1,721,147 research outputs found
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
Patient engagement in healthcare: Pathways for effective medical decision making
No full textMaking patients protagonists of decisions about their care is a primacy in the 21st century medical ethics. Precisely, to favor shared treatment decisions potentially enables patients' autonomy and self-determination, and protects patients' rights to make decisions about their own future care. To fully accomplish this goal, medicine should take into account the complexity of the healthcare decision making processes: patients may experience dilemmas when having to take decisions that not only concern their patient role/identity but also involve the psychosocial impact of treatments on their overall life quality. A deeper understanding of the patients' expected role in the decision making process across their illness journey may favor the optimal implementation of this practice into the day-to-day medical agenda. In this paper, authors discuss the value of assuming the Patient Health Engagement Model to sustain successful pathways for effective medical decision making throughout the patient's illness course. This model and its relational implication for the clinical encounter might be the base for an innovative "patient-doctor relational agenda" able to sustain an "engagement-sensitive" medical decision making
Patient Health Engagement (PHE) model in enhanced recovery after surgery (ERAS): Monitoring patients' engagement and psychological resilience in minimally invasive thoracic surgery
No full textIn the last decade, the humanization of medicine has contributed to an important shift in medical paradigms (from a doctor-centered to a patient-centered approach to care). This paradigm shift promoted a greater acknowledgement of patient engagement as a crucial asset for healthcare due to its benefits on both clinical outcomes and healthcare sustainability. Particularly, patient engagement should be considered a vital parameter for the healthcare system as well as it is a marker of the patients' ability to be resilient to the illness experience and thus to be an effective manager of his/her own health after the diagnosis. For this reason, measuring and promoting patient engagement both in chronic and acute care is today a priority for healthcare systems all over the world. In this contribution, the authors propose the Patient Health Engagement (PHE) model and the PHE scale as scientific and reliable tools to orient clinical actions and organizational strategies based on the patient engagement score. Particularly, this work discusses the implication of the adoption of these scientific tools in the enhanced recovery after surgery (ERAS) experience and their potentialities for healthcare professionals working in thoracic surgery settings
Innovating healthcare in the era of patient engagement: Challenges, opportunities & new trends
No full textMaking patients active participants in their healthcare is recognized as a crucial component of high-quality healthcare services, particularly in the treatment of chronic diseases. The growing understanding of the key role of patient engagement in improving healthy behaviours and clinical outcomes has led healthcare to search for innovative ways to foster individuals’ roles in the care process: patient engagement may lead to more responsive services and better outcomes of care by incorporating the patient’s values and preferences into care plans. While, patient (dis)engagement may produce a waste of healthcare resources and poor clinical outcomes, comprehensive patient engagement across the continuum of care still presents a challenging task for hospitals and health systems, as it requires not only redesigning current care approaches, but also working with patients to identify ways to integrate care management into daily routines and activities; with this aim, new technologies may play a fundamental role. Based on these premises, this chapter sets the ground for the topics presented in this book and introduces the main challenges that healthcare systems currently face. Within this framework, this chapter also highlight the reasons why healthcare professionals and managers must regard patient engagement as the key to redesigning healthcare and making it more sustainable at the economic, sociological, and psychological levels
Engagement-sensitive decision making: Training doctors to sustain patient engagement in medical consultations
No full textQuestioning about "how to talk with patients" and how to make them engaged in healthcare decision making is currently a policy imperative for Western healthcare systems. Making patients active participants of their care process is increasingly advocated as an ideal model for medical consultations, as it has the potential to deliver better health outcomes and a more efficient use of resources through retaining patients’ autonomy and self-determination. However, beyond the evident benefits of patient engagement in healthcare, it should be also considered that doctors - in their daily practice - are commonly challenged by the diversity of situations that arise when they attempt to engage health consumers in clinical decision making. Indeed, consistently engaging patients in daily clinical practice asks doctors to be able to recognize that patients’ different clinical statuses and engagement dispositions might require different relational styles. Clearly, different situations require different communication approaches and doctors should be trained to adapt their relational style according to the specificities of such situations. This chapter will be devoted to discussing the opportunities offered by an "engagement-sensitive decision making" in order to orientate doctors’ relational skills and decisional style according to patients’ needs at each phase of the health engagement process. Insights for medical education and the potential value of new technologies aimed at improving doctors’ relational strategies to improve patient engagement will be also provided
