title: Activities Patients and Nurses Undertake to Promote Patient Participation.
abstract: To describe and understand activities patients and nurses undertake to enact patient participation in nursing care.
  
  
  
  This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse-patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014.
  
  
  
  Field notes were collected and were analyzed both inductively and deductively.
  
  
  
  Nurse-patient interactions promoted patient participation through dialogue and knowledge sharing. Less evident was patient involvement in planning or self-care. Nurses exerted control over patient care, which influenced the extent of patient participation.
  
  
  
  Patient participation appears to be difficult to enact. Nurses' controlling approach, influenced by organizational issues, was in conflict with a patient-centered approach to care. Nurse-patient communication is one aspect of patient-centered care enacted more frequently.
  
  
  
  Nurses may benefit from strategies at the individual and organizational level to enhance their patient-centered practices. Fostering nurses' communication may enhance patient-centered practices in hospitals.
authors.affiliation: Phi Delta-At-Large, Doctoral Candidate, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
authors.forename: Georgia
authors.initials: G
authors.lastname: Tobiano
authors.affiliation: Professor Acute and Complex Care Nursing, National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Queensland, Australia and Gold Coast Health, Queensland, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marshall
authors.affiliation: Xi Omicron, Professor and Foundational Chair in Nursing, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Victoria, Australia and Alfred Health, Victoria, Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: Bucknall
authors.affiliation: Phi Delta-At-Large, Director, National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003142:Communication; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000706:statistics & numerical data*; D018802:Patient-Centered Care
keywords: Communication; nurse-patient relations; nursing care; organizational culture; patient participation; patient-centered care