Patient involvement climate: views and behaviours among registered nurses in myocardial infarction care.

Aims And Objectives: To introduce and define the patient involvement climate and measure its quality and strength via views and behaviours among nurses in coronary care units.

Background: Patient involvement is receiving increased attention among healthcare providers. To better understand and optimise the interpersonal dynamics of patient involvement, it is important to study the organisational context in which the patient-provider interaction occurs.

Design: Cross-sectional, self-report questionnaire study.

Methods: Registered nurses across 12 coronary care units (n = 303) completed a questionnaire reporting their views and behaviours regarding patient involvement. Analyses assessed climate quality (the positive or negative nature of nurses' perceptions) and climate strength (the degree of consensus within coronary care units).

Results: Climate quality and strength were greatest for the dimensions measuring nurses' views of patient involvement, the nurse-patient information exchange process and nurses' responsiveness to patient needs. Climate quality and strength were weaker for the dimensions measuring nurses' views of the hindrances associated with patient involvement, discussion of daily activities and efforts to motivate patients to take responsibility for their health. In units with consensus that patient involvement poses hindrances, nurses were less likely to address patient needs.

Conclusions: When nurses perceived patient involvement as less of a hindrance in their work, they were more responsive to patient needs. A patient involvement climate characterised by motivational behaviour among nurses was marked by better information exchange and discussion of suitable activities postdischarge.

Relevance To Clinical Practice: Managers can capitalise on positive climate aspects by encouraging ward activities that facilitate active patient involvement among nurses. One suggestion is educational interventions at the workplace focused on reducing perceptions of patient involvement as a hindrance and encouraging the attitudes that it can enrich nursing work and patient outcomes.