NURSES’ CONCEPTIONS OF OLDER PEOPLE’S PARTICIPATION IN COORDINATED DISCHARGE CARE PLANNING

Abstract

The discharge care planning (DCP) from hospital to home care is a complex and challenging assignment. Patient participation includes their access to health care, their rights to safe care, information about risks and benefits of treatment and the right to complain. The aim of the study was to explore nurses’ conceptions of older people’s participation in DCP and to identify the structure of awareness underlying the nurses’ varying experiences of participation. Fifteen registered nurses were interviewed. A phenomenographic analysis described by Åkerlind was used. The analysis revealed five categories of description showing different ways of experiencing older people’s participation in DCP. Four themes of Expanding awareness were identified as; Taking on the role of patient advocacy; Ethical responsibilities to protect older people’s self-esteem; Being restricted in what to communicate and perform and Necessity to conspire in defending active participation. The outcome space showed nurses’ conceptions to be that older people’s participation is prerequisite and it needs to be well founded. It also showed that nurses understood and took on ethical responsibilities to protect older people’s self-esteem. Our findings have outlined the complexity in the process of discharge planning, and consider the older patients’ active participation in decisions. Nurses have a key role in supporting older people and their family members in the process.