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‘Patient participation’ in everyday activities in special care units for persons with dementia in Norwegian nursing homes
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. (Omvårdnad)
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. (Omvårdnad)ORCID iD: 0000-0003-0417-6161
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. (Omvårdnad)
2010 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, Vol. 5, no 2, 169-178 p.Article in journal (Refereed) Published
Abstract [en]

Aim.  The aim of this study was to explore ‘patient participation’ in everyday activities for persons with dementia living in special care units in nursing homes. Background.  Studies about how ‘patient participation’ appears in the context of special care units for persons with dementia are lacking. Design.  The study has an explorative design. Method.  Grounded theory was chosen. Data collection was carried out by means of open observations and additional conversations with residents and personnel. Simultaneously, data analysis was performed with open, axial and selective coding. Findings.  The findings showed that ‘patient participation’ concerned ‘A matter of presence’ as the core category. The other categories described as ‘presence of personnel’ and ‘presence of residents’, were strongly connected to the core category as well as to each other. Presence of personnel comprised three levels; being there in body, which required physical presence; being there in mind, which required presence with all senses based on knowledge and competence; and being there in morality which was understood as being fully present, as it was based on humanistic values and included the two other levels. Presence of residents comprised ‘ability and wish’ and ‘adaptation’. The presence of the personnel had a huge impact on the ability and will to participate of the residents. Organizational conditions concerning leadership, amount of personnel and routines as well as housing conditions concerning architecture and shared accommodation, could stimulate or hinder ‘patient participation’. Conclusions and implications.  The study highlighted the great impact of the personnel’s presence in body, mind and morality on the participation capacity of the residents. The great importance of the nurse leaders was stressed, as they were responsible for organizational issues and served as role models. Group supervision of the personnel and their leaders would be an implication to propose, as these kinds of reflection groups offer opportunities to reflect on values, actions and routines.

Place, publisher, year, edition, pages
Blackwell Publishing, 2010. Vol. 5, no 2, 169-178 p.
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-11999DOI: 10.1111/j.1748-3743.2010.00223.xOAI: oai:DiVA.org:kau-11999DiVA: diva2:507563
Available from: 2012-03-05 Created: 2012-03-05 Last updated: 2014-12-11Bibliographically approved
In thesis
1. Patient participation in everyday life in special care units for persons with dementia
Open this publication in new window or tab >>Patient participation in everyday life in special care units for persons with dementia
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to acquire knowledge about patient participation in everyday life of persons with dementia living in SCUs in nursing homes.

Data collection and analysis in studies I-III was carried out according to Grounded Theory. Data was collected by open non- participant observations during 51 hours, and conversations with 8 residents and 17 health care personnel (I), interviews carried out twice with 12 relatives (II) and 11 nursing personnel (III), and by a study specific questionnaire based on the findings from study I-II to 233 relatives (IV). Descriptive and non-parametric statistics were used (IV).

Presence of nursing personnel in body, mind and morality was found to be the prerequisite for patient participation (I). This required personnel with high competence in dementia care, commitment to and interest in the resident, and continuity in their work (I, III). Wellbeing and dignity in the resident’s everyday life was found to be the most important goal, not necessarily a high level of patient participation (II-III). The level of participation had to be adjusted to the resident’s ability and wish to take part in decisions in the very moment. However, the level was often primarily adjusted to suit the personnel’s ideas about how to carry out daily care (I, III). Relatives had an important role in the participation process by interacting, and exchanging information, with the personnel. By forming a basis for individualised care in this way, relatives made a difference to the resident’s everyday life and contributed to their wellbeing and dignity (II-IV). The SCU’s context also affected patient participation (I-IV).

Patient participation must be given attention by leaders and be prioritised in dementia care. Nursing personnel can enhance patient participation by promoting relatives’ partaking in the participation process, as this has potential for further contributing to quality of care.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2013. 70 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2013:43
Keyword
Patient participation, dementia, special care units for persons with dementia (SCUs), relatives, nursing personnel, grounded theory, cross-sectional
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-29208 (URN)978-91-7063-520-5 (ISBN)
Public defence
2013-11-08, Lagerlöfsalen, 1A 305, Karlstads universitet, Karlstad, 10:00 (Norwegian)
Opponent
Supervisors
Available from: 2013-10-17 Created: 2013-09-27 Last updated: 2017-08-15Bibliographically approved

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