Patients as Partners: A Qualitative Study of Patients’ Engagement in Their Health Care

Abstract

To advocate for patients to be more actively involved with the healthcare services they receive, particularly patients living with chronic illness, the Faculty of Medicine of the University of Montreal and its affiliated hospitals developed the Patients as Partners concept where the patient is considered a full-fledged partner of the health care delivery team and the patient’s experiential knowledge is recognized. This study aims to show how patients view their engagement with healthcare professionals regarding their direct care. Using theoretical sampling, 16 semi-structured interviews were conducted with patients with chronic illness who were familiar with the concept of Patients as Partners. Data analysis followed a constructivist grounded theory approach. Patients describe themselves as proactively engaging in three types of practice, regardless of health professionals’ openness to their role as partners. The first is a process of continuous learning that allows them to acquire experiential knowledge about their health, as well as scientific information and technical know-how. The second involves their assessment of the healthcare they receive, in terms of its quality and how it aligns with their personal preferences. It includes their assessment of the quality of their relationship with the health professional and of the latter’s scientific knowledge and technical know-how. The third type, adaptation practices, builds on patients’ learning and assessments to compensate for and adapt to what has been perceived as optimal or non-optimal health or healthcare circumstances. Patients appear to play a more active and less docile role in their own direct care than suggested so far in the literature, regardless of the degree of reciprocity of the partnership or the degree to which the health professional seeks to encourage patient engagement.

Patients’ perspective on surgical intervention for Dupuytren’s disease – experiences, expectations and appraisal of results

“…Examples of factors related to process [14], were the participants' views of response from the staff in terms of support and shared knowledge, and issues of lack of information and a wish for further follow-up. These findings supports previous research from other areas of health care concluding that structure and process aspects of care are of importance for patients' overall evaluation of care [28], and that patients evaluate their caregivers intervention, their knowledge and skills, and the interaction between them [41].…”

How Co-Creation Helped Address Hierarchy, Overwhelmed Patients, and Conflicts of Interest in Health Care Quality and Safety

“…For example, in a qualitative study, patients who had received training in interprofessional collaboration and care partnerships at the University of Montreal identified themselves as valuable resources to the health care team due to their experiential knowledge, unique perspective, and tangible impact on the care of fellow patients. These patients also reported an improved understanding of the health care system and its nuances as well as of their own health and ways to maintain it [25].…”

Envolvimento dos pacientes no gerenciamento da qualidade dos serviços de saúde

“…Among these stages are the learning practices, evaluation, and adaptation. (3) The patient is now admitted as an active agent in the health care process. (3) The subject of patient involvement has been addressed in different ways, both conceptually, as well as in terminology.…”

“…(3) The patient is now admitted as an active agent in the health care process. (3) The subject of patient involvement has been addressed in different ways, both conceptually, as well as in terminology. (4) One approach is the discussion on the subject from three observed trends.…”