title: Patient involvement climate: views and behaviours among registered nurses in myocardial infarction care.
abstract: OBJECTIVE
  To introduce and define the patient involvement climate and measure its quality and strength via views and behaviours among nurses in coronary care units.
  
  
  BACKGROUND
  Patient involvement is receiving increased attention among healthcare providers. To better understand and optimise the interpersonal dynamics of patient involvement, it is important to study the organisational context in which the patient-provider interaction occurs.
  
  
  METHODS
  Cross-sectional, self-report questionnaire study.
  
  
  METHODS
  Registered nurses across 12 coronary care units (n = 303) completed a questionnaire reporting their views and behaviours regarding patient involvement. Analyses assessed climate quality (the positive or negative nature of nurses' perceptions) and climate strength (the degree of consensus within coronary care units).
  
  
  RESULTS
  Climate quality and strength were greatest for the dimensions measuring nurses' views of patient involvement, the nurse-patient information exchange process and nurses' responsiveness to patient needs. Climate quality and strength were weaker for the dimensions measuring nurses' views of the hindrances associated with patient involvement, discussion of daily activities and efforts to motivate patients to take responsibility for their health. In units with consensus that patient involvement poses hindrances, nurses were less likely to address patient needs.
  
  
  CONCLUSIONS
  When nurses perceived patient involvement as less of a hindrance in their work, they were more responsive to patient needs. A patient involvement climate characterised by motivational behaviour among nurses was marked by better information exchange and discussion of suitable activities postdischarge.
  
  
  CONCLUSIONS
  Managers can capitalise on positive climate aspects by encouraging ward activities that facilitate active patient involvement among nurses. One suggestion is educational interventions at the workplace focused on reducing perceptions of patient involvement as a hindrance and encouraging the attitudes that it can enrich nursing work and patient outcomes.
authors.affiliation: School of Medicine, Wayne State University, Detroit, MI, USA; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Arnetz
authors.forename: Ludmila
authors.initials: L
authors.lastname: Zhdanova
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003325:Coronary Care Units; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010358:Patient Participation; D011795:Surveys and Questionnaires
keywords: cardiology; climate; myocardial infarction; patient involvement; registered nurses