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Dubois H, Manser T, Häbel H, Härgestam M, Creutzfeldt J. Exploring differences in patient participation in simulated emergency cases in co-located and distributed rural emergency teams - an observational study with a randomized cross-over design. BMC Emerg Med 2024; 24:118. [PMID: 39009973 PMCID: PMC11247836 DOI: 10.1186/s12873-024-01037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND In northern rural Sweden, telemedicine is used to improve access to healthcare and to provide patient-centered care. In emergency care during on-call hours, video-conference systems are used to connect the physicians to the rest of the team - creating 'distributed teams'. Patient participation is a core competency for healthcare professionals. Knowledge about how distributed teamwork affects patient participation is missing. The aim was to investigate if and how teamwork affecting patient participation, as well as clinicians' perceptions regarding shared decision-making differ between co-located and distributed emergency teams. METHODS In an observational study with a randomized cross-over design, healthcare professionals (n = 51) participated in authentic teams (n = 17) in two scripted simulated emergency scenarios with a standardized patient: one as a co-located team and the other as a distributed team. Team performances were filmed and observed by independent raters using the PIC-ET tool to rate patient participation behavior. The participants individually filled out the Dyadic OPTION questionnaire after the respective scenarios to measure perceptions of shared decision-making. Scores in both instruments were translated to percentage of a maximum score. The observational data between the two settings were compared using linear mixed-effects regression models and the self-reported questionnaire data were compared using one-way ANOVA. Neither the participants nor the observers were blinded to the allocations. RESULTS A significant difference in observer rated overall patient participation behavior was found, mean 51.1 (± 11.5) % for the co-located teams vs 44.7 (± 8.6) % for the distributed teams (p = 0.02). In the PIC-ET tool category 'Sharing power', the scores decreased from 14.4 (± 12.4) % in the co-located teams to 2 (± 4.4) % in the distributed teams (p = 0.001). Co-located teams scored in mean 60.5% (± 14.4) when self-assessing shared decision-making, vs 55.8% (± 15.1) in the distributed teams (p = 0.03). CONCLUSIONS Team behavior enabling patient participation was found decreased in distributed teams, especially regarding sharing power with the patient. This finding was also mirrored in the self-assessments of the healthcare professionals. This study highlights the risk of an increased power asymmetry between patients and distributed emergency teams and can serve as a basis for further research, education, and quality improvement.
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Affiliation(s)
- Hanna Dubois
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, K32 Karolinska University Hospital, Stockholm, S-14186, Sweden.
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, S-11883, Sweden.
| | - Tanja Manser
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, K32 Karolinska University Hospital, Stockholm, S-14186, Sweden
- FHNW School of Applied Psychology, FHNW University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| | - Henrike Häbel
- Department of Learning, Informatics, Management and Ethics, Medical Statistics Unit, Karolinska Institutet, C7, Stockholm, S-171 77, Sweden
| | - Maria Härgestam
- Department of Nursing, Umeå University, S-907 87, Umeå, Sweden
| | - Johan Creutzfeldt
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, K32 Karolinska University Hospital, Stockholm, S-14186, Sweden
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Jang SG, Ock M, Kim S. Qualitative Comparison of Perceptions Regarding Patient Engagement for Patient Safety by Physicians, Nurses, and Patients. Patient Prefer Adherence 2024; 18:1065-1075. [PMID: 38854478 PMCID: PMC11162203 DOI: 10.2147/ppa.s456050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/23/2024] [Indexed: 06/11/2024] Open
Abstract
Purpose Patient engagement in ensuring patient safety is widely acknowledged, there is still a need to explore how perceptions of patient engagement vary among different stakeholders within the healthcare system. We aimed to compare the perceptions regarding patient engagement for patient safety among physicians, nurses, and patients by exploring the perspectives. Patients and Methods A qualitative study, comprising three focus group discussions (six to eight people each), was conducted in South Korea. Physicians and nurses who worked at the general hospital level or higher, and patients who had been hospitalized for more than 24 hours, were included. Researchers analyzed the transcripts, and a content analysis was performed to describe influencing elements of patient engagement for patient safety. A word cloud was created through keyword analysis of the transcripts. Results Based on 479 coded data, three categories and eight sub-categories were derived. The first moment of patient engagement was viewed as the choice of medical institutions. Reputation occupied a large part in the hospital selection for all participants, but they did not know about or use the national hospital evaluation data. Participants said that continuous patient engagement, such as the patient's active questioning attitude, guardian's cooperation, sufficient medical personnel, and patient safety education was required during treatment. However, it was said that patient engagement was ignored after patient safety incidents occurred. They mentioned that they were emotional and busy arguing for their own positions, and that it was difficult to use a medical dispute resolution method in practice. In the word cloud by group, fall, explanation, hospital, and patient were common words. Conclusion All three groups agreed on the importance of patient engagement for patient safety but differed in its influencing factors. Efforts should be made to reduce the difference between the three groups on how to involve patients for patient safety.
