Importance Of Patient Participation Research Articles

Management strategy of healthcare organizations. PDRQ–9 method

The main source of success for a customer-centric organization is the ability to identify its customers, identify their needs, and use that information to develop a customer-centric strategy. In this regard, there is a widespread change in attitudes toward the construction of management in organizations. Whereas previously the competitiveness of an organization could be measured by its financial performance, now the intellectual potential of an organization is at the forefront. As the role of the patient in the health care system has intensified, the importance of patient participation has received increasing attention and has become central to health care research. In this regard, in today’s environment, the foundation of success in the treatment and delivery of professional care in medicine is primarily the degree of patient satisfaction. Patient-centered care acts as a new paradigm for the development of the health care system, which is characterized by a shift in the center of gravity to the patient. In this regard, in the field of health care, the relationship between the patient and the doctor, as perceived by the patient, is one of the main elements of the methodology of scientific research. The purpose of this article is to review and analyze the results of the PDRQ–9, which assesses the patient-physician relationship. The PDRQ–9 provides researchers with a brief assessment of the therapeutic aspects of the patient-physician relationship in the primary care setting. It is a valuable tool for research and practice purposes that includes monitoring the patient-doctor relationship.

Person-centered endoscopy safety checklist: Development, implementation, and evaluation.

AIMTo describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a “checklist intervention”.METHODSThe checklist, based on previously published safety checklists, was developed and locally adapted, taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team’s performance were conducted before and after the introduction of the checklist. In addition, questionnaires focusing on patient participation, collaboration climate, and patient safety issues were collected from patients and staff.RESULTSA person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted (from 0% at baseline to 87% after 10 mo, P < 0.001), and remained high among nurses (93% at baseline vs 96% after 10 mo, P = nonsignificant). Observations indicated that the professional staff made frequent attempts to use the checklist, but compliance was suboptimal: All items in the observed nurse-led “summaries” were included in 56% of these interactions, and physicians participated by directly facing the patient in 50% of the interactions. On the questionnaires administered to the staff, items regarding collaboration and the importance of patient participation were rated more highly after the introduction of the checklist, but this did not result in statistical significance (P = 0.07/P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist; hence, no statistical difference was noted.CONCLUSIONThe intervention led to increased patient identity verification by physicians - a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.

Prevention of Pressure Ulcers in the Acute Care Setting: New Innovations and Technologies.

Pressure ulcers (PUs) challenge many in the healthcare field requiring costly and complex care. PUs result from prolonged ischemia and subsequent soft-tissue injury caused by unrelieved pressure over a bony prominence. Proper risk assessment and implementation of prevention strategies for PUs are crucial to providing comprehensive care while reducing healthcare costs. The emphasis has led to the expansion of research in PU prevention technologies in the recent years. The aim of this review is to present an evidence-based summary of some of the new innovations in PU prevention. A literature search was performed. Articles were included if the article discussed the cost, prevalence, assessment, diagnosis, and/or prevention of PUs. The literature search was limited to 2013 to 2016. A total of 1393 potential studies were identified using the search criteria. Three hundred fifty-three articles were reviewed and when possible, preference for inclusion was given to those studies with a higher level of evidence or those discussing novel ideas/innovations. The summary of topics explored includes the following: the use of risk assessment scales as an adjunct in risk identification, the benefit of alternative support surfaces to aid in prevention as compared with standard hospital mattresses, effective repositioning strategies, silicone prophylactic dressing for shear reduction, microclimate control, nutritional considerations, use of electrical stimulation for spinal cord injury patients, and the importance of patient participation.

Assessing Patient Participation in Health Policy Decision-Making in Cyprus.

Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients' involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

The Concept of Patient Participation in Forensic Psychiatric Care: The Patient Perspective.

The importance of patient participation is advocated in medical treatment and nursing care and has been linked to increased quality of care, increased patient satisfaction, and treatment adherence. Still, patients in forensic psychiatric care often report being unhappy with their experienced level of participation. The concept of patient participation is complex and has several definitions, thus it is important to investigate it from different perspectives in different contexts. The aim of this study was to describe patients' perceptions of the concept of patient participation in forensic psychiatric care. A qualitative design with a phenomenographic approach was used, and interviews with 19 participants in a Swedish setting were completed. The participants described the concept of patient participation in forensic psychiatric care as follows: influence, to have good communication and to be involved; confidence, to have mutual trust and to trust the care; and own responsibility, to participate in activities and to take the initiative. On the basis of the results of this study, improved patient participation in forensic psychiatric care may be achieved with active communication, by building up and maintaining trust for professional competence and by encouraging patients' own responsibility. It is important that knowledge about patients' views of the concept of patient participation is included in the planning and improvement of forensic care.

Client participation in care of disabled in victims of traffic accidents: a conceptual analysis

Background: Patient participation in nursing has great application and values the humanarian values of patients. Patient participation is an international golden standard in the modern nursing paradigm. Despite the importance of patient participation and its routine use in professional care, this concept is not clear, especially in social and cultural context of Iranian nursing. This study clarifies the meaning of patient participation and determines its critical attributes for victims of traffic accidents. Material and Methods: In this study the concept of patient participation was analyzed by using hybrid method in three stages as follows: (1) review of the literature, 103 related articles, available from the Google Scholar, PubMed, Yahoo, and Google databases until 2013 analyzed to identify relevant articles with keywords such as “participation in care”, “nursing”, “patient participation”, “victims of traffic accidents”; (2) the field stage, qualitative content analysis was used by interviewing 7 victims of traffic accidents and 3 in field nurses; and (3) in the final stage, an overall analysis done for the previous two stages. Findings: Based on a review of the results of three stages four themes emerged from the concept analysis of participation by victims of traffic accidents as follows: “Promoting a sense of responsibility”“, Active engagement to return to normal, “providing the field”, and “patient empowerment to improve health”. The concept of traffic accident victims participation is a dynamic process that changes over time and can complement the work of nursing and care providers through facilitating, participation, understanding, and dedicated work. Conclusion: Factors affecting patient participation in treatment decisionmaking are organizational. Knowledge of the patient, and patient willingness to participate in health care that the patient desires are the most important factors in determining participation. In the meantime, this concept is a new and complex one within the context of our nursing, which requires further study of social and cultural context of health care.

