Patient Participation in Nursing Handover in a Coronary Intensive Care Unit: A Qualitative Study.

AIM: To explore the perceptions of patients and nursing professionals regarding patient participation in nursing handover in a coronary intensive care unit.

DESIGN

An exploratory qualitative study grounded in patient-centered care and informed by the continuum of patient engagement.

METHODS

The study was conducted in a coronary intensive care unit of a hospital in Rio de Janeiro, Brazil. Participants were 22 nursing professionals and 16 hospitalized patients. Data were collected between October 2023 and May 2024 through individual semi-structured interviews and analysed using inductive thematic content analysis. The study was reported according to the COREQ checklist.

RESULTS

Nursing professionals recognized that patient participation in handover could improve communication and patient safety by allowing patients to clarify, correct, or complement information about their care. However, they also expressed concerns regarding confidentiality, privacy, emotional burden, technical language, increased handover duration, and patients' clinical or cognitive conditions. Although patients valued receiving information and opportunities to communicate with professionals, many did not perceive themselves as legitimate participants in the handover process and preferred a passive role unless explicitly invited to contribute.

CONCLUSIONS

Bedside handover alone does not ensure meaningful patient participation. Transitioning from bedside to participatory handover requires organizational readiness, effective communication strategies, and flexible approaches that respect patients' preferences, clinical condition, health literacy, and willingness to participate. Rather than a universal intervention, participatory handover should be implemented as an individualized opportunity to strengthen communication and patient-centred care.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare organizations seeking to implement participatory nursing handover should combine staff training, structured communication processes, plain-language communication, explicit invitations to patients, and privacy safeguards. These strategies may facilitate the transition from professionally centred bedside communication to collaborative, patient-centred handover while maintaining patient safety.

IMPACT: This study distinguishes bedside handover from participatory handover by demonstrating that patients' presence during bedside communication does not necessarily translate into meaningful engagement. The findings highlight organizational, cultural, and communication factors that should guide the implementation of participatory handover in intensive care settings.

REPORTING METHOD: The study report was guided by the COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. Patients participated as research participants but were not involved in study design, conduct, analysis, interpretation, or manuscript preparation.