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Patient participation as a nursing philosophy and practice has grown in popularity. Research studies have reported the possible positive effects of involving patients in their health and care, while investigations interested in the meaning of participation have tended to concentrate upon the patient's perspective. However, little research has focused upon the practitioner's understanding of the concept or its execution. The aim of this ethnographic study was to uncover the perceptions of primary nurses towards the notion of patient participation, and represents early explorative work within a larger project devoted to discharge decision making. A group discussion was led by the author with four primary nurses working within a rehabilitation unit for elderly people. The data were subjected to a content analysis and two central themes or principles emerged. First, participation was regarded as having both a formal and informal meaning as well as a formal and dormal method or practice, and secondly, it was seen to involve mutual informing or negotiation between patient and nurse. Both these principles were regarded as closely linked to the concepts of nurse-patient closeness and patient individuality.