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Affiliation(s)
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Soyoon Kim
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
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Li T, Feng H, Bandugula V, Ding Y. Designing a Consumer-centric Care Management Program by Prioritizing Interventions Using Deep Learning Causal Inference. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2024; 2024:584-592. [PMID: 38827098 PMCID: PMC11141861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Care management is a team-based and patient-centered approach to reduce health risks and improve outcomes for managed populations. Post Discharge Management (PDM) is an important care management program at Elevance Health, which is aimed at reducing 30-day readmission risk for recently discharged patients. The current PDM program suffers from low engagement. When assigning interventions to patients, case managers choose the interventions to be conducted in each call only based on their limited personal experiences. In this work, we use deep learning causal inference to analyze the impact of interventions conducted on the first call on consumer engagement in the PDM program, which provides a reliable reference for case managers to select interventions to promote consumer engagement. With three experiments cross-validating the results, our results show that consumers will engage more in the program if the case manager conducts interventions that require more nurse-patient interactions on the first call. On the other hand, conducting less interactive and more technical interventions on the first call leads to relatively poor consumer engagement. These findings correspond to the clinical sense of experienced nurses and are consistent with previous findings in patient engagement in hospital settings.
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Affiliation(s)
- Tianhao Li
- The University of Texas at Austin, Austin, TX, USA
| | - Haoyun Feng
- Elevance Health, Inc., Indianapolis, IN, USA
| | | | - Ying Ding
- The University of Texas at Austin, Austin, TX, USA
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Wang Y, Zhang Q, Wang X, Yan D, Yin J, Zhuang S, Qiang W. Current status and influencing factors of participating satisfaction during surgical treatment decision-making among breast cancer patients with immediate breast reconstruction. Eur J Oncol Nurs 2023; 66:102402. [PMID: 37738841 DOI: 10.1016/j.ejon.2023.102402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/22/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Breast reconstruction (BR) is a positive contribution to aesthetic effect among breast cancer patients. Identification of influenced factors for participating satisfaction may provide insights on the decision-making theory to promote patient's autonomy in surgical choice. The purpose of this study was to examine the level of participating satisfaction with surgical treatment decision-making and its predictors among breast cancer patients with immediate BR. METHODS A cross-sectional study was conducted including 163 breast cancer patients with immediate BR in Mainland China. Data was collected using patients' participation satisfaction in medical decision-making scale (PSMDS), Big five Short-Form (BFI) Scale, Patient Participation Competence Scale(PPCS) and Patients' Preference (MPP) scale. Descriptive, bivariate, and multivariate regression analyses were used. RESULTS Scores of PSMD were 86.38 ± 15.74. Multiple regression analyses indicated autonomous decision-making, marital statue, information acquisition competence, agreeableness, and decision-making preferences as indicators, explaining 29.6% of the response variation (P < 0.05). CONCLUSIONS The level of PSMD in breast cancer patients with immediate BR need to be improved. Patients with greater autonomous decision-making, married, higher information acquisition competence, agreeableness, and collaborative role are more likely to have an preferable PSMD. A comprehensive assessment and effective decision-making support are needed initially for BC patients to promote positive participation when making surgical decision.
