Building patient capacity to participate in care during hospitalisation: a scoping review

Abstract

ObjectivesTo map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project.DesignScoping review.Data sourcesMEDLINE, Embase and CINAHL (Inception −2017).Study selectionStudies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included.Data extractionTitle and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers.ResultsDatabase searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs.ConclusionsThe majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.

Approaches to optimize patient and family engagement in hospital planning and improvement: Qualitative interviews

“…Prior research that referred to PE largely focused on engaging individuals in their own clinical care or as members of research teams. 16,17 Other research on PE in health-care organizations was conducted in the primary care context, revealing numerous barriers. [4][5][6] Little prior research examined organizational PE in hospitals.…”

A scoping review of person and family engagement in the context of multiple chronic conditions

“…The science of behavioral economics and behavior change has motivated efforts to understand the optimal design of system structures such as choice architecture (e.g., defaults, active choice, and precommitment), physical environments, 61 and communication technologies 62 to facilitate desired outcomes. Choice architecture refers to the idea that the way decisions are presented to a person will affect the choices they make; humans are not purely rational beings who make path‐independent decisions.…”

Action research as a catalyst for change: Empowered nurses facilitating patient participation in rehabilitation

“…To deflect potentially prejudiced assumptions about patient participation that could colour and affect the approach and readiness to change practice as described in previous studies (Angel & Frederiksen, 2015; Goodridge et al., 2019; Longtin et al., 2010), the first step was to identify and attain critical awareness of own habits and the extent to which they facilitate patient participation. To identify the co‐researchers' professional habits and reflect on the current state of patient participation at the centre, we analysed, explored and reflected on 19 combined ‘cases’.…”

“…Consequently, patient participation has been reported to empower patients to take control over their bodies and their situations during rehabilitation (Castro et al., 2016). Furthermore, it can potentially increase patient safety, reduce healthcare costs (Goodridge et al., 2019; Weingart et al., 2011), improve the quality of life (Kwok, Pan, Lo, & Song, 2011) and bridge the knowledge of the patient and the knowledge of the health professional leading to better health solutions (Castro et al., 2016). Therefore, it is not surprising that patient and professional organisations, national policies and hospital managements emphasise the need for health professionals to focus on patient participation (Freil, Wandel, Pedersen, Jönsson, & Nyborg, 2014; Jørgensen, 2019; World Health Organization [WHO], 2001).…”

“…In healthcare, action research has been used to improve quality of care, enhance staff knowledge and skills, bring changes to clinical practice and improve staff job satisfaction and well‐being (Montgomery, Doulougeri, & Panagopoulou, 2015). The applicability of action research to healthcare and the difficulties experienced in developing a culture and organisational set‐up supporting patient participation (Angel & Frederiksen, 2015; Goodridge et al., 2019; Longtin et al., 2010) point to the relevance of exploring the potentials of applying the methodology of action research to facilitate patient participation in SCI rehabilitation. Accordingly, the aim of this article is to illustrate—with the aid of a case study—how an action research process can engage nurses in developing the type of care that promotes patient participation.…”