A model of patient participation with chronic disease in nursing care

Chronic diseases are one of the greatest challenges that health systems facing with them today. Recently, patient participation is considered as a key element in chronic care models. However, there are few studies about participation of patients with chronic disease in caring activities. The aim of this study was to identify the factors, which are relevant to patient participation and the nature of participation in caring activities. A qualitative approach with a basic theory method was used in this study. 22 persons including 9 patients, 8 nurses, and 5 family members were recruited using purposeful and theoretical sampling in three hospitals affiliated with Iran University of Medical Sciences. Data were collected with semi-structured interview and participant observation. Constant comparison was used for data analysis. Findings of this study indicated that participation of patients with chronic disease in nursing care is a dynamic and interactive concept that occurs between nurse, patient and family member in a care-servicing system. The core theme of this study was "convergence of caring agents" that included four categories: adhering, involving, sharing and true participation. This study suggests a pyramid model for explaining patient participation. Participation occurs in different levels, which depends on the factors related to caring agents.