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Affiliation(s)
- Yan Wang
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Qingyue Zhang
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Xiaoyuan Wang
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Di Yan
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Jian Yin
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | | | - Wanmin Qiang
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
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Xiao Y, Miller K, Werner N, Smith K, Hendrix N, Hemmelgarn C. Co-Design with Patients for Improving Patient Safety: Strategies, Barriers and pitfalls. PROCEEDINGS OF THE HUMAN FACTORS AND ERGONOMICS SOCIETY ... ANNUAL MEETING. HUMAN FACTORS AND ERGONOMICS SOCIETY. ANNUAL MEETING 2023; 67:633-638. [PMID: 38213999 PMCID: PMC10782182 DOI: 10.1177/21695067231192416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
What happens when "frontline" workers are patients and family members performing health-related tasks? As more and more complex healthcare tasks are performed by patients and family members, and more emphasis is placed on patient- and family-centered care, strategies are needed to engage patients and family members in co-design "work systems" and patient-professional collaborative work. Human factors professionals are well-equipped to apply participatory ergonomics to patient and collaborative tasks. However, there are a number of barriers and pitfalls in engaging patients in design. Moving from tokenism to meaningful engagement in research requires patience, constant reflection, and a commitment to codesign. Our panel will explore the continuum of engagement and strategies to move from tokenism to partnership to cocreation in patient safety research, ranging from ambulatory medication safety to diagnosis in the emergency department. Strategies and barriers are presented as a starting point to discuss how to achieve effective work system designs.
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Affiliation(s)
- Yan Xiao
- University of Texas at Arlington,
Arlington, Texas, USA
| | - Kristen Miller
- MedStar Health and Georgetown
University, Washington, DC, USA
| | - Nicole Werner
- Indiana University Bloomington,
Bloomington, Indiana, USA
| | | | - Noah Hendrix
- University of Texas at Arlington,
Arlington, Texas, USA
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Di Tosto G, Hefner JL, Walker DM, Gregory ME, McAlearney AS, Sieck CJ. Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study. BMC Health Serv Res 2023; 23:846. [PMID: 37563581 PMCID: PMC10413602 DOI: 10.1186/s12913-023-09785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives designed to help patients participate in health decisions, there remains a limited understanding of engagement from the perspective of patients and a lack of measures designed to capture the multi-faceted nature of the concept. METHODS Development of a concept map of patient engagement followed a five-step modified Group Concept Mapping (GCM) methodology of preparation, generation, structuring, analysis and interpretation. We engaged a Project Advisory Committee at each step, along with three rounds of survey collection from clinicians and patients for element generation (272 clinicians, 61 patients), statement sorting (30 clinicians, 15 patients), and ranking and rating of statements (159 clinicians, 67 patients). The survey of three separate samples, as opposed to focus groups of 'experts,' was an intentional decision to gain a broad perspective about the concept of patient engagement. We conducted the structure and analysis steps within the groupwisdom concept mapping software. RESULTS The final concept map comprised 47 elements organized into 5 clusters: Relationship with Provider, Patient Attitudes and Behaviors, Access, Internal Resources and External Resources. There was considerable agreement in the way elements in each cluster were rated by patients and clinicians. An analysis of the importance of the constitutive elements of patient engagement relative to their addressability highlighted actionable items in the domain of Relationship with Provider, aimed at building trust and enabling patients to ask questions. At the same time, the analysis also identified elements traditionally considered barriers to engagement, like personal access to the internet and the patient's level of digital literacy, as difficult to address by the healthcare system, but also relatively less important for patients. CONCLUSIONS Through our GCM approach, incorporating perspectives of both patients and clinicians, we identified items that can be used to assess patient engagement efforts by healthcare systems. As a result, our study offers specific insight into areas that can be targeted for intervention by healthcare systems to improve patient engagement.
