s. p.

31.

Kvale

Brinkmann

. Interviews: Learning the craft of qualitative research interviewing. Los Angeles, Calif.: Sage; 2009. XVIII, 354 s. p.

32.

Kvale

. Det kvalitative forskningsintervjuet. Oslo: Ad Notam Gyldendal; 2001.

33.

Rankinen

Suominen

Kuokkanen

Kukkurainen

Doran

. Work empowerment in multidisciplinary teams during organizational change. International Journal of Nursing Practice. 2009; 15: 403–16.

34.

Vatne

Bjornerem

Hoem

. Development of professional knowledge in action: Experiences from an actionscience design focusing on acknowledging communication in mental health. Scand J Caring Sci. 2009; 23: 84–92.

35.

Currie

. Improving the efficiency of patient handover. Emergency Nurse. 2002; 10(3): 24–7.

36.

Whitehead

Annells

, editors. Sampling data and data collection in qualitative research 2007.