Lack of clarity in the concept of partnership has led to the use of the alternative term as involvement and collaboration. While in partnership, the patient will be co-opted in all caregiving processes while other concepts such as participation will be partially enhanced (Sahlsten et al., 2007). Participation is founded on an interpersonal relationship that is nurtured when the practicing nurse and patient interact. The dimension from which a patient is involved in the delivery of nursing services affects how he/she perceives the progress of care while medical services are dispensed. The degree of relationship at the primary care level between the patient and the caregiver is an impetus in developing understanding and preparation to appreciate further medical care. When participation is fostered, then the patient is in the active partner and this contributes positively to respond to health care. According to Sahlsten et al., (2007), this is necessary as it amplifies motivation as well as satisfaction between the nurse and patient as care is administered. During the participation, how the patient chooses to utilize the opportunity to influence his/her health care, acclimatization depending on abilities and the prevailing status will be important.
According to Lester and Tritter (2006), a patient-caregiver relationship can be a political affair especially in mentally heal cases. Henderson (2002) shares inferences with Lester and Tritter, though adding other factors of social, ethical, and empirical nature. The study was performed concerning the relationship between professionals and mentally ill persons. Social background is important when the parties involved are related. For instance in cases where relatives are involved (Chisinatsvakayikapungu, et al., (2010). While Hook (2006), considers the need for consistency and mutual understanding in ensuring participation is perpetuated further. According to Henderson (2002), this participation will influence the decision-making processes of the patient. Splaine (2008) considers participation due to the increasing elderly population, diversity of backgrounds in the US, and advancement in medical research.
Henderson (2002) conducted a wide literature review concerning participation, decision-making, and healthcare. This study considers involving patients in decision-making could enhance their health outcomes. How positively oriented the partnership between the patient and caregiver is established is mirrored on solutions provided over time. A range of issues related to patients’ complaints, stress feelings as well as anxiety could be minimized when the art of participation is nurtured. This means that throughout a positive interpersonal relationship, a bonding will exist during their interaction. According to Sahlsten et al., (2007) the caregiver’s perception, approach, and professional art is an independent variable that will influence the result achievement of this interpersonal relationship. Equally important is the capacity of the patient to discern and opt for the better choice among those offered by the caregiver (Sahlsten et al., 2007). Just as exemplified in other interactive cases, the relationship will determine the health of communication between patients and caregivers. The uses of social networking tools such as instant messaging have seen the realization of the interpersonal relationship as a correlated interaction between the communicating parties. According to Lee and Sun (2009), the use of the internet as an interactive media by Taiwanese adolescents was becoming a popular tool in advancing their relationships. It is further emphasized in studies by Pistole, et al., (n.d.).
In partnership, during the initiation phase, the underlying concerns are part of the framework for operations (Sahlsten et al., 2007). The patient will then make consideration concerning the operational goals. The degree of achievement of the goals forms the part of appraising the partnership (Sahlsten et al., 2007). This can lead to reorienting the outlook of how the patient and the caregiver relate in terms of functions (Sahlsten et al., 2007).
Aims or purpose of the analysis
The study was conducted through an interview on seven focus groups of nurses to capture them as informants within five months Sahlsten et al., (2007). The typical discussions were on their perceptions. The interviews focused on the meaning and implementation of patient participation (Sahlsten et al., 2007). Findings were further captured in a tabulated format. The length of the interview did not exceed one and a half hours. Thus the study is grounded on diversity and reliability.
Hook’s (2006) study involves an analytical approach on the professional caregiver and the patient participation as a relationship. Henderson (2002) pursued the phenomenon of patient participation. Splaine (2008) aimed at the conceptual background of participation.
Lester and Tritter (2009) involved a qualitative approach and engaged six patients, six health professionals, and six combined focus groups. Lester and Tritter’s (2009) study involves conducting interviews with eight focus groups of care trusts. Interviewers were widely sourced from different community-based patient networks. To achieve comprehensive coverage of the participant’s views, the setting chosen were non-clinical with facilitation being co-hosted. The study found a close semblance to previous works. For instance, the patient participation is at four levels: the kind of individual help considered concerning other patients, interaction with caregivers with the patient, management of remote services to patients as well as general frameworks of dispensing services.
Antecedents
The background of the participation concept is a mutual negotiation. The negotiation will involve finding a harmonious ground for understanding and sharing. According to Sahlsten et al., (2007), this is cooperation at the same level of engagement between the patient and caregiver. Hook (2006) backgrounds participation in the caregiver-patient relationship clarified in the study that the relationship through participation develops over time. According to Lester and Tritter (2009), three interlaced themes are essential in understanding patient involvement. These include the practical experience, the role of co-opted decision-making as well as significant waged services. Splaine (2008) seeks to describe the background and realize a new model of delivery with regards to participation. These include trust, empathy, communication, and reciprocity among others.
Consequences
Sahlsten et al., (2007) applied the grounded theory approach in studying participation concerning its meaning and implementation by the patient. The study provides a table of core, sub-core, category, and sub-category of how the study factors relate. The core aspect is mutuality in negotiation and sub-core being interpersonal procedures, therapeutic approach, focus on resources and opportunities for influence. Henderson (2002) applied the ground theory as well. This allowed for the examination of social interaction and common meanings. Henderson’s (2002) study focused more on the patient perspective. Hook’s (2006) study is on the aspects of relations, power-sharing, and negotiation while considering the aspect of empowerment as a key integral part of a relationship. Splaine (2008) considers empowerment as the main consequence.
