How nurses support self-management of hospitalized patients through verbal communication: a qualitative study

Caroline E M Otter; Joost C Keers; Celeste Reker; Jakobus Smit; Lisette Schoonhoven; Janneke M de Man-van Ginkel

doi:10.1186/s12912-022-01099-3

How nurses support self-management of hospitalized patients through verbal communication: a qualitative study

BMC Nurs. 2022 Nov 28;21(1):329. doi: 10.1186/s12912-022-01099-3.

Authors

Caroline E M Otter¹, Joost C Keers², Celeste Reker², Jakobus Smit³, Lisette Schoonhoven^{4

5}, Janneke M de Man-van Ginkel^{4

6}

Affiliations

¹ Martini Hospital, Van Swietenlaan 1, Groningen, 9728 NT, The Netherlands. c.otter@mzh.nl.
² Martini Hospital, Van Swietenlaan 1, Groningen, 9728 NT, The Netherlands.
³ University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands.
⁴ Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, HP Str. 6.131, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
⁵ School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, University Road, Southampton, S017 1BJ, UK.
⁶ Academic Nursing, Department of Gerontology and Geriatrics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.

Abstract

Background: Patients' self-management of the implications of their disease(s) is becoming increasingly important. Research shows that hospitalization disrupts established self-management routines. Nurses can play an important role in supporting patients' self-management. The aim of this study is to describe how nurses support the self-management of hospitalized patients through verbal communication during routine nursing care.

Methods: A qualitative descriptive study, using overt, non-participant observations was conducted on three wards of a general teaching hospital in the Netherlands. A total of 215 hours of nursing work during 49 shifts was observed. Data was analyzed using thematic analysis based on the six phases of Braun and Clarke.

Results: Our observations showed that nurses discuss patients' self-management mainly in short conversations during the care provision. Nurses ask patients about their self-management at home and stimulate patients to express their opinions and to be involved in the care process. Three themes reflect how nurses support self-management: 'Discussing patient's self-management', 'Enhancing patient's involvement in care' and 'Focusing on patient's perspective'.

Conclusion: Hospital nurses have methods to support hospitalized patients' self-management but it does not seem to be an integral part of daily practice. Given current developments in healthcare, it is reasonable to argue that self-management should be given greater emphasis within the hospital setting, requiring a collaborative approach with patients and other healthcare professionals across the care continuum.

Keywords: Hospital; Hospitalized adolescent; Observation; Qualitative study; Self-care; Self-management; Self-management support; Verbal communication.