Experiences of multi-ill elderly patients with user participation in hospital discharge : Is co-production an unattainable ideal? ; Multisyke eldre pasienters erfaringer med brukermedvirkning ved utskrivning fra sykehus: Er samproduksjon et uoppnåelig ideal?

The subject of this article is multi-ill elderly patients’ experiences with the possibilities for good participation processes when being discharged from the hospital. The backdrop is the political guidance that user participation should take place as co-production, where healthcare personnel and patients actively use each other’s resources. Several studies show challenges in practice. To find effective approaches, there is a need for increased knowledge concerning the patients’ perspectives in transitions between healthcare services. Based on qualitative interviews with fifteen elderly patients, who have been urgently admitted to the hospital, the study examined how the patients experience the conditions for co-production in hospital discharge. The results show several tensions between patient-centred goals and organizational frameworks. Among other things, central prerequisites for user participation are not present, and the patients are given very little opportunity to participate actively: They are given insufficient information, previous experiences and patient expertise create differences, and their relatives are little taken care of as a resource ; Temaet for denne artikkelen er multisyke eldre pasienters erfaringer og opplevelser med mulighetene for gode medvirkningsprosesser ved utskrivning fra sykehus. Bakteppet er de politiske føringene om at brukermedvirkning i dag skal foregå som samproduksjon, der helsepersonell og pasienter aktivt anvender hverandres ressurser. Flere studier viser utfordringer i praksis, og at det er behov for mer kunnskap om pasientperspektivet i overganger mellom helsetjenester for å kunne finne effektive tilnærminger. Basert på en kvalitativ intervjuundersøkelse med femten eldre pasienter, som har hatt bruk for akutt helsehjelp på sykehus, undersøkes hvordan de erfarer betingelsene for samproduksjon. Resultatene viser flere spenninger mellom pasientsentrerte mål og organisatoriske rammer. Funnene viser blant annet at sentrale forutsetninger for brukermedvirkning ikke er til ...