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Norwegian Healthcare Professionals' Perceptions of Patient Knowledge and Involvement as Basis for Decision Making in Hematology

Frode Heldal
Aslak Steinsbekk
ONF 2009, 36(2), E93-E98 DOI: 10.1188/09.ONF.E93-E98

Purpose/Objectives: To investigate how healthcare professionals relate to patients with different levels of knowledge and involvement in their disease and treatment.

Design: Qualitative, exploratory approach based on semi-structured interviews.

Setting: A hematologic outpatient clinic in Norway.

Sample: 5 nurses and 5 doctors.

Methods: Semistructured interviews were conducted, recorded on audiotape, transcribed, and analyzed with qualitative techniques.

Main Research Variables: Patient knowledge, patient involvement, and decision making.

Findings: Study participants perceived that they had stable, basic relationships with patients and were flexible toward patients with different levels of knowledge and involvement. Healthcare professionals grouped patients into four behavior types: passive, withdrawn, uncooperative, and expert. The perceived behaviors formed the basis for relationships involving shared or nonshared decision making.

Conclusions: Patients' perceived propensity in mastering medical knowledge affects how healthcare professionals involve them in decision making. Healthcare professionals' tendency to see relationships with patients as asymmetric and stable may inhibit patients' ability to involve themselves in their healthcare decisions.

Implications for Nursing: This study's findings can be used to raise awareness of how nurses' biases about patients influence shared decision making. Nurses should be aware of a tendency to exclude patients from decision making if they perceive that patients are incapable of involving themselves.

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