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How do we facilitate carers' involvement in decision making?

E Walker1, B J Dewar

  • 1Department of Health and Nursing, Queen Margaret University College, Edinburgh, UK. b.dewar@qmuc.ac.uk

Journal of Advanced Nursing
|May 1, 2001
PubMed
Summary
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Informal carers reported dissatisfaction with their involvement in healthcare decisions. Addressing hospital systems and staff relationships is crucial for improving patient and carer engagement in health services.

Area of Science:

  • Healthcare Policy and Practice
  • Patient and Carer Engagement
  • Qualitative Research Methods

Background:

  • Government policies advocate for increased service user involvement in healthcare decision-making.
  • Despite policy recommendations, a significant gap persists between policy and actual practice regarding user involvement.
  • Carers' organizations consistently report challenges in achieving meaningful involvement in healthcare.

Purpose of the Study:

  • To investigate user involvement within a specific healthcare setting.
  • To identify opportunities for enhancing carer involvement in healthcare.
  • To propose practical strategies for improving carer engagement in health services.

Main Methods:

  • A qualitative case study design was employed.

Related Experiment Videos

  • Interviews were conducted with informal carers (n=20) and multidisciplinary team members (n=29).
  • Non-participant observation of ward routines and meetings, alongside constant comparative analysis of interview and observational data.

    • Main Results:

    • Carers identified four key markers of satisfactory involvement: information sharing, inclusion in decision-making, accessible contact persons, and responsive services.
    • A majority of informal carers expressed dissatisfaction with their current level of involvement.
    • Barriers to effective carer involvement were identified within hospital systems, processes, and the nurse-carer relationship.

    Conclusions:

    • Improving carer involvement requires addressing systemic and relational barriers within healthcare settings.
    • Healthcare practitioners must actively identify and challenge these barriers to facilitate meaningful engagement.
    • Enhancing carer involvement is essential for aligning healthcare practice with policy objectives and improving service user experience.