Perceptions of relevance and sufficiency of information: a qualitative multiple-case study of information exchange between inpatients and nurses in acute general ward settings

Objective
To explore the relevance and sufficiency of information exchanged by inpatients and nurses in surgical and medical ward settings.

Methods
A multiple-case study design was used. Each case comprised one patient, the nurses interacting with that patient, and the interactions between them. Interactions were observed and audio-recorded remotely. Individual interviews with patients and nurses followed, and were related to, the observations.

Results
There were 19 cases, comprising 19 patients, 22 nurses and 47 interactions. The longest interaction was 24 minutes and 33 seconds and the shortest was 10 seconds. Patients described information as being relevant for their wellbeing, involvement in their treatment and care, and for socialisation. Nurses described information as relevant for patient assessment and as an ethical obligation. Sufficiency of information, as perceived by participants, was explained by: having no more questions; ongoing information sharing; good patient/nurse relationships; and, the use of lay terms. However, the observation data suggest that information exchanged by patients and nurses was insufficient, due to withholding information, paternalistic practice and lost opportunities.

Conclusion
Patients’ wellbeing, and their involvement in treatment and care, may be detrimentally affected if personally relevant information is not exchanged due to assumptions being made. Actively encouraging patient contribution in healthcare interactions, and assessing their preferences for information, may help nurses tailor information to patients’ needs. Sufficiency of information, as perceived by participants, depends on the criteria applied. Patients report sufficiency of information, however, held up against contemporary models of information exchange, sufficiency may be lacking. A rethink of the fit of contemporary models to ward-based nursing practice is required. Policymakers should target policies on shared decision-making and information exchange across a range of different healthcare environments.