102,131 research outputs found
Giving (Back) a Role to Patients in the Delivery of Healthcare Services: Theoretical Roots of Patient Engagement
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Consumer-brand engagement: toward a comprehensive theoretical framework
No full textConsumer-brand engagement (CBE) is a recent concept in the marketing literature expanding the domain of relationship marketing. The concept of CBE has become increasingly important in the academic and managerial marketing debate over the last years, as Brodie et al. (2011) and Gambetti and Graffigna (2010) pointed out, being recently recognized as a central marketing issue by the Marketing Science Institute (2010). CBE has been seen by academics as a fundamental driver of both consumer decision-making process and brand equity, being considered by marketers as a priority in branding strategies. In the current academic marketing debate there is a clear intention toward the development of a unitary definition of the CBE concept. Extant studies made a great effort in defining the key dimensions which play a role in the development of CBE as well as the main drivers of this construct. However, authoritative scholars interested in defining and measuring CBE focused so far on this concept as a static state of mind of an individual that can be circumscribed to an affinity-based oneto- one relationship form between brand and consumer. Only a few scholars put forth the idea that CBE is a process-based phenomenon, acting as an overarching construct that has a dynamic nature and that includes and organizes other dimensions of the consumption experience. In this regard, we believe that in order to attempt a realistic definition of CBE, it is necessary to found the construct on the basis of a context-driven, inductive, field research approach. Hence, our study develops a Grounded Theory methodological approach pursuing an inductive point of view rooted in the field and firmly anchored in data that investigates consumers’ and practitioners’ experience of CBE. Our aim is to draft a first ecological foundation of the CBE construct
Understanding the Meaning of Fatigue at the End of Life: An Ethnoscience Approach
No full textPurpose: Fatigue is a devastating state of body and mind associated with distress at the end of life. We report the results of the third in a series of papers outlining a novel approach we have developed for understanding the meaning of fatigue by exploring how this meaning is shaped by beliefs and values. The aims of the study were to examine the perception and experiences of fatigue held by patients attending a hospice in England; identify the behavioural patterns that distinguish fatigue from tiredness and exhaustion; provide conceptual definitions of tiredness, fatigue and exhaustion.
Method: An Ethnoscience design was selected. The sample comprised nine people who attended a hospice between May and December 2009. Inclusion criteria included: at least 18 years of age, experiencing fatigue, able to provide informed consent and resident in the selected city in northern England for 10 years. Data were collected from two consecutive semi-structured interviews for each participant.
Results: We found that tiredness, fatigue and exhaustion are markers of progressive functional decline. Fatigue had two dimensions: 1) Mental Challenge, which included: emotional effects, cognitive realisation of decline and mental tenacity and 2) Physical Challenge, which included: limitations in leisure activities, limitations in functional roles and re-patterning routines.
Conclusions: This study provides evidence that symptom experience is socially constructed, which has potential implications for the development of effective interventions
Editorial: Consumer Engagement in Health and Well-being: Theoretical and Empirical Perspectives in Patient Centered Medicine
No full textThe growing understanding of the key role of people in improving healthy behaviors and clinical outcomes has led healthcare to search for innovative ways to foster individuals' roles in the care and health promotion processes. It comes as no surprise, therefore, that making consumers active agents in their health and care is up today recognized as a key priority for services' innovation. In the era of participatory health, the concept of “engagement” may be particularly promising to give consumers a starring role in managing their health and well-being.
The healthcare field has recently introduced the term “engagement” in its lexicon to call for a renewed partnership among the actors (i.e., patients, caregivers, practitioners, decision makers...) implied in the health and care management. Overall, the concept of engagement attempts to offer a compass for action in the current complex and uncertain context of healthcare design and health promotion initiatives. The main aim is giving (back) a leading role to patients and taking them on board for a more efficient and effective process of care delivery and of health promotion initiatives. Furthermore, consumer health engagement can be the key to systematically diagnose and make sense of the different organizational, relational, and psychological components in play in the dynamic exchange between “demand” and “supply” of health and care. This challenge could or even should be integrated with a complex attempt coming from the literature on medicine and regarding a new medical model that should be offered to patients/clients/consumers: that of a patient centered medicine, based on a biopsychological epistemolog
How to prevent and avoid barriers in co-production with family carers living in rural and remote area: an Italian case study
No full textBackground: Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted. Methods: To investigate this topic, we undertook a single case study - a longitudinal project (Place4Carers (Graffigna et al., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process. Results: The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants’ inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers’ satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production. Conclusions: Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together
Patient engagement as a qualifier of the exchange between demand and supply of health: The case of chronicity
No full textThe last decades' changes in the epidemiological trends of chronic disease for the majority of Western population have introduced important changes in the organization and management of the healthcare systems. Therefore, health systems throughout the world are searching for new and effective ways of making their services more responsive to the new patients and the public health needs and demand. To make people aware of their health services options by supporting them in the decision-making process and to engage them in enacting preventive healthy behavior is crucial to achieve successful health outcomes and reduce healthcare costs. In this paper, we will outline a model that explains the subjective experience patients' get through to be engaged in their care process and its implication for the patient-doctor relation and for the patient's quality of life. Moreover, the concept of patient engagement will be discussed in relation to other concepts - such as patient adherence, patient compliance, self-management, patient involvement, patient participation, shared decision-making, and patient activation - traditionally used to denote the active role of patients in their care
Engaging patients to recover life projectuality: an Italian cross-disease framework
No full textPurpose: Chronic disease is recognized as having a large impact on patient quality of life (QoL), which can be defined as an individual’s satisfaction or happiness with life in domains he or she considers important. Policy makers and clinicians recognize increasingly that patients can safeguard their QoL by making healthy lifestyle choices and being actively engaged in their health care. However, in the emphasis on promoting patient engagement to enhance patients’ QoL, there is no consensus regarding the relationship between QOL and patient engagement, resulting in a lack of shared guidelines among clinicians on interventions. Furthermore, no studies have provided an in-depth exploration of the perspective of patients with chronic conditions who are engaged in their health care and their requirements to achieve an improved QoL. Given this theoretical gap, the present study attempted to explore the patient engagement experience and its relationship with patient QoL in the context of the Italian healthcare system and in relation to different chronic diseases.Methods: In-depth qualitative interviews on a sample of 99 patients with a wide variety of chronic conditions (heart failure, chronic obstructive pulmonary disease, stroke, diabetes, and cancer).Results: Patient engagement in health care can be defined as a context-based and cross-disease process that appears to enable patients to recover their life projectuality, which had been impaired by the onset of chronic disease. Successful patient engagement may also be related to a positive shift in the ways in which patients perceive self and life and experience empowerment to realize their life potential, thus improving quality of life. Patient engagement is a powerful concept capable of reflecting significant psychosocial changes that promote patient QoL along the care process. There appears to be theoretical and empirical justification for a broad definition of QoL.Conclusions: QoL deeply depends on the patient ability to engage in their care and on the health expectations they have. We propose a model of the relation between patient engagement and patients’ trajectories in critical event responses and use it to illustrate a new perspective on QoL. This research showed the heuristic value patient engagement as a is a key concept in the promotion of a patients’ experience-sensitive QoL interventions and assessment measures
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