Reluctant collaborators: do patients want to be involved in decisions concerning care?

Against the background of the popularity of the concept of 'patient collaboration' in care, this paper describes, from the frame of reference of the patients, how they perceive being involved in decisions concerning their own treatment and nursing care. A convenience sample of 12 patients were selected. The data collection and analysis were informed to some extent by the approach known as grounded theory. Although only 12 in-depth interviews were conducted, one major theme emerged from the data and that was named 'toeing the line'. The data suggests that some patients are more concerned about doing what is right, that is, pleasing the nurse, than participating in decisions concerning care. It is contended that if nurses adopt practices which encourage involvement they may unwittingly coerse patients to comply. It is argued that patients will accept this situation even if they do not wish a collaborative role. Despite the small sample size, interesting questions are raised concerning the underlying rationale of patient involvement. The conclusion is drawn that promoting individualized care is not necessarily synonymous with active patient involvement as advocated in much of the literature.