Adopting a learning pathway approach to patient partnership in telehealth: A proof of concept

Towards a New Integrated Model for Taking Into Account the Experiential Knowledge of People With Chronic Diseases, Integrating Mediation, Therapeutic Education and Partnership: The Expanded Chronic Care Patient-Professional Partnership Model

INTRODUCTION

The Chronic Care Model (CCM), the Expanded Chronic Care Model (ECCM) and the eHealth Enhanced Chronic Care Model (eCCM) focus on how healthcare teams and eHealth support can offer effective care and relevant solutions for patients facing chronic care conditions. However, they do not consider how patients can help these teams in their work, nor do they promote ways in which patients can help themselves. However, in the last decade, three different models have emerged that can complete our capacity to design and deliver integrated care for people with chronic diseases. In this article, we propose a revised version of the model that integrates the patient perspective and patients' experience-based knowledge. It integrates three different ways of engaging patients that complement the other patient engagement point of view: the experience of care and mediation in healthcare, therapeutic patient education and patient learning pathways, as well as patient-professional partnership.

METHODOLOGY

For each of the three models, we conducted a review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct and government reports on patient engagement and partnership with their healthcare providers, to integrate the different components of these models into the ECCM and eCCM. The goal is to create a model that better takes into account the experiential knowledge of patients and citizens throughout its different dimensions.

RESULTS

We identified 129 papers based on their framework, design, sample, measures and fit with patient engagement and chronic illness and added our own research when relevant. Integrating the three models provides an opportunity to amplify the role played by the patient perspective in the management of chronic disease. The Expanded Chronic Care Patient-Professional Partnership Model (E2C3PM) is intended to rebalance power relations between healthcare professionals and patients (and their caregivers). This new model is based on recognizing patients' experiential knowledge and their roles as caregivers and as full members of the care team. Integrating patient empowerment into the E2C3PM underscores the importance of coproduction care with patients at the clinical, organizational and system levels within a supportive environment.

CONCLUSION

Applying this new model should make it possible to better take into account the complexity of chronic diseases, improving the integration not only of care, services and eHealth support but also the various determinants of health and reaching a mutually beneficial settlement among all actors involved.

PATIENT OR PUBLIC CONTRIBUTION

A patient-researcher contributed to the development of the protocol, the data collection and the preparation and writing of this manuscript.

Patient Learning Pathway: Identifying Patient Competencies in Teledermatology for Effective Management of Dermatological Conditions

BACKGROUND

Dermatology consultations in Québec, Canada, face accessibility challenges, with most dermatologists concentrated in urban areas. Teledermatology, offering remote diagnosis and treatment, holds promise in overcoming these limitations. However, concerns regarding patient-doctor relationships and logistical issues exist.

OBJECTIVES

This article aims to introduce a dermatology patient learning pathway (PLP) developed by the Centre of Excellence on Partnership with Patients and the Public (CEPPP), focusing on knowledge, abilities, and skills mobilized by patients and their loved ones at key moments of the life course with an illness, as well as emerging educational needs.

METHODS

The PLP development was co-developed with dermatology patient and caregiver partners, stakeholders, and the CEPPP team. The process encompassed stakeholder engagement, exploration, recruitment of patient and caregiver partners, co-development of the PLP draft, and validation through consensus building.

RESULTS

The PLP methodology led to the creation of 44 learning objectives, comprising a total of 107 subobjectives. These objectives were organized into 8 phases of the patient life course with a dermatological condition: (1) prevention and predisposition; (2) discovery, self-examination, or observation of a change; (3) first consultation; (4) wandering; (5) consultation with a dermatologist; (6) diagnosis; (7) treatments; and (8) living with it.

CONCLUSIONS

The dermatology PLP serves as a resource outlining patient competency across different stages of managing a dermatological condition throughout their life course. In the context of teledermatology, the PLP might facilitate patient and caregiver engagement by helping select appropriate information and tools to support active participation in care.

"In My Mind, It Was Just Temporary": A Qualitative Study of the Impacts of Cancer on Men and Their Strategies to Cope

Individuals who are diagnosed and treated for cancer use a variety of strategies to manage its impacts. However, there is currently a lack of research on men's experience with managing cancer impacts, which is necessary to better support them throughout the cancer care continuum. This study explored the experience of men diagnosed with cancer, focusing on the impacts of the illness and its treatment and men's strategies to cope. A qualitative descriptive design was used. Thirty-one men (Mage = 52.7 [26-82] years) diagnosed with various cancer types were recruited to take part in individual telephone interviews (n = 14) or online focus groups (n = 17) addressing the impacts of cancer and strategies they used to cope with these impacts. Directed content analysis was performed, using Fitch's (2008) supportive care framework to guide the analysis. Cancer impacts and strategies used to cope were classified into six categories: physical, psychological, interpersonal, informational, practical, and spiritual. Results indicate that the cancer experience is diverse and multifaceted rather than homogeneous. Medical and supportive care services could be more effectively personalized to meet the diversity of men's needs by adopting a comprehensive and holistic approach to supportive care. Working in partnership with patients, it appears promising to recognize and identify men's needs and match them to appropriate resources to provide truly supportive care.