Tools and Technologies for Patients and Caregivers Engagement: A Qualitative Analysis of Health Professionals’ Attitudes and Day-to-Day Practice
No full textAs patient engagement cannot be achieved without health professionals co-operation and agreement, attention to the clinicians’ views and attitudes about patient engagement is essential in order to deepen potential enablers and barriers for its implementation. This qualitative study aimed to identify health professionals’ attitudes towards patient engagement and the perceived hindrances and facilitators to the implementation of the patient engagement strategies in their routine practice with a particular focus of health information technologies for patient engagement. It identifies the dimensions underlying patient engagement realization, namely clinicians’ “Meanings and attitudes towards patient engagement”, “practical experience of patient engagement”, and “being a health professional in the era of patient engagement”, as well as highlights the fashion in which these dimensions operate will either activate or inhibit patient engagement innovation. Finally, the study highlighted the great potential of health technologies to support patient engagement if they are enablers of the patient-clinician relationship and not replace it
Spotlight on the patient health engagement model (PHE model): A psychosocial theory to understand people’s meaningful engagement in their own health care
No full textThe concept of patient engagement in health care is gaining more and more attention not only in the scientific literature, but also as a requirement in the everyday practices of health care organizations. In general terms, the growing body of literature devoted to patient engagement is mainly inspired by the sociological and public health perspectives, which have generated various theories and models trying to explain how people become active agents in their health and care management. However, theories focusing on the psychosocial dimensions intervening in the patient engagement experience are still limited. This paper proposes a psychosocial perspective on patient engagement and discusses the Patient Health Engagement model, which is an evidence-based psychological theory built on extensive qualitative narrative research and literature analysis aimed at explaining patient engagement and its development in the patients’ perspective. The model has been applied to orient patient and professional educational interventions and has contributed to the generation of the first scientific measure of the psychological experience of patients’ engagement in their own care (Patient Health Engagement scale). According to this theory, patient engagement is a developmental process that involves the recovered patients’ ability to have a life projectuality and goal directedness – even if living with a disease. The paper will also discuss the theoretical origins of this model and will conduct a critical comparison of the theory with the Transtheoretical Model of Change developed by Prochaska and the five-stage grief theory by Kubler-Ross
Ethics and etiquette in neonatal intensive care: The value of parents' engagement in everyday ethics and recommendations for further advancing the field
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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
How does patient engagement work in a real-world setting? Recommendations, caveats, and challenges from a psychosocial perspective
No full textObjective: To propose a possible taxonomy for diverse stakeholders outside the healthcare communication field and to promote meaningful patient engagement in healthcare settings. Moreover, to support them in making more coherent policy, strategy, and practice decisions to enhance patient participation in their healthcare systems. Discussion: This paper is part of the pEACH Position Papers Series and provides a critical and experience-based reflection on patient engagement in different healthcare-related settings. We propose a framework that operationalises actionable patient engagement at the micro-meso-macro levels. Finally, the authors will highlight some “points of attention” that need to be addressed to support patient engagement implementation in healthcare organisations. Conclusion and practice implications: Understanding and systematising the established meanings of patient engagement through a psychosocial lens is critical to addressing the following questions: "how can various health care organisations ensure that authentic patient engagement informs decision-making and strategies", "how can these organisations build authentic connections with their patients", and importantly, "how can patients gain valuable and reliable insights through patient engagement"? Answering these questions can enable key stakeholders to make informed decisions that ensure the quality and effectiveness of patient engagement initiatives in different healthcare settings
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