How to empower patients, and involve the public

Abstract

Individual empowerment and Patient and Public Involvement are a key focus for contemporary NHS policy in a quasi-market health economy concerned to emphasise patient decision making and representation as a feature of a customer focused NHS.Such language suggests a rebalancing of power in the nurse-patient relationship. The reality is it masks the wider issues of power and control in a complex health service of professional agendas and leadership, government targets and a business culture.Nevertheless, and despite these ideological and organisational constraints, there are ways in which nurses can facilitate aspects of individual patient empowerment and Patient and Public Involvement.

The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

“…However, while Anderson and Funnell (2010) agree that ‘there are certainly cultural differences in the expression of a patient’s sense of empowerment’, they alert us to the fact that culture does not hinder the ‘ability to assume responsibility and make informed decisions’ or be empowered. Authors in the UK (Piper, 2010, 2014), Italy (Russo et al, 2019) and the United Arab Emirates (UAE) (Bodolica and Spraggon, 2019) seem to agree to this point. Thus, further validation of the framework in different cultures and larger groups, including with respect to other NCDs, is necessary.…”

“…Other issues that must not be ignored include cross-cultural differences and how they might influence empowerment. Among them may be variations in strategies for engaging or empowering individuals with NCDs as well as the social-political environment and, consequently, its openness to advocacy and acceptance of individuals living with NCDs as relevant stakeholders and decision makers (Anderson and Funnell, 2010; Bodolica and Spraggon, 2019; Hawley and Morris, 2017; Piper, 2010; Roberts, 1999, 2014). As a result, in other cultures, not all steps and stages of the EL may be seen as desirable by individuals living with NCDs.…”

“…Community empowerment, on the contrary, is associated with 'joint organized work aimed at improving collective living conditions' (Ferreira and Castiel, 2009) and embraces the community and societal stages of the EL. Some activities that we attribute to Stages 2 and 3 have been described by Piper (2010Piper ( , 2014 as individual roles within the UK health system, such as engaging in the participatory process and influencing peers and policies. Thus, in the leadership training model described below, as in other traditional programmes and movements (Barbot, 2006;Escuela de Formación de Monitores FDJ, 2016;IDF, 2019;Medtronic, 2018;Pineda-Wieselberg et al, 2020; United Nations Development Programme [UNDP], 2019), empowerment extends well beyond psychological and patient-level treatment engagement and self-care decision making (restricted to Stage 1), to encompass the community and society.…”

The consultation of rugby players in co-developing a player health study: feasibility and consequences of sports participants as research partners

“…The pursuit of a democratic approach to healthcare provision and research, which has driven the growth of involvement in research, has been discussed as empowering healthcare users and patient representatives to contribute to the research process and hold researchers accountable in publicly funded research. Methods of actively empowering patients and members of the public have previously been suggested [ 31 , 32 ], and research training for the public has been discussed as enabling members of the public to critique the research cycle more effectively and improve public confidence in articulating their sentiments during involvement [ 17 ].…”