Nurses’ behaviour regarding patients’ attempts to self-manage, what’s behind it?

Abstract

Background: Self-management can be defined as the ability of an individual to, with the help of others, manage their disease and upcoming treatments and symptoms. Until now, little attention is paid to self-management support during hospitalisation. An ongoing study showed that patients attempted to self-manage when admitted in a hospital. So far, it is known how nurses' respond to patients' attempts to self-manage, but it remains unclear why nurses do so and what thoughts and perspectives are underlying nurses behaviour. Aim: Exploring motives and assumptions underlying the nurse behaviour regarding patients’ attempts to self-manage during hospitalisation. Method: A generic explorative qualitative study was performed exploring nurse’s insiders’ view. ‘Think Aloud’ and reflection interviews were used to elaborate on nurses’ responses, additional thoughts and perspectives. Both interviews were supported by patient-participant casuistries obtained through observations by shadowing. The thematic analysis of Braun and Clark was applied in an inductive way. Findings: Data of 14 participants generated ten subthemes and four main themes. Nurses’ motives and assumptions regarding patients’ attempts were related to the professional aspects of nursing care, nurses interpretations of patients’ attempts, the nature of the attempt and the patients’ situation. Conclusion and recommendation: Nurses’ motives and assumptions in the field of the nursing profession, the nurse, patient and attempts’ nature are underlying the nurse behaviour regarding patients’ attempts. To refine nurses self-management support skills, they need to become more aware of their interpretive perspectives, the importance of good patient-nurse partnership, and the patients’ attempts advantages. Nurses must also build confidence in dealing with patients’ attempts, as well as schedule time to encourage these attempts. Future large-scale research is recommended to substantiate the results and to enhance transferability.