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Affiliation(s)
- Gennaro Di Tosto
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA.
| | - Jennifer L Hefner
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Daniel M Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Megan E Gregory
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Sieck
- Center for Health Equity, Dayton Children's Hospital, Dayton, OH, USA
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Younus MM, Alkhakany M, Bahri P, Caro A, Rostom H, Ndagije HB, Elhawary MA. The ISoP PatEG-SIG for Promoting Patient Engagement in Pharmacovigilance: A Change of Paradigm is Needed. Drug Saf 2023:10.1007/s40264-023-01313-4. [PMID: 37231322 DOI: 10.1007/s40264-023-01313-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Manal M Younus
- Iraqi Pharmacovigilance Center, Ministry of Health, Baghdad, Iraq
- International Society of Pharmacovigilance Patient Engagement Special Interest Group, London, UK
| | - Mayada Alkhakany
- International Society of Pharmacovigilance Patient Engagement Special Interest Group, London, UK
- Healthcare Affair, Boehringer Ingelheim, Dubai, United Arab Emirates
| | - Priya Bahri
- International Society of Pharmacovigilance (ISoP)-Special Interest Group on Medicinal Product Risk Communication, European Medicines Agency, Pharmacovigilance Office, Amsterdam, The Netherlands
| | - Angela Caro
- International Society of Pharmacovigilance (ISoP), Pharmacy Career Director of Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Hadir Rostom
- International Society of Pharmacovigilance (ISoP)-Egypt Chapter, Cairo, Egypt
- Faculty of Pharmacy, MSA University, 6th of October City, Giza, Egypt
| | | | - Mohamed A Elhawary
- Egyptian Ministry of Health and Population, Central Administration for Pharmaceutical Affairs, Cairo, Egypt.
- Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
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Jeyakumar T, Younus S, Zhang M, Clare M, Charow R, Karsan I, Dhalla A, Al-Mouaswas D, Scandiffio J, Aling J, Salhia M, Lalani N, Overholt S, Wiljer D. Preparing for an Artificial Intelligence-Enabled Future: Patient Perspectives on Engagement and Health Care Professional Training for Adopting Artificial Intelligence Technologies in Health Care Settings. JMIR AI 2023; 2:e40973. [PMID: 38875561 PMCID: PMC11041489 DOI: 10.2196/40973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/29/2022] [Accepted: 12/29/2022] [Indexed: 06/16/2024]
Abstract
BACKGROUND As new technologies emerge, there is a significant shift in the way care is delivered on a global scale. Artificial intelligence (AI) technologies have been rapidly and inexorably used to optimize patient outcomes, reduce health system costs, improve workflow efficiency, and enhance population health. Despite the widespread adoption of AI technologies, the literature on patient engagement and their perspectives on how AI will affect clinical care is scarce. Minimal patient engagement can limit the optimization of these novel technologies and contribute to suboptimal use in care settings. OBJECTIVE We aimed to explore patients' views on what skills they believe health care professionals should have in preparation for this AI-enabled future and how we can better engage patients when adopting and deploying AI technologies in health care settings. METHODS Semistructured interviews were conducted from August 2020 to December 2021 with 12 individuals who were a patient in any Canadian health care setting. Interviews were conducted until thematic saturation occurred. A thematic analysis approach outlined by Braun and Clarke was used to inductively analyze the data and identify overarching themes. RESULTS Among the 12 patients interviewed, 8 (67%) were from urban settings and 4 (33%) were from rural settings. A majority of the participants were very comfortable with technology (n=6, 50%) and somewhat familiar with AI (n=7, 58%). In total, 3 themes emerged: cultivating patients' trust, fostering patient engagement, and establishing data governance and validation of AI technologies. CONCLUSIONS With the rapid surge of AI solutions, there is a critical need to understand patient values in advancing the quality of care and contributing to an equitable health system. Our study demonstrated that health care professionals play a synergetic role in the future of AI and digital technologies. Patient engagement is vital in addressing underlying health inequities and fostering an optimal care experience. Future research is warranted to understand and capture the diverse perspectives of patients with various racial, ethnic, and socioeconomic backgrounds.
