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Exploring participation: older people on discharge from hospital


 Kathryn Roberts, Centre for Health Research and Evaluation, Edge Hill, Ormskirk, Lancashire L39 4QP, UK. E-mail:


Background and aim.  User participation has been a widely researched and debated phenomenon in the formulation and implementation of health and social care policy and indeed wider public sector policy in the United Kingdom (UK), yet there remains a vast array of definitions of the term and great variety in the findings of empirical studies. The aim of this paper is to discuss the main findings of an empirical study in order to build upon existing evidence and interpretation relating to user participation in health and social care.

Method.  The study reported here was carried out in the UK and explored the extent to which older people were able and willing to assume an active role in the process of using health and social care. Hospital discharge and the period shortly afterwards was the process under investigation. This study used a multi-method approach incorporating both quantitative and qualitative approaches; data from 260 questionnaires and 30 interviews were included.

Findings.  The majority of respondents felt that they had been involved in decisions regarding their discharge from hospital. All welcomed advice from professionals and some preferred service providers to make decisions on their behalf.

Discussion.  Arnstein's ladder of citizen participation is drawn upon in analysing the findings and notions of ‘partnership’, ‘relationship’, ‘communication’ and ‘paternalism’ are discussed.