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An observational study of older patients’ participation in hospital admission and discharge – exploring patient and next of kin perspectives

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  • Dagrunn N Dyrstad
  • Kristin A Laugaland
  • Marianne Storm

Abstract

Aims and objectives To explore older patients’ participation during hospital admission and discharge. Background Patient participation is suggested as a means to improve the quality of transitional healthcare. Older people with chronic diseases, physical disabilities and cognitive impairments often need to transfer from primary to hospital healthcare and vice versa. Design This study adopts a participant observational research design. Methods Participant observations of 41 older patients (over 75 years of age) during hospital admission and discharge were conducted in two hospitals in Norway (in 2012). The observations included short conversations with the patient and their next of kin to capture their participation experiences. Systematic text condensation was used to analyse the data material from the field notes. Results Varying degrees of information exchange between healthcare professionals and patients, and a lack of involvement of the patient in decision‐making (in admission and discharge) were observed and experienced by patients and their next of kin. The next of kin appeared to be important advocates for the patients in admission and provided practical support both during admission and discharge. Data suggest that patient participation in admission and discharge is influenced by time constraints and the heavy workloads of healthcare professionals. Patients’ health conditions and preferences also influence participation. Conclusions Several issues influence the participation of the older patients during hospital admission and discharge. Participation of the older patients needs continuous support from healthcare professionals that acknowledges both the individual patient's preferences and their capacity to participate. Relevance to clinical practice Study findings report discrepancies in the involvement of older people and their next of kin. There is a need to increase and support older patients’ participation in hospital admission and discharge.

Suggested Citation

  • Dagrunn N Dyrstad & Kristin A Laugaland & Marianne Storm, 2015. "An observational study of older patients’ participation in hospital admission and discharge – exploring patient and next of kin perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(11-12), pages 1693-1706, June.
    • Handle: RePEc:wly:jocnur:v:24:y:2015:i:11-12:p:1693-1706
    DOI: 10.1111/jocn.12773
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    References listed on IDEAS

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    1. Thompson, Andrew G.H., 2007. "The meaning of patient involvement and participation in health care consultations: A taxonomy," Social Science & Medicine, Elsevier, vol. 64(6), pages 1297-1310, March.
    2. Christina Foss, 2011. "Elders and patient participation revisited – a discourse analytic approach to older persons’ reflections on patient participation," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(13‐14), pages 2014-2022, July.
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    1. Ingrid Nyborg & Lars J Danbolt & Marit Kirkevold, 2017. "User participation is a family matter: A multiple case study of the experiences of older, hospitalised people and their relatives," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 4353-4363, December.
    2. Linda Aimée Hartford Kvæl & Jonas Debesay & Asta Bye & Anne Langaas & Astrid Bergland, 2019. "Choice, Voice, and Coproduction in Intermediate Care: Exploring Geriatric Patients’ and Their Relatives’ Perspectives on Patient Participation," SAGE Open, , vol. 9(3), pages 21582440198, September.
    3. Lindy King & Ann Harrington & Ecushla Linedale & Elizabeth Tanner, 2018. "A mixed methods thematic review: Health‐related decision‐making by the older person," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(7-8), pages 1327-1343, April.

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