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  4. Striving to establish patient participation in rehabilitation: the challenges experienced by nursing staff when changing practice to include the patient’s perspective

Striving to establish patient participation in rehabilitation: the challenges experienced by nursing staff when changing practice to include the patient’s perspective

Front. Rehabil. Sci., 2024 · DOI: 10.3389/fresc.2024.1504984 · Published: December 19, 2024

Spinal Cord InjuryPatient ExperienceNursing

Simple Explanation

This study explores the difficulties faced by nurses when trying to involve patients' views in spinal cord injury rehabilitation. It highlights how nurses find it challenging to prioritize listening to patients due to time constraints and a focus on physical tasks. The research shows that nurses struggle to balance the need to listen to patients with the demands of their daily routines and the expectations of their colleagues. They often feel they lack the time and training to effectively engage in conversations with patients. The study suggests that to improve patient involvement, there needs to be a shift in the way rehabilitation is organized, with a greater emphasis on the importance of listening to patients' perspectives and incorporating them into the rehabilitation process.

Study Duration
Two years
Participants
Four nurses and four certified healthcare workers
Evidence Level
Original Research, Action Research

Key Findings

  • 1
    Nursing staff found it difficult to truly listen to patients' perspectives, struggling to set aside other tasks and be fully present in conversations.
  • 2
    The nursing staff faced challenges in finding time to listen to patients, feeling compelled to prioritize other tasks and manage interruptions.
  • 3
    Nursing staff felt the need to legitimize the patient's perspective in rehabilitation, advocating for conversations to be seen as an integral part of the treatment process.

Research Summary

This study explores the challenges experienced by nursing staff in their effort to improve patient participation in rehabilitation within a spinal cord injury center. The findings highlight difficulties on personal, group, and organizational levels. The central themes identified include struggling to really listen to the patient's perspective, searching for time to listen, and legitimizing the patient's perspective in rehabilitation. These challenges stem from task-oriented structures and prioritization of physical nursing tasks. The study concludes that changes in practice, organizational structure, and the overall approach to patient participation are necessary to fully incorporate the patient's perspective into rehabilitation. This requires a shift towards valuing conversations and caring as equally important elements of patient care.

Practical Implications

Re-organize rehabilitation

Rehabilitation settings need to prioritize time for nurses to engage in meaningful conversations with patients.

Training and Support

Provide nurses with specific training in communication skills and patient-centered care to improve their ability to elicit patient perspectives.

Organizational Culture Shift

Foster a culture that values patient participation and recognizes the importance of the nurse-patient relationship in rehabilitation.

Study Limitations

  • 1
    Small sample size of nursing staff.
  • 2
    Limited involvement of inter-professional colleagues.
  • 3
    Local context may limit generalizability.

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