Potilaiden hoitoon osallistuminen psykiatrisessa sairaalassa – potilasvahinkoilmoitusten dokumenttianalyysi

Patient participation in their own care is an essential part of patient safety and quality of care. This study examined patient participation in psychiatric hospital care. The data consisted of patient injury notices submitted to the Patient Insurance Centre between 2010 and 2021 (n=81) and decisions made by the Patient Insurance Centre. The research method was document analysis, and the data was analysed using a combination of inductive content analysis and thematisation as suitable for document analysis. According to the results, participation in care in patient injury notices was related to communication, decision-making, and limitations on activities and opportunities. Communication appeared to be a challenge in interaction, and patients did not feel that they had been heard or had received appropriate information about their care. There were obstacles to participating in the decision-making regarding one’s own care planning. On the other hand, patients also hoped that the nursing staff would take responsibility for decision-making when the patient was unable to make decisions due to their illness. Restrictions on activities or opportunities were linked to various restrictive measures and patients' descriptions of power relations in which patients were not treated equally. A quantitative overview of the data highlighted content of medication, involuntary treatment, inappropriate treatment, and somatic illness as issues related to participation in care. Of the decisions made by the Patient Insurance Centre on notices of patient injury, 95% (n=77) were negative and 5% (n=4) were positive. There has been limited research on patient participation in psychiatric hospital care, and patient injury notices have not previously been utilised in research on patient participation. The results can be used to develop the participation of patients in psychiatric hospital care and thus also strengthen patient safety. Attention should be paid to treating patients with respect and interacting with them on an equal footing without power dynamics, as well as enabling patient participation by listening, taking the patient's opinion into account, providing information, and motivating the patient to participate in decision-making. Further research is needed on the issues that promote patient participation in psychiatric hospital care, from the perspective of both patients and healthcare professionals.