Knowledge sharing to support long-term condition self-management-Patient and health-care professional perspectives.

Sarah Brand,Stephen Timmons

doi:10.1111/hex.13209

Abstract

BackgroundIncreased self‐management is a suggested solution to the burden on health‐care services of long‐term conditions (LTCs). This requires effective sharing of knowledge between health‐care professionals and patients, and is an underexplored area.ObjectiveTo understand how patients and health‐care professionals (HCPs) share and utilize knowledge in the social context of health‐care interactions within long‐term condition management.MethodsThematic analysis of 93 hours of observations of health‐care interactions and 33 semi‐structured interviews involving patients, carers and HCPs.Results3 themes were identified: normative social roles, differing professional roles and the value of knowledge. Knowledge sharing was a complex process heavily influenced by social and cultural norms within the health‐care context. Not all knowledge was easily shared within routine health‐care interactions.DiscussionThe social context in which health‐care is practised influences what knowledge is shared and how this is achieved. It favours sharing of clinical knowledge from HCPs to patients and disadvantages patients in their ability to share their unique knowledge based on lived experience of illness. The opportunities for patients to be supported in their knowledge, skills and confidence within routine health‐care interactions are limited.ConclusionBoth patients and HCPs need support to recognize the characteristics of the social context of health care and their understandings of their roles within this in order for them to move beyond accepted behaviours to develop more effective partnership working.Patient or Public ContributionPatients were involved in initial design of the study, particularly ethics of ethnographic observation.

Highlights

Increased self management is a suggested solution to the burden on healthcare services of long term conditions (LTCs)
This assumption is contrary to much literature concerned with knowledge within healthcare contexts which highlight the difficulties of knowledge sharing associated with organisational barriers, resource constraints, multi-professional working, and the constant production of new knowledge [14, 15]
Reported here are three main themes emergent from the data which illuminated how knowledge sharing was achieved between patients and healthcare professionals (HCPs) within routine interactions

Summary

Introduction

Increased self management is a suggested solution to the burden on healthcare services of long term conditions (LTCs). One of the proposed solutions for the challenge posed by increasing prevalence of LTCs is to support patients to better manage their conditions themselves, thereby reducing uptake of healthcare services and progression of severity of disease [2, 4, 5]. This requires both patients and healthcare professionals (HCPs) to share knowledge and utilise it in order for supportive self-management to take place. This assumption is contrary to much literature concerned with knowledge within healthcare contexts which highlight the difficulties of knowledge sharing associated with organisational barriers, resource constraints, multi-professional working, and the constant production of new knowledge [14, 15]

Objectives

Results

Discussion

Conclusion