gms | German Medical Science

Background and Purpose: Nurses are in frequent contact with patients in home care and have a particular responsibility for initiating patient participation. The aim of the study was to explore those areas in home care in which patient participation seems to be appropriate from the nurses’ perspective.

Methods: Qualitative problem-centred expert interviews were conducted with 29 nurses, nursing managers and quality assurance officers in home care. The data was analysed in an iterative process using applied thematic and case analysis. The theoretical focus of the analysis was guided by theoretical approaches of negotiation and person-centred care.

Results: Nurses describe certain conditions that are necessary to enable patient participation, such as patients’ willingness to cooperate, low potential of harm to patients and caregivers, and patients’ ability to cope with the situation. Nurses consider the following as limiting factors for patient participation: high vulnerability of patients, working conditions of home care marked by staff shortages, lack of time and pressure through external quality assurance bodies, and qualification deficits of nurses. Nurses consider patient participation in home care possible mainly in everyday situations and related to basic care. However, in treatment care and specialised care nurses see no opportunities for patient participation as they regard this to be the responsibility of doctors.

Conclusions: The areas of action for patient participation in home care are rather limited. The results of the study can be used to inform nursing training and care-related policy development.