Patienten och ronden. : Patienters upplevelse av rondarbetet

Sammanfattning:

Background: Despite being a central routine in hospitals worldwide the ward round hasnot been studied well, nor mentioned thoroughly in text books. Traditionally the wardround means that the responsible staff goes through the patients’ health status on theirown and thereafter meet the patient to update status, confirm diagnosis, adjust treatmentand predict prognosis. The ward round in its current form has been found to beproblematic: lack of integrity and lack of effective communication being the biggestissues. On several places there has been attempts to improve the ward round,höglandssjukhuset in Eksjö being the most prominent example. This study aims toexamine the patients’ experience of the ward round.Methods: Two individual interviews and one group interview were conducted among atotal of six patients in the ages from 52 to 91, all with experience of traditional wardrounds from höglandssjukhuset in Eksjö during January 2014. The interviews weretranscribed and analyzed using a phenomenological qualitative approach.Results: The main finding in the interviews were that the most important part of a wardround for the patients is a well-functioning communication with the doctor. The patientsdescribed the existence of honest questions during the ward round as a benchmark forthe quality of the communication. Four factors were identified as underlying causes fora well-functioning communication: Equality between doctor and patient, comprehensionof the ward round routines, enough time, and a preserved integrity of the patient.Discussion and conclusion: The social psychological concepts of social responsivity andpower were used to analyze and explain the findings. Suggestions were made to thetraditional ward round to change the routines to make the staff more equal to the patient,increase the knowledge of the patient about the routines, increase the time spent onevery patient and secure the integrity of the patient during the ward round.The findings from this study will be a part of a bigger research project about the wardround that also will be used in an improvement work about the ward round inHöglandssjukhuset in Eksjö and in the region of Jönköpings län.