Barriers in achieving patient participation in the critical care unit

This article by Falk, Schandl and Frank was published online in “Intensive and Critical Care Nursing” during December 2018.
Objectives:  Patient participation in healthcare is important for optimizing treatment outcomes and for ensuring satisfaction with care. Therefore, this study aims to identify barriers to patient participation in the critical care unit, as identified by critical care nurses.
Design and settings:  Qualitative data were collected in four focus group interviews with 17 nurses from two separate hospitals. The interviews were analyzed using qualitative content analysis.
Findings:  The results show three main categories: nurse’s attitude toward caring, the organization of the critical care unit and the patient’s health condition.
Conclusion:  Barriers for patient participation in the ICU were found and this lead to a power imbalance between patient and nurse. In contrast to other care settings, this imbalance could be a consequence of the critical care organization and its degree of highly specialized care. The clinical application of our results is that these barriers should be considered when implementing patient participation in such a highly technological care situation as a critical care unit.
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