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This assignment report will discuss them in-depth concept analysis of the patient’s participation. This analysis would be done by following the method defined by the Walker and Avant. Moreover, this report will identify and define what is the concept, what is the structure, purpose and critical attributes of this model (Ausserhofer and Schubert et al. 2013. Furthermore, the concept of a patient partnership will also be defined along with the patient’s participation. The consequences and antecedents of patient participation will be examined the importance of concept analysis. The concept analysis is recognised as crucial for the enhancement of the theory of nursing (Carman and Dardess et al. 2013). Therefore, it is very rigorous, creative and natural process which produce and explain the significance of one concept. The purpose of this conceptual analysis is to provide the purposiveness and framework to think which may otherwise roam purposelessly and indefinitely in the different systems and cultures (Huber and van et al. 2016).
Definition of Concept
The concept denotes a sign or a foundation of a big spectrum. It can be referred to as the basis for researchers in the field of nursing (Hibbard and Greene, 2013). The research can also be done with the help of evidence-based research because it is the rigorous inquiry, which is used to answer the questions which are related to the phenomenon. The concept analysis can be explained as the partition of the concept among simple components in order to encourage clarity and provide common empathy in the nursing (Kemppainen, Tossavainen and Turunen, 2013). If the professionals are unaware of the concept, then they must undertake the analysis regarding concept in order to have a clear understanding of the concept. Moreover, a concept analysis is an in-depth analysis of the phenomenon of interest. Its related concepts are creating conceptual meaning and the clarification of the concept (McCambridge, Witton and Elbourne, 2014).
The Purpose of Concept
There are various reasons associated with the research, practice and the education of nursing in order to do concept analysis (McCambridge, Witton and Elbourne, 2014). The proper concept analysis provides the ability to differentiate the concepts from one another. Moreover, the concept related to the patient’s participation is a commonly accepted principle in the practice of modern nursing. Now, it is considered part of the theory of professional nurses which is used as a guide for enhancing the human dignity and decision making, furthermore, improve the quality of life because the participation of patient is considered crucial (Small and Bower et al. 2013). The purpose of this concept is to explore and find the characteristic of the concept and to explain and clarify the nature and meaning of the patient’s participation concept in the field of nursing. This patient’s participation concept analysis also proposes to light the responsibilities and role of a nurse related to the patient participation and enable them to gain knowledge, experience and skills, which nurse need to acquire for the practice (McCambridge, Witton and Elbourne, 2014).
Importance of the Patient’s Participation
Patient’s participation is very crucial for the medical treatment and the care of nurses because in recent decades the position of the patient is more strengthened both nationally and internationally (Ando, Cousins and Young, 2014). However, the previous views are replaced by the potential of an active involvement of the patients in their own care. In spite of this, the patients have faced inadequate participation, complains and dissatisfaction have been increased. On the other hand, the patient’s participation has reduced the anxiety and stress and increased the satisfaction and motivation of the patients because now they are receiving patient centred care. Moreover, every patient and every nurse have their own ideas or opinions regarding the implementation and meaning of the patient’s participation (Schulz and Nakamoto, 2013).
The patient’s participation is largely used every day and it is a complex and subtle concept, which have very crucial for nursing (Rees, Jenkins and Doherty, 2013). Concepts are necessary and considered as a foundation for the enhancement of the knowledge base of the nurse and it is also crucial for the critical thinking and precise communication. The concept of patient’s participation is considered as a phenomenon of mental constructions, which help in the development of conceptual definitions which permits the analysis to do an environmental analysis (McCambridge, Witton and Elbourne, 2014). Therefore, it is a very valuable method which can be used to simplify the overused concepts with unclear meaning which is currently used in the practices of nursing. However, the previous researches present an investigation about the concept of the participation of the patient and its connection to the nursing after finding the true meaning of the patient’s participation concept form the literature (Small and Bower et al. 2013). The basic theory from the model of Walker and Avant (1995) regarding the analysis of the concept is used to analyse, define attributes, determine and characteristics of the patient’s participation concept. However, this model consists of 8 steps, which are used to describe the different aspects and important characteristics of the concept (McMillan and Kendall et al. 2013).
