Patient Behaviors A Grounded Theory Typology
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Abstract
This classic grounded theory study uncovered both a basic social process theory and an emerging typology of patients based upon their behavior as they react and adapt to the healthcare environment. The theory emerged in the context of care of 32 hospitalized patients and their interactions and relationships with interprofessional healthcare teams. The patients’ main concerns were to constantly ensure protection of their own personhood in order to receive optimal care. When striving for optimal care, patients can develop specific types of behaviors to the respective healthcare environment and in response to healthcare professionals' attitudes and behaviors towards patient expectations. Patients tend to exhibit one of three types of behavior, thus a typology of these behaviors emerged: propitiation, vigilance, and confidence. Types of patient behaviors are differentiated by their position on the control continuum, their level of trust in healthcare professionals and their past experiences. The typology of behaviors has the power to show patients’ levels of empowerment and the way they are engaged in their own optimal and humanized care.
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References
Abelson, J., Canfield, C., Leslie, M., Levasseur, M. A., Rowland, P., Tripp, L., Vanstone, M., Panday, J., Cameron, D., Forest, P.-G., Sussman, D., & Wilson, G. (2022). Understanding patient partnership in health systems: Lessons from the Canadian patient partner survey. BMJ Open, 12(9), e061465. https://doi.org/10.1136/bmjopen-2022-061465
ANA. (2015). Code of ethics for nurses with interpretive statements. http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html
Buber, M. (1965). The knowledge of man: A philosophy of the Interhuman (M. Friednam & R. G. Smith, Trans.; M. Friedman, Ed.). Harper & Row.
Didier, A., Dzemaili, S., Perrenoud, B., Campbell, J., Gachoud, D., Serex, M., Staffoni-Donadini, L., Franco, L., Benaroyo, L., & Maya, Z.-S. (2020). Patients’ perspectives on interprofessional collaboration between health care professionals during hospitalization: A qualitative systematic review. JBI Evidence Synthesis, 18(6), 1208-1270. https://doi.org/10.11124/jbisrir-d-19-00121
Didier, A., Nathaniel, A. K., Scott, H., Look, S., Benaroyo, L., & Zumsteint-Shaha, M. (2024). Protecting personhood: A classic grounded theory. Grounded Theory Review, 23(1). View of Vol. 23 No. 1 (2024) (groundedtheoryreview.org). (Reprinted from Protecting personhood: A classic grounded theory. Qualitative Health Research, 33(13). 1973. https://doi.org/10.1177/10497323231190329)
Donalson, S.K., & Crowley, D.M. (1978). The discipline of nursing. Nursing Outlook, 26, 113-120.
Federal Assembly of the Swiss Confederation. (2014). Federal act on reserach involving human beings. Federal office of Public health.
Federal Assembly of the Swiss Confederation. (2024). Human Research Ordinance. Federal office of Public health.
Frank, A. W. (2013). From sick role to practices of health and illness. Medical education, 47(1), 18-25.
Glaser, B. G. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Sociology Press.
Glaser, B. G. (1998). Doing grounded theory: Issues and discussion. Sociology Press.
Glaser, B. G., & Strauss, A. L. (1965). Awareness of dying. Aldine Publishing.