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Affiliation(s)
| | | | | | - Megan Clare
- Michener Institute of Education, University Health Network, Toronto, ON, Canada
| | - Rebecca Charow
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Inaara Karsan
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Dalia Al-Mouaswas
- Michener Institute of Education, University Health Network, Toronto, ON, Canada
| | | | - Justin Aling
- Patient Partner Program, University Health Network, Toronto, ON, Canada
| | - Mohammad Salhia
- Michener Institute of Education, University Health Network, Toronto, ON, Canada
| | | | - Scott Overholt
- Patient Partner Program, University Health Network, Toronto, ON, Canada
| | - David Wiljer
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Rivest J, Rouly G, Brouillette MJ, Nguyen O, Desbeaumes Jodoin V. Improving Palliative Care and Medical Assistance in Dying Practice in Canada: How Patients-Partners Could Contribute to Continuing Medical Education. Palliat Med Rep 2023; 4:116-119. [PMID: 37095864 PMCID: PMC10122257 DOI: 10.1089/pmr.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
Medical Assistance in Dying (MAiD) is still considered an evolving practice in Canada. Practitioners are facing the challenge of staying up to date and hence need efficient continuing medical education (CME). A patient-partner has been recently invited as a keynote speaker to CME activities in Canada to share her perspectives and views about patient engagement in palliative care and MAiD practice, calling for compassion. To our knowledge, few data exist on patient-partners' contribution to CME on these topics. Based on that experience, we discuss different issues on patient engagement's contribution in such CME events and call for further research.
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Affiliation(s)
- Jacynthe Rivest
- Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), Montreal, Québec, Canada
- Address correspondence to: Jacynthe Rivest, MD, MA(Ed), FRCPC, Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), 1051 rue Sanguinet, Montreal, Québec H2X 0C1, Canada.
| | - Ghislaine Rouly
- Centre of Excellence on Partnership with Patients and the Public, Montreal, Québec, Canada
| | - Marie-Josée Brouillette
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
- Department of Psychiatry, McGill University Health Centre, Montreal, Québec, Canada
| | - Olivia Nguyen
- Palliative Care Division, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Véronique Desbeaumes Jodoin
- Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), Montreal, Québec, Canada
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Sieck CJ, Nicks SE, Salem J, DeVos T, Thatcher E, Hefner JL. Addressing Equity and Social Needs: The New Frontier of Patient Engagement Research. Adv Health Care Manag 2022; 21:151-165. [PMID: 36437621 DOI: 10.1108/s1474-823120220000021008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Patient engagement has been a focus of patient-centered care in recent years, encouraging health care organizations to increase efforts to facilitate a patient's ability to participate in health care. At the same time, a growing body of research has examined the impact that social determinants of health (SDOH) have on patient health outcomes. Additionally, health care equity is increasingly becoming a focus of many organizations as they work to ensure that all patients receive equitable care. These three domains - patient engagement, SDOH, and health care equity - can intersect in the implementation of social needs screenings among health care organizations. We present a case study on a two-phase social needs screening implementation project and describe how this process focuses on equity. As health care organizations seek to increase patient engagement, address SDOH, and improve health equity, we highlight the need to move away from a siloed approach and view these efforts as interrelated. By approaching efforts to address these challenges and barriers as the duty of all those involved in the patient care process, there may be larger strides made toward equitable health care.
