Background Heart failure is a chronic condition that affects patients’ life situation. Living with heart failure puts high demands on self-care and patient participation. Patients often need advanced care due to deterioration of their heart failure symptoms, and one option is homecare. Prerequisites for participation may differ when receiving home-care.
Objective The aim of this study was to identify and describe participation in care encounters during home visits in heart failure home-care.
Participants and setting Seventeen patients diagnosed with heart failure, aged 63-95 years, and ten registered nurses participated. The patients received home-care from three different home-care providers in Sweden.
Methods Data from nineteen home visits was collected through observations and documented by video-recordings. The verbal communication in these video-recordings was transcribed verbatim and complemented with non-verbal communication. Data was analysed using qualitative content analysis, and the video-recordings and transcribed material were analysed in parallel.
Results We identified two themes with three and four categories respectively; (a) Participation in the care encounter is made possible by interaction, including exchange of care-related information, care-related reasoning, and collaboration, and (b) Participation in the care encounter is made possible by an enabling approach, including the patient expresses their own wishes and shows an active interest, and the nurse is committed and invites to a dialogue.
Conclusion Our findings underline that patient participation is multifaceted and that the home-care context shows good potential for patient participation as the care encounters were categorised by interaction and an enabling approach.