Grocott, A., & McSherry, W. (2018). The patient experience: Informing practice through identification of meaningful communication from the patient's perspective. Healthcare (Basel), 6(1). https://doi.org/10.3390/healthcare6010026
Groves, P. S., Bunch, J. L., & Kuehnle, F. (2023). Increasing a patient's sense of security in the hospital: A theory of trust and nursing action. Nursing Inquiry, 30(4), e12569. https://doi.org/https://doi.org/10.1111/nin.12569
Holmström, I., & Röing, M. (2010). The relation between patient-centeredness and patient empowerment: A discussion on concepts. Patient Education and Counseling, 79(2), 167-172. https://doi.org/https://doi.org/10.1016/j.pec.2009.08.008
Hovey, R. B., Dvorak, M. L., Burton, T., Worsham, S., Padilla, J., Hatlie, M. J., & Morck, A. C. (2011). Patient safety: A Consumer’s perspective. Qualitative Health Research, 21(5), 662-672. https://doi.org/10.1177/1049732311399779
ICN. (2021). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/2023-06/ICN_Code-of-Ethics_EN_Web.pdf
International Federation of Social Workers. (2018). Global social work statement of ethical principles. https://www.ifsw.org/global-social-work-statement-of-ethical-principles/
International Federation of Sports Physical Therapists. (2014). https://ifspt.org/code-of-ethics/#:~:text=IFSPT%20Code%20of%20Ethics&text=respect%20the%20rights%20and%20dignity,competent%20and%20accountable%20professional%20services
Jadad, A. R., Rizo, C. A., & Enkin, M. W. (2003). I am a good patient, believe it or not. BMJ Open, 326(7402), 1293-1295. https://doi.org/10.1136/bmj.326.7402.1293
Khalil, D. D. (2009). Nurses' attitude towards ‘difficult’and ‘good’patients in eight public hospitals. International Journal of Nursing Practice, 15(5), 437-443.
Martin, G. P., & Finn, R. (2011). Patients as team members: Opportunities, challenges and paradoxes of including patients in multi-professional healthcare teams. Sociology of Health & Illness, 33(7), 1050-1065. https://doi.org/https://doi.org/10.1111/j.1467-9566.2011.01356.x
Mayeroff, M. (1971). On caring. Harper & Row.
Michaelsen, J. J. (2021). The 'difficult patient' phenomenon in home nursing and 'self-inflicted' illness. Scandinavian Journal of Caring Sciences, 35(3), 761-768. https://doi.org/https://doi.org/10.1111/scs.12890
Milton, D. (2004). Talcott Parsons and the Theory of the ‘Sick Role’. Kent Academic Repository. KAR id:62743
Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3). https://doi.org/10.3390/ijerph17030835
Nursing & Midwifery Council. (2015). The code: Professional standards of practice and behavior for nurses, midwives, and nursing associates. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
Parsons, T. (1975). The sick role and the role of the physician reconsidered. The Milbank Memorial Fund Quarterly. Health and Society, 257-278.
Sasso, L., Stievano, A., Jurado, M.A., Rocco, G. (2008). Code of ethics and conuct for European nursing. Nursing Ethics, 15(6), 821-836. https://doi.org/10.1177/0969733008095390
Swanson, K. M. (1991). Empirical development of a middle range theory of caring. Nursing Research, 40(3), 161-166. http://nursing.unc.edu/files/2012/11/ccm3_032548.pdf
Vanstone, M., Canfield, C., Evans, C., Leslie, M., Levasseur, M. A., MacNeil, M., Pahwa, M., Panday, J., Rowland, P., Taneja, S., Tripp, L., You, J., & Abelson, J. (2023). Towards conceptualizing patients as partners in health systems: A systematic review and descriptive synthesis. Health Research Policy and Systems, 21(1), 12. https://doi.org/10.1186/s12961-022-00954-8
Watson, J. (1988). Nursing: Human science and human care. National League for Nursing.
Watson, J. (2002). Intentionality and caring-healing consciousness: A practice of transpersonal nursing. Holistic Nursing Practice, 16(4), 12-19. http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=12060941&site=ehost-live
Watson, J. (2018). Unitery caring science: Philosophy and praxis of nursing. Uniersity Press of Colorado.
WHO. (2017). Patient safety: Making health care safer. https://apps.who.int/iris/handle/10665/255507
World Medical Association. (2022). WMA International Code of Medical Ethics. https://www.wma.net/policies-post/wma-international-code-of-medical-ethics/
World Physiotherapy. (2022). Ethical principles and the responsibilities of physiotherapists and member organizations. https://world.physio/sites/default/files/2022-03/PS-2022-Ethical_responsibilities_principles_Eng.pdf