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.
Highlights
Healthcare systems in North America and Europe are currently confronted with the rising incidence of chronic illness [1]
To advocate for patients to be more actively involved with the healthcare services they receive, 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
We presented our findings at a colloquium in Montreal in May 2014, as well as at a Collaboration and Patient Partnership Unit (CPPU) meeting in September 2014 where patients and carers from the CPPU and other organizations were present and able to comment on our research findings
Summary
Healthcare systems in North America and Europe are currently confronted with the rising incidence of chronic illness [1]. In Canada it is estimated that one out of two people suffer from at least one chronic illness, and these figures are likely to increase in the coming years [2]. This epidemiological shift is challenging the traditional healthcare delivery models that were developed and established immediately following World War II, largely to provide acute care and manage transitory infectious diseases. Engagement, is only recently receiving greater attention [7] as it becomes increasingly evident that it can be an innovative and viable approach to ensuring appropriate care in the current environment strained by limited resources [8, 9]. Health organizations, care delivery institutions, and universities are striving to expand patient engagement beyond a token [9] level of involvement
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