Bengtsson Pernilla, Larsson Maria, Eklund Anna Josse
Department of Health Sciences, Karlstad University, Karlstad, Sweden.
Karlstad Central Hospital, County Council of Värmland, Karlstad, Sweden.
Int J Older People Nurs. 2025 May;20(3):e70031. doi: 10.1111/opn.70031.
To map and summarise research literature describing patient participation in hospital care for frail older persons and their next of kin.
Patient participation refers to the active involvement of patients in healthcare decision-making processes. An aging population and increased life expectancy have led to a growing number of older adults requiring hospital care, and engaging older patients in decision-making can be challenging due to the complexities of their health conditions. Thus, there is a need to deepen our understanding of patient participation, concerning frail older persons and their next of kin.
Scoping review.
A systematic search was conducted across four databases. Abstracts and titles were evaluated for relevance according to predetermined inclusion criteria. A total of 140 studies were read in full text, and 17 quality-appraised studies were selected for analysis.
Five instruments for measuring participation were identified. Patient participation was mainly characterised as being informed, understanding provided information, conducting good communication and being given the opportunity to make decisions. Patients could adopt different participation strategies. Next of kin participation is characterised as being informed, communicating with healthcare staff and being involved in decision-making. Conditions facilitating participation are dependent on healthcare staff, environmental conditions and written information. Barriers to participation stem from staff attitudes, their lack of availability and approachability, unsatisfactory communication, patient shortcomings, substandard continuity of care, organisational routines and unsatisfactory physical environments.
Older persons and their next of kin have reasonable demands for them to experience participation. Therefore, it should not be difficult for healthcare staff to meet patient expectations by ensuring patients and their next of kin receive understandable information and are given the opportunity to make their own decisions, and for organisations to create a climate where staff are available, approachable and empathetic so patients feel that they are participating in the planning and delivery of their care-in summary, to keep them in the loop.
梳理并总结描述患者参与体弱老年人及其亲属住院护理的研究文献。
患者参与是指患者积极参与医疗保健决策过程。人口老龄化和预期寿命的延长导致需要住院护理的老年人数量不断增加，由于其健康状况复杂，让老年患者参与决策可能具有挑战性。因此，有必要加深我们对体弱老年人及其亲属患者参与情况的理解。
范围综述。
在四个数据库中进行系统检索。根据预先确定的纳入标准评估摘要和标题的相关性。共阅读了140篇全文研究，并选择了17篇经过质量评估的研究进行分析。
确定了五种衡量参与度的工具。患者参与主要表现为了解情况、理解所提供的信息、进行良好沟通并有机会做出决策。患者可以采用不同的参与策略。亲属参与的特点是了解情况、与医护人员沟通并参与决策。促进参与的条件取决于医护人员、环境条件和书面信息。参与的障碍源于工作人员的态度、他们缺乏可及性和亲和力、沟通不畅、患者自身不足、护理连续性不佳、组织惯例以及不理想的物理环境。
老年人及其亲属对自身参与体验有合理要求。因此，医护人员通过确保患者及其亲属获得易懂的信息并有机会做出自己的决定来满足患者期望，以及组织营造一种工作人员随时可及、态度亲和且富有同理心的氛围，让患者感觉自己参与到护理的规划和实施中——简而言之，让他们随时了解情况，应该并非难事。