According to the Oxford dictionary, the meaning of the work participation is to take part and to be involved. This term is taken from the Latin word participate, it means to share it. This concept of participation is used in different contexts (McCambridge, Witton and Elbourne, 2014). Indirect or collective participation is done as an unknown participation in the research, commissioning of service and the formulation of policy. The current concept analysis shows that research regarding the participation of the patient in the nursing care is consistent about the elements, definition and the processes (McMillan and Kendall et al. 2013). This deficiency is improved by the use of various terms such as user, client, patient, consumer, their partnership, involvement and collaboration. Therefore, the client and patient referred to the now a day’s participants of the mental, health and social care. The participation of consumers seems to be used interchangeably with the participation of users (Rees, Jenkins and Doherty, 2013).
The researchers have defined that there is a huge difference in the concept of consumer and user because a user is a different term which is used for the potential health care and current recipients, on the other hand, consumers referred to a person who has right of choosing anything he wants (Scholl, Härter and Dirmaier, 2014). Therefore, the patient participation used interchangeably with the term user involvement. In addition, the word collaboration is significantly used (Schulz and Nakamoto, 2013). The use of these various terms can be derived from the decision makers and the government’s various denominations regarding the patient’s participation in the documents of policy (Schulz and Nakamoto, 2013). The patient’s participation is connected to a few definitions in the context of professional nursing. Different researchers have found patient participation as demonstrating the philosophical approach for the care of a patient and an applied factor of patient care as well. These philosophical approaches consist of holistic care or individual care, positive results for the patients, realistic plans depending on the negotiation and motivating the patients to remain active, not passive during their working hours (Small and Bower et al. 2013).
The useful factor includes, nursing process should focus on the wants of the patients and what customer needs about his self-care and discharge such as taking part in the care physicians and nurse must inform patient regarding his or her activities during the stay at hospital.it is concluded that the participation of the patient means involving him in the process of decision making regarding the evaluation of his own care and his delivery (Small and Bower et al. 2013). Therefore, defining means considering the patients as an individual, asking the patients for their opinions and providing them control over their own care. The other researchers defined the participation of patient as a dynamic role which changes over time and very crucial for the work of carers and nurses. This procedure is done with the partnership, facilitation, emotional work and understanding of the person (McMillan and Kendall et al. 2013). Therefore, the partnership is considered as a crucial process which reinforces the participation by explaining the beliefs and values on which conversation is based. Sometimes, staff in the hospital take decisions for the patients, which is possible by this dynamic process (Schulz and Nakamoto, 2013).
The patient’s participation can be elaborated as a process and elements. It is claimed that it is crucial to know the differences among the tasks and role elements of participation of patients and to main that difference (Ausserhofer and Schubert et al. 2013. Moreover, its failure can cause the conceptual confusion and increment of few false assumptions for the participation in different tasks which made parallel changes in the responsibilities such as more power given to the patients. The patient’s participation is related to the involvement in the decision making and expression of different views on the various treatments. It consists of communicating feelings, sharing information, communicating symptoms and compliance with the physicians and nurses orders (Huber and van et al. 2016). Moreover, it is stated that the patient’s participation must be to comprehend, confident, maintain a sense of control, seek and recognition of own roles and responsibilities as a patient. From the perspective of the nurse, the participation of the patient is more toward the individual adjustment of information, so that patient can take a decision which is favourable for him and act accordingly (Hibbard and Greene, 2013).
The experience of patients regarding participation as roughly which they need to accept an active personal attitude, on the other side the experience of nurses is something which they provide to the patients in order to keep them active (McCambridge, Witton and Elbourne, 2014). The participation of a user is considered a dynamic process because it moves beyond only raising voice, involvement in the evaluation of real planning of delivery and care service. This consists of a person-centred approach, for example, a sharing and equal relationship with the cooperative facilitator. Moreover, the participation of consumer in information sharing, decision making power and opinion (Carman and Dardess et al. 2013). It must not be restricted to the only shared clinical decisions rather it must include the general participation of individuals in the daily aspects during the stay at the hospital. In addition, the participation of a patient can be associated with various attitudes. It is observed that the professionals have control over the practice which affects the patient’s participation level of activeness (McCambridge, Witton and Elbourne, 2014).
It is the commitment of the nurses regarding participation which they won’t make it happen (Small and Bower et al. 2013). The concept of participation of the patient derived from the democratisation and the consumerist approach. This consists of four different positions of moving the power of decision making to the user such as explanation and information and second is consultation which includes transfers. The third position is of partnership which includes the joint decision making and the fourth one is of user control such as power is divided to enable the user to make a decision or to involve someone else (Rees, Jenkins and Doherty, 2013).
