Being in an exchange process: Experiences of patient participation in multimodal pain rehabilitation

Abstract

Objective: To explore primary healthcare patients' experiences of patient participation in multimodal pain rehabilitation. Patients and methods: A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis. Results: One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients' emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient's personal relationships with the health professionals, forming the category Confidenceinspiring alliance. In the category Competent health professionals, the health professionals' expertise, empathy and personal qualities, were emphasized to favour patient participation. Conclusion: Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient's needs in the participation process may favour patient participation.

Patient participation from the perspective of staff members working in spinal cord injury rehabilitation

“…For patients to make use of the knowledge, it is important that staff members deliver the information in a manner commensurate with patients' individual needs and abilities [15]. Moreover, the staff members need to get to know and respect the patients in order to build a close cooperative relationship [15,[18][19][20]. Cooperation is fostered by an inviting environment where staff members are genuinely attentive to the patient and the patients are recognized as human beings [18].…”

Patient Participation in Physical Medicine and Rehabilitation: A Concept Analysis

“…14 Other studies refer to the process of participation and its subjective meaning for the patients. 38,39,[43][44][45] Some examples are being in an exchange process; 43 a mutually shared process 44 and becoming in charge as soon as possible, but not until they felt ready. 38 The patient is present as an actor in all three examples and they all refer to the encounter between the patient and the RPs.…”

“…With regard to the patients' description of participation the encounter is most fruitful when RPs invite them to a dialogue. 43 Patients can experience that they participate in the encounter when they can respond to the suggestions made by the RPs and when they are asked for opinions. 43,45,46 Moreover, patients feel that they participate when they are respected as unique persons 39,43,[45][46][47] and when their opportunities to participate are individually tailored.…”

“…43 Patients can experience that they participate in the encounter when they can respond to the suggestions made by the RPs and when they are asked for opinions. 43,45,46 Moreover, patients feel that they participate when they are respected as unique persons 39,43,[45][46][47] and when their opportunities to participate are individually tailored. 5,36,37,39 In relation to patient participation there are two rehabilitation activities frequently used, namely goal planning and shared decisionmaking.…”

“…Both parts are seen as important contributors; patients with their subjective experiences and RPs with their medical and clinical competence, which they must share. 4,11,37,39,43,44,49,51,53,55,57 iii. Focus on and respect for the patient's condition, needs, desires and preferences.…”