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Chauhan A, Newman B, Walpola RL, Seale H, Manias E, Wilson C, Harrison R. Assessing the environment for engagement in health services: The Audit for Consumer Engagement (ACE) tool. Health Expect 2022; 25:3027-3039. [DOI: 10.1111/hex.13610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/07/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences Macquarie University North Ryde New South Wales Australia
| | - Bronwyn Newman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences Macquarie University North Ryde New South Wales Australia
| | - Ramesh Lahiru Walpola
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney Kensington New South Wales Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney Kensington New South Wales Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation Deakin University Melbourne Victoria Australia
| | - Carlene Wilson
- Olivia Newton‐John Cancer Wellness and Research Centre Austin Health Heidelberg Victoria Australia
- School of Psychology and Public Health La Trobe University Bundoora Victoria Australia
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences Macquarie University North Ryde New South Wales Australia
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Tolotti A, Barello S, Vignaduzzo C, Liptrott SJ, Valcarenghi D, Nania T, Sari D, Bonetti L. Patient Engagement in Oncology Practice: A Qualitative Study on Patients' and Nurses' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11644. [PMID: 36141919 PMCID: PMC9517681 DOI: 10.3390/ijerph191811644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Patient engagement has gained increasing attention in cancer care as it is widely acknowledged as an essential element of high-quality care. There are limited data on how oncology nurses might apply techniques that encourage patient engagement. Therefore, this study aims to understand which nursing strategies can favour patient engagement in oncological care from patients' and nurses' perspectives. We conducted a qualitative study involving oncology patients and oncology nurses. Patients were interviewed, while nurses were involved in focus groups (FGs). Both interviews and FGs were analysed by the means of thematic analysis. We interviewed six patients and conducted two FGs, involving 17 nurses. Five themes were identified from patients' interviews: effective information, having the opportunity to choose, being considered a person, trusted relationship with nurses, and receiving support and advice. Additionally, five themes were identified from the FGs: the nurse-patient relationship, personalisation of care, information style, engagement strategies, and the team. The participants highlighted the importance of comprehensive information in order for patients to feel more involved. Great importance was given to the nurse-patient relationship, which must be based on trust and mutual respect. Both nurses and patients emphasised the importance of person-centred care. A more systematic implementation of suggestions from the participants in this study is desirable for the future.
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Affiliation(s)
- Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Camilla Vignaduzzo
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Sarah Jayne Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
- Nursing Development and Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale (EOC), Via Ospedale 12, 6500 Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097 Milan, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland or
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Via Violino, 11, 6928 Manno, Switzerland
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13
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Tobiano G, Marshall AP, Gardiner T, Jenkinson K, Shapiro M, Ireland M. Development and psychometric testing of the patient participation in bedside handover survey. Health Expect 2022; 25:2492-2502. [PMID: 35898173 PMCID: PMC9615084 DOI: 10.1111/hex.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/19/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction When handover is conducted at the patient's bedside, active patient participation can be encouraged, which may improve the safety and quality of care. There is a need for valid and reliable tools to measure patient perceptions of participation in bedside handover, to ensure the rising number of implementation and improvement efforts are consistently and effectively evaluated. The aim of this study is to systematically develop and evaluate the psychometric properties of a self‐report survey to measure patients' perceptions of participation in bedside handover. Methods In Phase 1, our team developed a conceptual framework and item pool (n = 130). In Phase 2, content validity was assessed with four health consumers, four nurses and four researchers. Next, 10 current hospital inpatients tested the survey for end‐user satisfaction. In Phase 3, 326 inpatients completed the survey, allowing exploratory factor analysis, reliability analyses and convergent/divergent validity analyses to occur. Results Phase 1 and 2 resulted in a 42‐item survey. In Phase 3, 321 surveys were available for analysis. Exploratory factor analysis revealed a three‐factor solution, with 24 items, which matched our conceptual framework. The three factors were: ‘Conditions for patient participation in bedside handover’, ‘Level of patient participation in bedside handover’ and ‘Evaluation of patient participation in bedside handover’. There was strong evidence for factor reliability and validity. Additionally, the correlation between factors was strong. Conclusion This study furthers our conceptual understanding by showing that nurse facilitating behaviours are a strong precursor for patient participation and perceived handover outcomes, justifying the need for nursing training. A robust survey has been developed to measure patient perceptions of participation in bedside handover, which can effectively evaluate this approach to care. Engaging consumers and nurses as research team members was invaluable in ensuring that the survey is acceptable for end‐users. Patient or Public Contribution A health consumer and nurse partnered as members of the research team from study inception to dissemination.
