Nuffield Research Award: Elderly patients’ participation in discharge decision making: 1

This article is the first of a two part series describing a study that explored patient participation in discharge decision making. The study involved two phases and focused on the participatory relationship between older patients and nurses. In phase one, the author conducted a group interview with primary nurses at two elderly care units specializing in rehabilitation. The second phase involved a series of interviews with five elderly patients during their hospital admission. The data from both phases of the study were analysed using the Ethnograph software package. This first article discusses the views of the nurses while the views of patients are addressed in the second article. Phase one of the study showed that the nurses interviewed had an elaborate understanding of participation. They tended to stress practical examples of participation rather than stating the reasons why it should be encouraged. Informants recognized the need to involve patients in decisions about their discharge from hospital. However, they viewed elderly patients as being both passive and reluctant to participate in decision making. Several reasons were given for this which were seen as resulting from patient rather than nursing behaviour. Part two of this article will appear in Vol 5(17): 26 September.