Antecedents and Consequences of Patient Participation
The RPs are considered as the evidence of patient participation (McMillan and Kendall et al. 2013). The professionals must be respectful and listen to the unique situation and conditions of the patients. They should motivate and involve the patient to participate and help in his own rehabilitation. The health professionals need to be flexible enough to make them unable to take care of themselves. The health professionals must inform the patient regarding their situation as well as the process of rehabilitation and patients responsibilities in it (Ando, Cousins and Young, 2014). All the patient may not agree on their role and the patient must adopt and accept the before the active involvement. Various techniques and tools and procedure in order to encourage the active role of patients, particularly, in deciding her or his goals which are commonly used (McCambridge, Witton and Elbourne, 2014). Therefore, these cannot be considered as an antecedent but it must be considered as supporters. Few examples are the Patient Goals Priority Questionnaire and The Goal Attainment Scale, the Patient Participation System. In real the tools, which can be used to encourage and invite the patient in order to describe and identify the preferences, needs and goals (Rees, Jenkins and Doherty, 2013).
This can permit both the communication among the health professionals and the patients as well as it can set the focus on the past activities of patients and the future conditions (Ausserhofer and Schubert et al. 2013. The patient participation provides support to the complete goal along with the rehabilitation such as improvement in the functions and also in the patient’s everyday facilitation which provides benefits because of patient participation. It is claimed that the patients participate actively in the sessions of therapy more attentively by focusing on the instruction and provide receptive feedback and also work hard (Huber and van et al. 2016). Therefore, they may come out of their rehabilitation. The objective assessment of the participation of the patient is correlated positively in order to enhance the physical functioning. Similarly, the interventions to enhance the participation of the patients which is related to the better self-management, coping and satisfaction with the care (Carman and Dardess et al. 2013). Resultantly, proved in the qualitative studies that the participation of patients is treated as a complete person with dignity (McCambridge, Witton and Elbourne, 2014). It can be measured parallel with the rehabilitative of a perspective of the patient which is responsible and capable for his own actions and behaviours. Furthermore, the patient who participates in the decision making or in the setting goals may more encouragement for participating actively in the complete rehabilitation process (Kemppainen, Tossavainen and Turunen, 2013).
Eight Steps of Concept Analysis Method
The eight steps are defined by the Walker and Avant in the linear fashion (Hibbard and Greene, 2013). They recognised this concept analysis as an iterative process. These steps are defined below.
Select a Concept
- In this first step, the concept is chosen as here is the concept of patient participation which is very interesting and needs to be deeply examined (McCambridge, Witton and Elbourne, 2014).
- It defined choose that concept which can easily manage (McMillan and Kendall et al. 2013).
- The concept should be chosen which is crucial and helpful for the project development concept (Ausserhofer and Schubert et al. 2013.
Determine the Aims or Purpose of Analysis
- In this steps, Walker and Avant defined why the analysis should be done. Therefore, here the analysis is done on the concept of patient participation because it is very new in the current health professionalism (Ando, Cousins and Young, 2014). There is not extensive research present on this topic, it very widely needed because patient participation encourages the patient to take care of themselves as well rather than relying only on health professionals (Schulz and Nakamoto, 2013).
- The major purpose of this topic was to highlight the advantages and disadvantages of patient participation during the stay at the hospital (McCambridge, Witton and Elbourne, 2014).
Identify all uses of the concept that can be discovered
- The nature of the concept is related to the theoretical framework, which is more related to the health care sector (Ausserhofer and Schubert et al. 2013.
- Various sources were used to find the concept related terms and the literature review related to the patient participation (Huber and van et al. 2016). Furthermore, the current findings were also analysed regarding patient participation because currently this area in the health sector more focused because of its advantages and they do not have many flaws (Hibbard and Greene, 2013).
- Various articles were downloaded from the scholarly websites and articles were taken which were not more than 5 years old (McMillan and Kendall et al. 2013).
- This connect was discussed only related to the nursing in this report.
- The physiological, physical, societal, environmental, spiritual, intellectual, economic, religious, and political and various contextual perspective of the concept was considered in broadway (Ausserhofer and Schubert et al. 2013.