Lester and Tritter (2009) seek to explain perceptions, potential, and the description of patients engaged in the primary care between the professional caregiver and mentally affected persons. Patients perceived that only those with mental cases in the previous experience of mental problems could understand them better. Patients also perceived participation as a social and poverty issue. Caregivers had a lower interest in developing a mutual partnership that allows for a higher level of participation. According to the professionals, inadequate treatment alternatives were a turning point in achieving consultative interaction. Incentives to patients are considered important in triggering the application of skill towards improving consultation by some professionals.
Defining Attributes
According to (Sahlsten et al., 2007), mutuality is defined as an interactive experience between the patient and nurse that persists through intimacy, contact as well as understanding. Mutuality was considered a nurse’s voluntary initiative who will consider the patient as a partner.
Professional achievement esteem and authority was a limiting factor in achieving this end. Through skill, the nurse would manipulate the abilities and stability hand in hand with the patient’s needs. On the other hand, the negotiation was a communication variable that was meant to initialize interaction. Hook (2006) reaffirms the consideration of other authors, that participation involves eight attributes. Among these establishing a relationship, consulted decision-making and patient achieving some level of autonomy are distinct to partnership concept (Hook, 2006).
Lester and Tritter (2009) also agree with other previous works, with participation achieved at four levels (as mentioned above). In addition, participation from a secondary care viewpoint could enhance that of primary. Splaine (2008) provides a tabulation that contains consequences. This consists of interdisciplinary aspects of knowledge and skill, relationship building, and communication as shared with other works. According to Henderson (2002), factors that have influenced patient involvement are Age, previous hospital experience, level of clinical knowledge, previous hospital experience, desire to conform to the hospital set ethical code, knowledge of the self, and attitude to care.
Empirical Referents
The study by Sahlsten et al., (2007) suggests that participation is a positive direction but rarely actuated in practice. For mentally challenged person participation involves four operational levels (as mentioned above). While in support of the patient’s involvement, participation was defined based on cooperation and shared responsibility. This was a common view by other authors. Sahlsten et al., (2007) found out that understanding that was formerly to be applicable theoretically and not practically and is equally important in partnerships as well as in participation. Splaine (2008) gives an operational definition of participation as a relationship characterized by cooperation and responsibility. Lester and Tritter (2009), based on the four levels of participation, the conceptions of patient involvement include those to whom communication is made, the main subject of consultation, and those at the helm of control.
Relationship among Concept and Related Concepts
Sahlsten et al., (2007) in agreement with other works found out that negotiation was a key ingredient in achieving participation. The mutuality factor was an important pre-inclusion in readiness for negotiation. Opportunities to choose and potential in decision-making were seen as influencing the achievement of negotiation and mutuality. Clarity on opportunities and lifestyle within mentally challenged persons were established as limiting considerations concerning the relationship between them and caregiving professionals (Lester & Tritter, 2009). Enhancement of relationships will also focus on attitudinal change. According to Henderson (2002), the cultural background could be a limiting factor. Culture may influence negatively for instance in racism. Racism is captured in studies by Corning and Buchianeri, (2010).
Model
Clinical Implications
According to Hook (2006), interaction through collaborating could be an added advocacy platform for better health services. This will benefit the health provider and the patient. Sahlsten et al., (2007) consider this study as important to enhance nurse education and better their practice. Engaging past experienced persons with mental challenges could achieve a significant improvement in services (Lester & Tritter, 2009). Further, this could be applied in achieving quality assurance.
According to Henderson (2002), participation allows the caregiver to respect the opinion of patients wishing to participate on issues concerning their health care. Furthermore, it provides the opportunity for the caregiver to understand elder people as capable of knowing their status as well as influencing the outcome. Understanding the dynamics behind the emergence of the new care models is very important (Splaine, 2008).
Further Research
Improve clarity and demarcation between partnership and participation concepts in the patient-caregiver relationship.
References
Chisinatsvakayikapungu, Donnabaptiste, Graysonholmbeck, Camimcbride, Melissarobinson-Brown, Allyse Sturdivant, Laurelcrown, and Robertapaikoff (2010). Beyond the ‘‘Birds and the Bees’’: Gender Differences in Sex-Related Communication Among Urban African-American Adolescents.
Corning, A.F. and Bucchianeri, M. M. (2010). Perceiving Racism in Ambiguous Situations: Who Relies on Easy-to-Use Information.
Henderson, S. (2002). Influences on patient participation and decision-making in care.
Hook, M. L., (2006). Partnering with patients–a concept ready for action. Journal of Advanced Nursing, 56(2), 133-43.
Lee, Y-C. & Sun Y. C., (2009). Using instant messaging to enhance the interpersonal relationships of Taiwanese adolescents: evidence from quantile regression analysis.
Lester, H. & Tritter, J., (2006). Patient involvement in primary care mental health: a focus group study. British Journal of General Practice, 56 (27), 415-422. 2006.
Pistole, M. C., Roberts, A. and Mosko, J. E. (2010) Commitment Predictors: Long-Distance Versus Geographically Close Relationships
Sahlsten, M. J. M., Larsson, I. E., Sjöström, B., Lindencrona, C.S. and Plos, K. A. (2007). Patient participation in nursing care: towards a concept clarification from a nurse perspective. Journal of Clinical Nursing, 16 (4), 630–637. Web.
Splaine, M., (2008). The partnership care delivery model: an examination of the core concept and the need for a new model of care. Journal of Nursing Management, 16 (5), 629-638. Blackwell Publishing Ltd.