Thai oncology nurses' perceptions of patient participation in acute cancer care

PURPOSE: Patient participation in care is considered a core component of high quality nursing care and medical treatment. In the context of cancer care in Thailand, we know very little about the way patient participation in care is perceived and enacted. The aim of this study was to explore Thai oncology nurses' perceptions and understandings of patient participation in their own care during hospitalization. METHOD: A qualitative descriptive research approach using focus groups was applied. Two focus group interviews (N=16) were conducted with registered nurses who provide care in oncology units of one tertiary care university hospital in Bangkok, Thailand. The transcribed interviews were analyzed using qualitative content analysis. RESULTS: In this study, nurses were aware of the value of patient participation during hospitalization but acknowledged that current processes to involve patients in their care were not as effective as they could be. Facilitating participation is seen as a means of supporting patients to make decisions independently that are in line with their treatment plans, in particular, decisions related to self-care and illness related symptoms. This raises the potential for conflict when patients make choices that are contrary to recommendations. Barriers to facilitating participation identified were high clinician workloads and lack of time, and ambiguity of existing guidelines for supporting lifestyle decisions. CONCLUSIONS: Facilitating patient participation is complex in acute cancer care. Patient participation is recognized by nurses as a positive way of promoting independence in patients. However, balancing patient autonomy with nurses' perceived professional responsibilities is challenging in practice.