Patient’s Participation in Nursing Care: an Integration of Orems Theory to the Nursing Process at Two Public Hospitals in Kenya

Patient participation in health care is regarded as a primary condition for quality care. However the traditional paternalistic perception among the health care workers is a major barrier to patient participation and non-involvement in their own care. This was a quasi-experimental study that was carried out from March 2013 to July 2015 in two public hospitals in Kenya. It aimed at establishing whether training of nurses on the nursing process and also its integration with Orem's theory, would improve patients participation in nursing care. Data was collected during the pre-test and post-test from the nurses and the patients they were nursing to determine level of patient involvement in care. Analysis was performed by use of computer software statistical package for social scientists (SPSS version 22). Descriptive statistics was used to summarize the quantitative data while to determine the difference between pre-test and post-test, Chi square test was used (p<0.05). Study findings revealed that during pretest 80.1% (n=117) of the nurses agreed that patients should be involved in decision making. The post-test findings showed a higher percentage w i t h (92.9%) agreeing that patients should be involved in decision making regarding their care and 76.2% (n=96) reporting that they involved patients in decision making. Achi-square test used to determine the relationship between the pretest and posttest outcomes showed a significant difference (p<0.05). Significant difference (p<0.05) was also found on whether nurses involved patients in clinical decision making. From the patient perspective during the pretest 51.9% (n=138) reported that they were involved in the decisions about the care and during post-test, 75.9% (n=198) reported involvement which was statistically significant (p>0.05). On the integration of theory to the nursing process the findings showed that there was significant difference (p<0.05) in the experimental group (Kiambu) on whether nurses enquired about patient perspectives in care and their perspectives on patient involvement in decision making while there was no significant difference (P>0.05) in control group (Thika). The study concluded that inclusion of nursing theory to the nursing process improved the level of patient participation in their own care Therefore the nursing management should establish policies to incorporate nursing theory to the nursing process to improve patient involvement in their care which is key to the provision of quality nursing care.