title: Patients' perceptions of participation in nursing care on medical wards.
abstract: BACKGROUND
  Patient participation benefits the patient and is a core concept of patient-centred care. Patients believe in their ability to prevent errors; thus, they may play a vital role in combating adverse event rates in hospitals.
  
  
  OBJECTIVE
  To explore hospitalised medical patients' perceptions of participating in nursing care, including the barriers and facilitators for this activity.
  
  
  METHODS
  This interpretive study was conducted on four medical wards, in two hospitals. Purposeful maximum variation sampling was operationalised to recruit patients that differed in areas such as age, gender and mobility status. In-depth semi-structured audiotaped interviews were undertaken and analysed using inductive content analysis.
  
  
  RESULTS
  Twenty patients participated in the study. Four categories were uncovered in the data. First, valuing participation showed patients' willingness to participate, viewing it as a worthwhile task. Second, exchanging intelligence was a way of participating where patients' knowledge was built and shared with health professionals. Third, on the lookout was a type of participation where patients monitored their care, showing an attentive approach towards their own safety. Fourth, power imbalance was characterised by patients feeling their opportunities for participation were restricted.
  
  
  CONCLUSIONS
  Patients were motivated to participate and valued participation. Cultivating this motivation may be crucial to patient empowerment and practices of safety monitoring, a fundamental strategy to addressing patient safety issues in hospitals. Engaging nurse-patient relationships, inclusive of knowledge sharing, is required in practice to empower patients to participate. Educating patients on the consequences of non-participation may motivate them, while nurses may benefit from training on patient-centred approaches. Future research should address ways to increase patient motivation and opportunities to participate.
authors.affiliation: Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Georgia
authors.initials: G
authors.lastname: Tobiano
authors.affiliation: Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Melbourne, Vic, Australia.|Alfred Health, Melbourne, Vic, Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: Bucknall
authors.affiliation: Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.|National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marshall
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Guinane
authors.affiliation: Gold Coast University Hospital, Gold Coast, Qld, Australia.|National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D009732:Nursing Care; D010361:Patients / Q000523:psychology*
keywords: consumer participation; nurse-patient relations; nursing care; patient engagement; patient involvement; patient participation; patient-centred care; person-centred care