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Patient participation during and after a self-management programme in primary healthcare: The experience of patients with chronic obstructive pulmonary disease or chronic heart failure
Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
Örebro University, School of Health Sciences.ORCID iD: 0000-0001-5418-3154
Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
Division of Nursing, Department of Medical and Health Sciences, Linköping University, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
2018 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 6, p. 1137-1142Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation.

METHODS: Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis.

RESULTS: Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context.

CONCLUSION: Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF.

PRACTICE IMPLICATIONS: A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 101, no 6, p. 1137-1142
Keywords [en]
Chronic heart failure, Chronic obstructive pulmonary disease, Person-centered care, Patient participation, Self-management programme
National Category
Nursing
Identifiers
URN: urn:nbn:se:oru:diva-64005DOI: 10.1016/j.pec.2017.12.020ISI: 000432345000019PubMedID: 29290329Scopus ID: 2-s2.0-85039553404OAI: oai:DiVA.org:oru-64005DiVA, id: diva2:1173283
Note

Funding Agencies:

Region Örebro County  

Uppsala-Örebro Regional Research Council 

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-08-13Bibliographically approved
In thesis
1. Patient participation from the patient's preferences, that's what counts
Open this publication in new window or tab >>Patient participation from the patient's preferences, that's what counts
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patient participation is a core element in legislation in most western countries today. From the patient’s perspective, patient participation includes respect, equality, sharing of knowledge, joint planning, and self-management. However, participation is not always experienced, and the patient’s experiences and preferences are seldom mapped.

The general aim of this thesis was to enhance the knowledge on patient participation from the preferences of patients with long-term conditions in outpatient healthcare by evaluating a measure (The Patient Preferences for Patient Participation: the 4Ps) on patient participation and by investigating a self-management programme’s impact on patient participation.

Qualitative evaluations of the 4Ps included Think Aloud interviews with patient experts (n = 11) and research experts (n = 10) in Study I. Psychometric evaluations were performed in Study II (n = 108) and after amendments in Study III (n = 150). Effects of the self-management programme on patient participation were investigated in a randomised controlled trial with the 4Ps as the outcome measure in Study III (n = 118), and in Study IV were influences investigated qualitatively in nine focus group interviews (n = 36).

The 4Ps was found to be sufficiently valid and reliable. As measured with the 4Ps, patients with long-term conditions had both set preferences in and experiences of patient participation, regardless of randomised to a self-management programme or not. Qualitatively the programme was found to include patient participation and to influence self-management.

The use of diverse methods was beneficial and complementary. The sufficiently valid and reliable 4Ps can fil the gap of a measure to map preferences for and experiences of patient participation. Patients with long-term conditions have set preferences for participation. The self-management programme can be applied to influence participation and future responsibilities.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 95
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 74
Keywords
Patient Participation, Patient Preferences, Measure, Content Analysis, Psychometric Evaluations, Self-Management, Long-Term Conditions
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-65314 (URN)978-91-7529-241-0 (ISBN)
Public defence
2018-05-04, Örebro universitet, Prismahuset, Hörsal 1, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-02-28 Created: 2018-02-28 Last updated: 2018-04-10Bibliographically approved

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Luhr, KristinaHolmefur, Marie

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