Promoting Patient Safety through Patient Involvement: A Qualitative Study of Nurses' Experiences and Perceptions

Main Article Content

Adeela Qayyum
Kiran Bashir
Sonia Rasheed
Farhana Fareed


Background: Spinal Cord Injury (SCI) presents a significant challenge to healthcare systems worldwide, often leading to severe physical disability and psychological distress, including depression. The rehabilitation process for SCI patients is complex, necessitating a multidimensional approach that addresses both the physical and psychological aspects of recovery. The interplay between occupational performance and mental health among individuals with SCI remains a critical area of investigation, particularly in regions like Peshawar, Pakistan, where such studies are scarce.

Objective: The primary objective of this study was to explore the association between occupational performance and depression among individuals with SCI in Peshawar, with a secondary aim of comparing occupational performance levels and their relationship with depression in this demographic.

Methods: A cross-sectional study was conducted at the Paraplegic Centre Peshawar over a six-month period, utilizing convenience sampling to recruit 120 participants. Depression and occupational performance were assessed using the Beck Depression Inventory and the Barthel Index Scale, respectively. Data analysis was performed using SPSS version 22, with statistical significance set at p<0.05.

Results: The study found that 35.8% of participants experienced moderate depression, while mild mood disturbances and borderline clinical depression were reported by 21.7% and 12%, respectively. Severe and extreme depression were less common, observed in 9.8% and 1.1% of the sample. Regarding occupational performance, 37% were totally dependent, 50% were severely dependent, and 13% were moderately independent. Statistical analysis revealed a significant association between occupational performance and depression levels (Pearson Chi-Square = 17.986, p=.05; Likelihood Ratio = 18.683, p=.04; Fisher Exact Test = 9.214, p=.002).

Conclusion: The study highlights a notable correlation between occupational performance and depression among SCI patients, emphasizing the need for integrated rehabilitation programs that address both physical disabilities and mental health concerns. Enhancing occupational performance through targeted interventions may reduce depression levels, thereby improving overall quality of life for SCI patients.

Article Details

How to Cite
Qayyum , A., Bashir, K., Rasheed, S., & Fareed, F. (2024). Promoting Patient Safety through Patient Involvement: A Qualitative Study of Nurses’ Experiences and Perceptions. Journal of Health and Rehabilitation Research, 4(1), 1307–1311.
Author Biographies

Adeela Qayyum , The Islamia University of Bahawalpur Pakistan.

Assistant Professor, MSc Nursing, Mphil Public Health, Generic Bsc Nursing, University College of Nursing, The Islamia University of Bahawalpur, Pakistan.

Kiran Bashir, Teaching Hospital Dera Ghazi Khan Pakistan.

Post RN, Specialization in Accidental & Emergency, Charge Nurse Trauma ICU, Teaching Hospital Dera Ghazi Khan, Pakistan.

Sonia Rasheed, Teaching Hospital Dera Ghazi Khan Pakistan.

Post RN, Accidental and Emergency Specialization, Charge Nurse in trauma ICU, Teaching Hospital Dera Ghazi Khan, Pakistan.

Farhana Fareed, Multan Institute of Kidney Diseases Multan Pakistan.

Mphil in Psychology, Post RN, General Nursing, Infection Control Nurse Manager, Multan Institute of Kidney Diseases Multan, Pakistan.


Entwistle VA, McCaughan D, Watt IS, Birks Y, Hall J, Peat M, et al. Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences. Quality and Safety in Health Care. 2010;19(6):e33-e.

Forsyth R, Maddock CA, Iedema RA, Lassere M. Patient perceptions of carrying their own health information: approaches towards responsibility and playing an active role in their own health–implications for a patient‐held health file. Health Expectations. 2010;13(4):416-26.

Schwappach DL, Hochreutener M-A, Wernli M, editors. Oncology nurses' perceptions about involving patients in the prevention of chemotherapy administration errors. Oncology nursing forum; 2010: Oncology Nursing Society.

Sarfo JO, Ocloo JEY, Ansah EW, Amoadu M. Safety culture and patient safety outcomes in developing countries: A narrative review. Integrated Health Research Journal. 2023;1(2):43-53.

Jerofke‐Owen TA, Tobiano G, Eldh AC. Patient engagement, involvement, or participation—entrapping concepts in nurse‐patient interactions: A critical discussion. Nursing inquiry. 2023;30(1):e12513.

Joseph-Williams N, Elwyn G, Edwards A. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient education and counseling. 2014;94(3):291-309.

Kenward L, Whiffin C, Spalek B. Feeling unsafe in the healthcare setting: patients' perspectives. British Journal of Nursing. 2017;26(3):143-9.

Murray JS, Clifford J, Larson S, Lee JK, Sculli GL. Implementing just culture to improve patient safety. Military Medicine. 2023;188(7-8):1596-9.

Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88.

Iedema R, Allen S, Britton K, Gallagher TH. What do patients and relatives know about problems and failures in care? BMJ quality & safety. 2012;21(3):198-205.

Gaffney TA, Hatcher BJ, Milligan R. Nurses' role in medical error recovery: an integrative review. Journal of clinical nursing. 2016;25(7-8):906-17.

Gonzalez M, Ogourtsova T, Zerbo A, Lalonde C, Spurway A, Gavin F, et al. Patient engagement in a national research network: barriers, facilitators, and impacts. Research Involvement and Engagement. 2023;9(1):7.

Davis R, Briggs M, Arora S, Moss R, Schwappach D. Predictors of health care professionals' attitudes towards involvement in safety‐relevant behaviours. Journal of Evaluation in Clinical practice. 2014;20(1):12-9.

Eijkelboom C, Brouwers M, Frenkel J, van Gurp P, Jaarsma D, de Jonge R, et al. Twelve tips for patient involvement in health professions education. Patient Education and Counseling. 2023;106:92-7.

Eldh AC, Ehnfors M, Ekman I. The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure. European Journal of Cardiovascular Nursing. 2006;5(1):45-53.

Eldh AC, Ekman I, Ehnfors M. A comparison of the concept of patient participation and patients' descriptions as related to healthcare definitions. International journal of nursing terminologies and classifications. 2010;21(1):21-32.

Agbar F, Zhang S, Wu Y, Mustafa M. Effect of patient safety education interventions on patient safety culture of health care professionals: Systematic review and meta-analysis. Nurse Education in Practice. 2023;67:103565.

Bennett-Weston A, Gay S, Anderson ES. A theoretical systematic review of patient involvement in health and social care education. Advances in Health Sciences Education. 2023;28(1):279-304.

Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. BMJ quality & safety. 2014;23(7):548-55.

Davis RE, Sevdalis N, Jacklin R, Vincent CA. An examination of opportunities for the active patient in improving patient safety. Journal of Patient Safety. 2012;8(1):36-43.

Ekdahl AW, Hellström I, Andersson L, Friedrichsen M. Too complex and time-consuming to fit in! Physicians' experiences of elderly patients and their participation in medical decision making: a grounded theory study. BMJ open. 2012;2(3):e001063.