- The meaning was defined with the help of dictionary and context as well (Ando, Cousins and Young, 2014).
- The information used is objective, there is no biasness in this research (Ando, Cousins and Young, 2014).
Determine the defining attributes: the “heart” of concept analysis
- The heart of this concept is that patient participation encourage the patient to properly take care of themselves, this will motivate them to work hard for their health recovery (Scholl, Härter and Dirmaier, 2014).
Construct a Model Case
This is a case study of John who was admitted to the ward of surgery, on the second day his nurse explained whole pre-operative instructions and spent some time with John. She emphasizes that John must follow all those instructions specifically, she focused more on the need of sharing the operation site (McMillan and Kendall et al. 2013). She explained to John that she needs to do the shave in order to remove the bacteria. Resultantly, increased the fear of infection development in the wound. Moreover, she said that it was normal for the nurse to do shave of the patient because the only nurse has knowledge regarding preferences of surgeons that how to do the pre-operative shaving. John shows reservation regarding shave and said that he is a very shy person and he will prefer to shave. However, the nurse refused his request and did the shave. This case shows some characteristics of patient participation that relationship exists between nurse and John (McMillan and Kendall et al. 2013).
Construct contrary Case
An old age patient in a very depressed state of mind was present in the hospital. She was there for the first time in life for the cholecystectomy. She reached in the ward and bed was shown to her by the nurse (Rees, Jenkins and Doherty, 2013). The nurse was responsible for the care, but there was no communication between them neither introduction nor discussion regarding the health condition. Thus the nurse left the patient there and went to complete her other work at her working station for the documentation. She used the notes of patients rather than discussing with her, these notes were made for pre-operative plans but these notes were not consulted with the patient (Schulz and Nakamoto, 2013).
Identify antecedents and consequences
Consequently, from the above cases, it is clear that the concept which is of interest is very crucial such as patient participation is necessary for the development and encouragement of the patient (Rees, Jenkins and Doherty, 2013).
This report was written to define the concept analysis by keeping in view the patient participation. Furthermore, the eight steps of Walker and Avant were discussed in detail which includes the case studies as well. The concept was defined in detail in terms of context and in terms of the meaning of dictionary. After this discussion, it can be concluded that patient participation is very crucial in the health sector.
- Ando, H., Cousins, R. and Young, C., 2014. Achieving saturation in thematic analysis: Development and refinement of a codebook. Comprehensive Psychology, 3.
- Ausserhofer, D., Schubert, M., Desmedt, M., Blegen, M.A., De Geest, S. and Schwendimann, R., 2013. The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: a cross-sectional survey. International journal of nursing studies, 50(2).
- Carman, K.L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C. and Sweeney, J., 2013. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2).
- Hibbard, J.H. and Greene, J., 2013. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health affairs, 32(2).
- Huber, M., van Vliet, M., Giezenberg, M., Winkens, B., Heerkens, Y., Dagnelie, P.C. and Knottnerus, J.A., 2016. Towards a ‘patient-centred’operationalisation of the new dynamic concept of health: a mixed methods study. BMJ open, 6(1).
- Kemppainen, V., Tossavainen, K. and Turunen, H., 2013. Nurses’ roles in health promotion practice: an integrative review. Health Promotion International, 28(4).
- McCambridge, J., Witton, J. and Elbourne, D.R., 2014. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. Journal of clinical epidemiology, 67(3).
- McMillan, S.S., Kendall, E., Sav, A., King, M.A., Whitty, J.A., Kelly, F. and Wheeler, A.J., 2013. Patient-centered approaches to health care: a systematic review of randomized controlled trials. Medical Care Research and Review, 70(6).
- Rees, F., Jenkins, W. and Doherty, M., 2013. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Annals of the rheumatic diseases, 72(6).
- Scholl, I., Zill, J.M., Härter, M. and Dirmaier, J., 2014. An integrative model of patient-centeredness–a systematic review and concept analysis. PloS one, 9(9).
- Schulz, P.J. and Nakamoto, K., 2013. Health literacy and patient empowerment in health communication: the importance of separating conjoined twins. Patient education and counseling, 90(1).
- Small, N., Bower, P., Chew-Graham, C.A., Whalley, D. and Protheroe, J., 2013. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Services Research, 13(1).
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