Profile of the Patient Who Refuses to Participate in the Expert Patients Program

Vega, Gema; Vega, M. Pérez de la; Alajarín, Llanos I.; Portero, Begoña; Ruiz, T. Rubí; Ruíz, Victoria; Marín, Conception; Lázaro, Conception; M, Gómez; Conde, Fernando Jiménez

doi:10.1177/1049732314535850

Cited by 3 publications

(3 citation statements)

References 17 publications

(16 reference statements)

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“…To some extent, patients’ individual characteristics and social context have the potential to impact the degree of their participation in self-management activities. Therefore tailored patient–professional partnerships and other strategic interventions should be designed for each type of participation (Vega et al, 2014). Meanwhile, the attitudes, communication style and the competences of health professionals are also critical components in a successful patient–professional partnership (Lawn et al, 2014; Moore et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient–Professional Partnerships

McNichol

Marczewski

et al. 2018

Qual Health Res

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Supporting patients in forming partnerships with health professionals is the key of effective self-management. This study aimed to explore the nature of patient-professional partnerships and its related factors that create facilitators and barriers to patients' self-management ability. A constructivist grounded theory approach was undertaken. Three main themes emerged: interaction and communication, integrated care, and service and system. A theoretical model was generated that posits effective communication, individualized integrated care, and high-quality service as key influences on the successful development of patient-professional partnerships and patients' ability to self-manage. Giving attention to these factors helps understand the development, implementation, mechanisms, and evaluation of building a patient-professional partnership and maximizes the opportunities for patient self-management of chronic pain. Future research and practice are needed to move beyond a simplistic focus on health outcomes to address the complex links between partnerships and treatment delivery processes, and interventions, effects, and patients' context.

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Section: Discussionmentioning

confidence: 99%

The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient–Professional Partnerships

McNichol

Marczewski

et al. 2018

Qual Health Res

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“…128 Self-management programmes also have, in some contexts, high dropout and refusal rates (10% and 51%, respectively, in a Spanish study). 129 Cross-sectional, longitudinal and relational continuities of care are likely to break down when users are highly mobile, even within a small locality, for instance for patients with serious mental illnesses. 130,131 When these practical limits are reached, patients often seek help (an extensive body of research describes under what circumstances they do or do not do so).…”

Section: Patients As Care Co-ordinatorsmentioning

confidence: 99%

Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination

Sheaff

Halliday

Øvretveit

et al. 2015

Health Serv Deliv Res

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BackgroundAn ageing population, the increasing specialisation of clinical services and diverse health-care provider ownership make the co-ordination and continuity of complex care increasingly problematic. The way in which the provision of complex health care is co-ordinated produces – or fails to produce – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational and relational). Care co-ordination is accomplished by a combination of activities by patients themselves; provider organisations; care networks co-ordinating the separate provider organisations; and overall health-system governance. This research examines how far organisational integration might promote care co-ordination at the clinical level.ObjectivesTo examine (1) what differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical co-ordination of care; (2) what difference provider ownership (corporate, partnership, public) makes; (3) how much scope either structure allows for managerial discretion and ‘performance’; (4) differences between networked and hierarchical governance regarding the continuity and integration of primary care; and (5) the implications of the above for managerial practice in primary care.MethodsMultiple-methods design combining (1) the assembly of an analytic framework by non-systematic review; (2) a framework analysis of patients’ experiences of the continuities of care; (3) a systematic comparison of organisational case studies made in the same study sites; (4) a cross-country comparison of care co-ordination mechanisms found in our NHS study sites with those in publicly owned and managed Swedish polyclinics; and (5) the analysis and synthesis of data using an ‘inside-out’ analytic strategy. Study sites included professional partnership, corporate and publicly owned and managed primary care providers, and different configurations of organisational integration or separation of community health services, mental health services, social services and acute inpatient care.ResultsStarting from data about patients’ experiences of the co-ordination or under-co-ordination of care, we identified five care co-ordination mechanisms present in both the integrated organisations and the care networks; four main obstacles to care co-ordination within the integrated organisations, of which two were also present in the care networks; seven main obstacles to care co-ordination that were specific to the care networks; and nine care co-ordination mechanisms present in the integrated organisations. Taking everything into consideration, integrated organisations appeared more favourable to producing continuities of care than did care networks. Network structures demonstrated more flexibility in adding services for small care groups temporarily, but the expansion of integrated organisations had advantages when adding new services on a longer term and a larger scale. Ownership differences affected the range of services to which patients had direct access; primary care doctors’ managerial responsibilities (relevant to care co-ordination because of their impact on general practitioner workload); and the scope for doctors to develop special interests. We found little difference between integrated organisations and care networks in terms of managerial discretion and performance.ConclusionsOn balance, an integrated organisation seems more likely to favour the development of care co-ordination and, therefore, continuities of care than a system of care networks. At least four different variants of ownership and management of organisationally integrated primary care providers are practicable in NHS-like settings. Future research is therefore required, above all to evaluate comparatively the different techniques for coordinating patient discharge across the triple interface between hospitals, general practices and community health services; and to discover what effects increasing the scale and scope of general practice activities will have on continuity of care.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Engagement can be examined at the level of both attending to counseling programs or interventions and the social dynamics of participation in counseling interaction. Low health literacy, stigma, gaps between the content offered and client lifeworld and needs, and externalized motivation have all been recognized as barriers to participating in diabetes counseling (e.g., Harris et al, 2019; Kinnafick et al, 2014; Vega et al, 2014). It has been suggested that feelings of stigma, irrelevance of content, and externalized motivation are all particularly suitable to being alleviated by group counseling, which aims at reflection and finding solutions and strategies, together with peers, that fit clients’ different life situations (Leong, 2008; Logren et al, 2017b).…”

mentioning

confidence: 99%

Effects of Transmission Delay on Client Participation in Video-Mediated Group Health Counseling

2021

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In face-to-face group counseling, active client participation contributes to the counseling agenda by a variety of social processes, but little is known about how video mediation shapes client participation. In this article, we use conversation analysis to investigate how transmission delay affects client participation in video-mediated group counseling through shaping the resolution of overlapping talk. Data are video recordings from three video-mediated group health counseling sessions recorded simultaneously in the two participating locations. The delay changes the timing of the overlapping turns and pauses at each end of the mediated counseling, making it difficult to interpret who should take the turn after the overlap. This may pose obstacles to client participation. While mediated counseling services can increase access to services and thus improve client participation at a macro level, transmission delay can pose threats to active client participation at the micro level of interaction.

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Profile of the Patient Who Refuses to Participate in the Expert Patients Program

Cited by 3 publications

References 17 publications

The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient–Professional Partnerships

The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient–Professional Partnerships

Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination

Effects of Transmission Delay on Client Participation in Video-Mediated Group Health Counseling

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