Patient Involvement in Health Care Decision Making: A Review

Background:Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions.Objectives:Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making.Materials and Methods:To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article.Results:Based on the review of articles and books, topics were divided into six general categories: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making.Conclusions:In most studies, factors influencing patient participation consisted of: factors associated with health care professionals such as doctor-patient relationship, recognition of patient’s knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.

Older patients’ participation in team meetings—A phenomenological study from the nurses’ perspective

Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM) to which the patient has been invited. The aim of this study is to highlight nurses’ experiences of older patients’ participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients’ vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: “the need for a guide,” “patient participation challenged by structures,” and “creating space for the whole human being.” In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.

Managing the urinary tract in spinal cord injury

This review sets out to provide an overview of the author’s approach to the management of the urinary tract in the patient who has suffered from an injury to their spinal cord. Emphasis is given to the need to understand the fundamental pathophysiological patterns that are seen with injuries that involve the sacral segments of the cord (the conus) and those that spare the conus but interrupt communication between the sacral parasympathetic and somatic centers and the brain (supraconal lesions). The importance of patient participation in management decisions is highlighted by considering the different ways in which the urinary tract can be managed and how the clinician needs to try to meet patient expectations and requirements while establishing safe urological management. Finally, consideration is given to the importance of establishing an appropriate follow up regime and managing urinary tract complications effectively.

Individuals’ responses to global CHD risk: A focus group study

Objective To explore how individuals respond to global coronary heart disease (CHD) risk and use it in combination with treatment information to make decisions to initiate and maintain risk reducing strategies. Methods We conducted four focus groups of individuals at risk for CHD ( n = 29), purposively sampling individuals with each of several risk factors. Two reviewers coded verbatim transcripts and arbitrated differences, using ATLAS.ti 5.2 to facilitate analysis. Results Participants generally regarded the concept of global CHD risk as useful and motivating, although had questions about its precision and comprehensiveness. They identified several additional influential factors in decision-making (e.g. achievable risk, the quickness and self-evidence of results) and generally preferred lifestyle changes to medications (although most would accept medications under certain circumstances). They also noted the importance of participating in decision-making. Conclusion Our results underscore the motivating potential of global CHD risk and the importance of patient participation in decision-making. Practice implications Global CHD risk is a useful adjunct to CHD prevention and can be presented in ways, and with information, that might improve CHD outcomes.

The Importance of Patient Participation in Second-Line Chemotherapy Decisions: Perspectives of African-American Patients

Minority populations have been considered to be less-active participants in their health and, consequently, more vulnerable to having decisions made for them. We interviewed African-American patients (N=26) with cancer who had recently consented to second-line chemotherapy, offered when their disease was no longer responding to standard first-line regimen. The majority (73%) reported involvement in the decision to start second-line chemotherapy. Forty-two percent reported making the decision together with their doctor. Support for autonomy was positively associated with education (p=0.01). Information seeking was considered more important than participating in decision-making. Patients who were less educated and had lower income reported stronger internal belief that their own actions and behaviors would determine their future health (p=0.04, p=0.007, respectively). Depression was identified in 35% of the study group and found not to be associated with any of the main outcomes. Although the majority of patients report participating in the decision to begin second-line chemotherapy, there are a diversity of views towards autonomy, the importance of information seeking and determinants of future health. Understanding patients' beliefs and attitudes around the time of disease recurrence may assist clinicians in supporting patients during this stressful time.

Symptom Status and Quality of Life Following Prostatectomy

When prostatectomy is proposed as treatment for the symptoms of prostatism, the decision to operate should depend on how patients evaluate their symptoms and on objective information about the outcomes. We undertook a health interview study to determine the probabilities for symptom relief, improvement in the quality of life, and complications following surgery and to evaluate patient concern about the symptoms of prostatism. The operation was effective in reducing symptoms: 93% of severely and 79% of moderately symptomatic patients experienced improvement; however, a statistically significant improvement in indices of quality of life occurred only among patients with acute retention or severe symptoms prior to surgery. Short-term complications of varying severity occurred in 24% of patients; in addition, 4% reported persistent incontinence and 5%, impotence. Patients with similar symptoms reported considerable difference in the degree to which they were bothered by their symptoms. The result emphasizes the importance of patient participation in the decision to undergo prostatectomy. ( JAMA 1988;259:3018-3022)

Do-Not-Resuscitate Orders

To the Editor.— The importance of patient participation in the decision not to resuscitate is widely accepted. 1 Bedell et al, 2 in a study of 521 patients who had a cardiopulmonary arrest, found that 76% of do-not-resuscitate (DNR) orders were written without patient participation because of abnormal mental status (due to dementia, encephalopathy, or coma). Study.— We examined a cohort of 133 consecutive admissions to an acute medical ward of a 966-bed teaching hospital. We looked for the presence of delirium both on admission and prospectively until discharge using DSM-III criteria, a definition inclusive of both encephalopathy and coma. In addition, we took note of any history of dementia and whether a DNR order was written. Thirteen (72%) of the 18 patients who died in our cohort were designated DNR, four from the day of admission and nine later in the hospital course. Ten (77%) of the 13 patients