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The development and initial validation of a clinical tool for patients' preferences on patient participation: The 4Ps
Division of Nursing Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun.ORCID iD: 0000-0002-7737-169X
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2015 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, no 6, p. 2522-2535Article in journal (Refereed) Published
Abstract [en]

Aims: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.

Background: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences.

Methods: Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability.

Results: 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout.

Conclusions: A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 18, no 6, p. 2522-2535
Keywords [en]
clinical tool, content validity, instrument development, patient participation, qualitative analysis
National Category
Nursing
Research subject
Caring sciences
Identifiers
URN: urn:nbn:se:oru:diva-41155DOI: 10.1111/hex.12221ISI: 000368250300058PubMedID: 24938672Scopus ID: 2-s2.0-84955180179OAI: oai:DiVA.org:oru-41155DiVA, id: diva2:780319
Note

Funding Agencies:

Capio Research Fund, Sweden

Family Medicine Research Centre, Örebro county council 

Available from: 2015-01-14 Created: 2015-01-13 Last updated: 2018-04-10Bibliographically 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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Eldh, Ann CatrineLuhr, KristinaEhnfors, Margareta

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