Larsson Inga E, Sahlsten Monika J M, Segesten Kerstin, Plos Kaety A E
Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
Scand J Caring Sci. 2011 Sep;25(3):575-82. doi: 10.1111/j.1471-6712.2010.00866.x. Epub 2011 Jan 17.
In many Western countries as in Sweden, patients have legal right to participate in own care individually adjusted to each patient's wishes and abilities. There are still few empirical studies of patients' perceptions of barriers for participation. Accordingly, there is a need to identify what may prevent patients from playing an active role in own nursing care. Such knowledge is highly valuable for the nursing profession when it comes to implementation of individual patient participation.
To explore barriers for patient participation in nursing care with a special focus on adult patients with experience of inpatient physical care.
Data were collected through 6 focus groups with 26 Swedish informants recruited from physical inpatient care as well as discharged patients from such a setting. A content analysis with qualitative approach of the tape-recorded interview material was made.
The ethics of scientific work was adhered to. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study.
The barriers for patient participation were identified as four categories: Facing own inability, meeting lack of empathy, meeting a paternalistic attitude and sensing structural barriers, and their 10 underlying subcategories.
Our study contributes knowledge and understanding of patients' experiences of barriers for participation. The findings point to remaining structures and nurse attitudes that are of disadvantage for patients' participation. The findings may increase the understanding of patient participation and may serve as an incentive in practice and nursing education to meet and eliminate these barriers, in quality assurance of care, work organization and further research.
在许多西方国家，如瑞典，患者拥有合法权利参与根据自身意愿和能力进行个性化调整的自身护理。关于患者对参与障碍的认知的实证研究仍然很少。因此，有必要确定哪些因素可能阻碍患者在自身护理中发挥积极作用。对于护理行业而言，此类知识在实施患者个体参与方面具有极高的价值。
探讨患者参与护理的障碍，特别关注有住院身体护理经历的成年患者。
通过6个焦点小组收集数据，从住院身体护理部门以及此类环境中的出院患者中招募了26名瑞典受访者。对录音访谈材料进行了定性内容分析。
遵循了科学工作的伦理规范。每位研究参与者在获得口头和书面信息后给予了知情同意。哥德堡大学伦理委员会批准了该研究。
患者参与的障碍被确定为四类：面对自身能力不足、遭遇缺乏同理心、遇到家长式态度以及感受到结构障碍，以及它们的10个潜在子类别。
我们的研究为患者参与障碍的体验提供了知识和理解。研究结果指出了不利于患者参与的现存结构和护士态度。这些发现可能会增进对患者参与的理解，并可能在实践和护理教育中激励人们应对和消除这些障碍，用于护理质量保证、工作组织和进一步研究。
