Patient Participation for Frail Older Persons and Their Next of Kin in Hospital Care—A Scoping Review

Abstract

Aim

To map and summarise research literature describing patient participation in hospital care for frail older persons and their next of kin.

Background

Patient participation refers to the active involvement of patients in healthcare decision-making processes. An aging population and increased life expectancy have led to a growing number of older adults requiring hospital care, and engaging older patients in decision-making can be challenging due to the complexities of their health conditions. Thus, there is a need to deepen our understanding of patient participation, concerning frail older persons and their next of kin.

Design

Scoping review.

Methods

A systematic search was conducted across four databases. Abstracts and titles were evaluated for relevance according to predetermined inclusion criteria. A total of 140 studies were read in full text, and 17 quality-appraised studies were selected for analysis.

Results

Five instruments for measuring participation were identified. Patient participation was mainly characterised as being informed, understanding provided information, conducting good communication and being given the opportunity to make decisions. Patients could adopt different participation strategies. Next of kin participation is characterised as being informed, communicating with healthcare staff and being involved in decision-making. Conditions facilitating participation are dependent on healthcare staff, environmental conditions and written information. Barriers to participation stem from staff attitudes, their lack of availability and approachability, unsatisfactory communication, patient shortcomings, substandard continuity of care, organisational routines and unsatisfactory physical environments.

Conclusion

Older persons and their next of kin have reasonable demands for them to experience participation. Therefore, it should not be difficult for healthcare staff to meet patient expectations by ensuring patients and their next of kin receive understandable information and are given the opportunity to make their own decisions, and for organisations to create a climate where staff are available, approachable and empathetic so patients feel that they are participating in the planning and delivery of their care—in summary, to keep them in the loop.