The Influence of Nurses' Demographics on Patient Participation in Hospitals: A Cross-Sectional Study

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Patient participation is an important issue in contemporary healthcare as it improves quality of care and enhances positive health outcomes. The participation of patients is mainly initiated by the nurses' willingness to share their power and responsibility, but knowledge on nurses' demographic characteristics influencing this behavior is nonexistent. This knowledge is essential to understand and improve patient participation.


To determine if nurses' demographic characteristics influence their willingness to engage in patient participation.


A cross-sectional multicenter study in 22 general and three university hospitals with 997 nurses was performed. The Patient Participation Culture Tool for healthcare workers, which measures patient participation behavior, was used. Multilevel analysis, taking into account the difference in wards and hospitals, was used to identify the influence of demographic characteristics.


A position as supervisor (range: p < .001–.028) and a higher level of education (range: p = <.001–.012) show significant higher scores. Younger nurses seem to be more reluctant in accepting a collaborative patient role (p = .002) and coping with more active patient behavior (p < .001). This new role was less accepted by nurses on geriatric wards (p = .013), who also showed less sharing of information with their patients (p < .001).

Linking Evidence to Action:

Age and level of education influence nurses' willingness to share power and responsibility with their patients, perhaps indicating that patient participation behavior is an advanced nursing skill and multifaceted interventions, are needed for optimal implementation. Moreover, supervising nurses have different perceptions on patient participation and possibly regard patient participation as an easier task than their team members. This could lead to misunderstandings about the expectations toward patient participation in daily practice, leading to struggles with their nursing staff. Both findings implicate that implementing patient participation on a wide scale is more difficult than expected, which is conflicting with the widespread societal demand for more participation.

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