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Affiliation(s)
- Georgia Tobiano
- Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia.,NHMRC CRE in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Andrea P Marshall
- Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Therese Gardiner
- Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Kim Jenkinson
- Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Margaret Shapiro
- Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Michael Ireland
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba, Queensland, Australia
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14
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Pomey M, Clavel N, Normandin L, Del Grande C, Philip Ghadiri D, Fernandez‐McAuley I, Boivin A, Flora L, Janvier A, Karazivan P, Pelletier J, Fernandez N, Paquette J, Dumez V. Assessing and promoting partnership between patients and health-care professionals: Co-construction of the CADICEE tool for patients and their relatives. Health Expect 2021; 24:1230-1241. [PMID: 33949739 PMCID: PMC8369086 DOI: 10.1111/hex.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 12/01/2022] Open
Abstract
CONTEXT Partnership between patients and health-care professionals (HCPs) is a concept that needs a valid, practical measure to facilitate its use by patients and HCPs. OBJECTIVE To co-construct a tool for measuring the degree of partnership between patients and HCPs. DESIGN The CADICEE tool was developed in four steps: (1) generate key dimensions of patient partnership in clinical care; (2) co-construct the tool; (3) assess face and content validity from patients' and HCPs' viewpoints; and (4) assess the usability of the tool and explore its measurement performance. RESULTS The CADICEE tool comprises 24 items under 7 dimensions: 1) relationship of Confidence or trust between the patient and the HCPs; 2) patient Autonomy; 3) patient participation in Decisions related to care; 4) shared Information on patient health status or care; 5) patient personal Context; 6) Empathy; and 7) recognition of Expertise. Assessment of the tool's usability and measurement performance showed, in a convenience sample of 246 patients and relatives, high face validity, acceptability and relevance for both patients and HCPs, as well as good construct validity. CONCLUSIONS The CADICEE tool is developed in co-construction with patients to evaluate the degree of partnership in care desired by patients in their relationship with HCPs. The tool can be used in various clinical contexts and in different health-care settings. PATIENT OR PUBLIC CONTRIBUTION Patients were involved in determining the importance of constructing this questionnaire. They co-constructed it, pre-tested it and were part of the entire questionnaire development process. Three patients participated in the writing of the article.
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Affiliation(s)
- Marie‐Pascale Pomey
- School of Public HealthUniversity of MontrealMontrealQCCanada
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
| | | | - Louise Normandin
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | - Claudio Del Grande
- School of Public HealthUniversity of MontrealMontrealQCCanada
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | | | | | - Antoine Boivin
- Department of Family MedicineUniversity of MontrealMontrealQCCanada
| | - Luigi Flora
- Faculté de MédecineUniversité Nice Sophia AntipolisNiceFrance
| | - Annie Janvier
- Department of PediatricsUniversity of MontrealMontrealQCCanada
| | - Philippe Karazivan
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
- Department of ManagementHEC MontréalMontrealQCCanada
| | | | - Nicolas Fernandez
- Department of EducationUniversité du Québec à MontréalMontrealQCCanada
| | - Jesseca Paquette
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | - Vincent Dumez
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
- Faculty of MedicineUniversity of MontrealMontrealQCCanada
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