Article

The Meaning of Patient Involvement and Participation in Health Care Consultations

School of Social and Political Studies, University of Edinburgh, Adam Ferguson Bldg, George Square, EH8 9LL Edinburgh, UK.
Social Science & Medicine (Impact Factor: 2.56). 04/2007; 64(6):1297-310. DOI: 10.1016/j.socscimed.2006.11.002
Source: PubMed

ABSTRACT A number of trends, pressures and policy shifts can be identified that are promoting greater patient involvement in health care delivery through consultations, treatments and continuing care. However, while the literature is growing fast on different methods of involvement, little attention has been given so far to the role which patients themselves wish to play, nor even of the conceptual meanings behind involvement or participation. This article reviews the current models of involvement in health care delivery as derived from studies of professional views of current and potential practice, prior to examining the empirical evidence from a large-scale qualitative study of the views and preferences of citizens, as patients, members of voluntary groups, or neither. Individual domiciliary interviews were carried out with 44 people recruited from GP practices in northern England. These respondents were then included in a second phase of 34 focus groups in 6 different localities in northern and southern England, of which 22 were with individuals unaffiliated to any voluntary/community groups, 6 related to local voluntary/community groups with specific interests in health or health care, and 6 related to groups without such specific interests. A final set of 12 workshops with the same samples helped to confirm emergent themes.

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    • "The focal dyad reported different approaches to engagement in relation to actor involvement in the consultation process. The data revealed these styles to include the paternalistic approach, shared decision-making and professional-as-agent (Thompson, 2007). 452 JSTP 25,4 The paternalistic approach is considered to be the traditional consultation model whereby patient involvement in the consultation is limited to reporting symptoms and not being engaged throughout the consultation. "
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    ABSTRACT: The increasing awareness that value creation lies in the patient’s sphere, which is facilitated by the relationship between the provider, has consequences for the approach to service delivery. Using a phenomenological approach, this study furthers our understanding of actor value perceptions on value co-creation in the focal doctor-patient dyad. The value perceptions of the patient examined in this study reveal an experiential nature, which is further analysed to show how this is exchanged between the doctor and patient. The findings suggest that patients’ value perceptions are linked to their experiences in the consulting room, whereas doctors primarily consider the functional value. In order to create value for patients, providers need to understand current trends in patient behaviours and attitude during healthcare consultations. Further, they should adopt an approach that engages with these behaviours, resulting in positive experiences.
    QUIS14 Symposium on Service Excellence in Management, Shanghai, China; 06/2015
    • "The focal dyad reported different approaches to engagement in relation to actor involvement in the consultation process. The data revealed these styles to include the paternalistic approach, shared decision-making and professional-as-agent (Thompson, 2007). 452 JSTP 25,4 The paternalistic approach is considered to be the traditional consultation model whereby patient involvement in the consultation is limited to reporting symptoms and not being engaged throughout the consultation. "
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    ABSTRACT: Purpose – The purpose of this paper is to investigate value co-creation processes from the focal dyad of the patient and the physician and how their experiences in the consulting room affect the value that is created. Design/methodology/approach – Semi-structured interviews incorporating the critical incident technique (CIT) were conducted with 8 doctors and 24 outpatients in selected hospitals in Ghana, exploring their experiences during their encounter in the service delivery impacting on the value creating healthcare opportunities. An abductive and thematic analytical approach was used to identify 76 useable critical incidents that had clear consequences on both the outcome of the service and the service experiences of the patient. Findings – The study reveals three critical areas needed to support the value co-creation process and respective elements or activities to be considered during the service encounter. The critical areas comprise of the social context, beliefs and perceptions, and partnership between the focal dyad. The findings also suggests that patients do not consider “getting well” as the only value that they seek, but also the total experiences they go through in the consulting room. Also some physicians find it difficult to accept the recent changes in the patients’ behaviour and attitudes, resulting in knowledge conflict that adversely affects actors’ experiences in the consulting room. Research limitations/implications – The study considered only one of the many professionals in the healthcare delivery, which may affect the true value perceptions of the patient. Practical implications – The study provides service providers understanding of the processes that influence the patients’ experiences and value creation and the changing trends in the patient’s attitudes. The findings suggest a need for providers to take a holistic view of the service delivery and consider the critical areas, which could impact on the overall service outcomes. Originality/value – This study extends the research on CIT to exploring the value co-creating processes in the healthcare setting. This also provides clarity in understanding the interdependence of the two actors and how this is managed as a resource in the value co-creation process at the micro level.
    Journal of Service Theory and Practice 05/2015; 25(4):443-462. DOI:10.1108/JSTP-03-2014-0062 · 0.98 Impact Factor
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    • "Active participation only occurs through reciprocal relationships of dialogue and shared decision-making (Bolster and Manias, 2010). Rather than being an information-giving exercise or just a chance to exchange greetings, patient and family involvement is an opportunity to make an important contribution to patient care (Thompson, 2007). While much has been written about the need to include patients and families in bedside handover, it is not clear whether in actual practice their views are considered at all, or indeed, whether health professionals really want them to be involved in the first place. "
    International Journal of Nursing Studies 12/2014; 51(12). DOI:10.1016/j.ijnurstu.2014.08.004 · 2.25 Impact Factor
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