title: Patient participation in nursing care: towards a concept clarification from a nurse perspective.
abstract: OBJECTIVE
  The aim of this study was to investigate the meanings of the concept of patient participation in nursing care from a nurse perspective.
  
  
  BACKGROUND
  Participation is essential and increases patients' motivation and satisfaction with received care. Studies of patient participation in nursing care are not congruent regarding definition, elements and processes. This lack of clarity is amplified by several terms used; patient/client/consumer involvement or collaboration, partnership and influence. Despite the fact that several nursing theories have emphasized the importance of patient participation, an empirically grounded theory has yet to be published.
  
  
  METHODS
  Seven focus group interviews were held with nurses providing inpatient physical care at five hospitals in West Sweden. The focus groups consisted of Registered Swedish nurses (n = 31) who described the meaning and implementation of patient participation in nursing care. A Grounded Theory approach has been applied to tape-recorded data. Constant comparative analysis was used and saturation was achieved.
  
  
  RESULTS
  Mutuality in negotiation emerged as the core category for explaining nurses' perspectives on patient participation in nursing care. It is characterized by four interrelated sub-core categories: interpersonal procedure, therapeutic approach, focus on resources and opportunities for influence. Mutuality in negotiation constitutes the dynamic nurse-patient interaction process.
  
  
  CONCLUSIONS
  The study clarifies that patient participation can be explained as an interactional process identified as mutuality in negotiation based on four components.
  
  
  CONCLUSIONS
  The results are important and can be used in nursing practice and education. Application in a clinical context means nursing care organized to include all the components presented. The results can also be used in quality assurance to improve and evaluate patient participation.
authors.affiliation: Institute of Nursing, Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. monika.sahlsten@swipnet.se
authors.forename: Monika J M
authors.initials: MJ
authors.lastname: Sahlsten
authors.forename: Inga E
authors.initials: IE
authors.lastname: Larsson
authors.forename: Björn
authors.initials: B
authors.lastname: Sjöström
authors.forename: Catharina S C
authors.initials: CS
authors.lastname: Lindencrona
authors.forename: Kaety A E
authors.initials: KA
authors.lastname: Plos
mesh_terms: D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D009726:Nurses / Q000523:psychology*; D009732:Nursing Care; D010358:Patient Participation