Consumerism in health care: the case of medication education.
BACKGROUND
The United Kingdom government's policy documents spanning the last decade clearly envisage the patient as a consumer of health care. In this context this paper discusses recent research findings related to the health-promotion practice of medication delivered by nurses in England in a variety of health care settings. Literature exploring consumerism in health care highlights a number of principles which were used to develop a framework to evaluate the data collected in this study.


METHODS
Non-participant observation and audio-recordings of nurse-patient interactions about medications were collected in seven different contexts focusing on adults, older people, mental health and community nurse settings. Post-interaction interviews with nurse and patient participants were conducted to explore views on quality, satisfaction with, and intended outcomes of, the interactions.


RESULTS
Generally, the findings demonstrated that the espoused theory and practice reality regarding the carrying out of consumerist principles are incongruous. Interactions contained relatively simple information, were dominated and led by nurses and offered little opportunity for patient choice. Patients, however, expressed a satisfaction with minimal information and involvement.


CONCLUSIONS
The findings are discussed with reference to a number of different contextual factors: acuity of illness, perceived balance of power, information gaps, patterns of contact and nurse-patient relationships, and patient-centred care.
Rycroft-Malone
J
J
Royal College of Nursing Institute, Radcliffe Infirmary, Oxford, England, UK.
Latter
S
S
Yerrell
P
P
Shaw
D
D
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003256:Community Participation / Q000379:methods* / Q000523:psychology*; D003254:Consumer Advocacy / Q000523:psychology* / Q000592:standards; D004358:Drug Therapy / Q000451:nursing* / Q000523:psychology*; D004739:England; D019317:Evidence-Based Medicine; D017144:Focus Groups; D006291:Health Policy; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D018802:Patient-Centered Care; D013222:State Medicine; D011795:Surveys and Questionnaires