‘Managing patient involvement’: provider perspectives on diabetes decision‐making

Shortus, Tim; Kemp, Lynn; McKenzie, Suzanne; Harris, Mark

doi:10.1111/j.1369-7625.2011.00700.x

Cited by 32 publications

(45 citation statements)

References 12 publications

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“…Findings have shown that the main motive for health professionals to initiate user involvement is to gain access to user knowledge as an alternative to professional knowledge or as support for professional knowledge (Sahlsten, Larsson, Sjöström, & Plos, 2009; Solbjør & Steinsbekk, 2011). However, the responsibility to deliver evidence-based or high-quality care, together with respecting service users’ right to make decisions, is sometimes described as conflicting (Shortus, Kemp, McKenzie, & Harris, 2013; Solbjør & Steinsbekk, 2011). Ensuring high-quality care is described as an argument for limiting user involvement and for professionals to decide and to exert control over patient care (Larsson, Liljedahl, & Gard, 2010; Shortus et al, 2013; Solbjør & Steinsbekk, 2011; Tobiano, Bucknall, Marshall, Guinane, & Chaboyer, 2015; Tobiano, Marshall, Bucknall, & Chaboyer, 2016), valuing professional knowledge above user knowledge (Solbjør & Steinsbekk, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…However, the responsibility to deliver evidence-based or high-quality care, together with respecting service users’ right to make decisions, is sometimes described as conflicting (Shortus, Kemp, McKenzie, & Harris, 2013; Solbjør & Steinsbekk, 2011). Ensuring high-quality care is described as an argument for limiting user involvement and for professionals to decide and to exert control over patient care (Larsson, Liljedahl, & Gard, 2010; Shortus et al, 2013; Solbjør & Steinsbekk, 2011; Tobiano, Bucknall, Marshall, Guinane, & Chaboyer, 2015; Tobiano, Marshall, Bucknall, & Chaboyer, 2016), valuing professional knowledge above user knowledge (Solbjør & Steinsbekk, 2011). Although actively involved patients were considered valuable to enrich the professionals’ work, it is also looked upon as time-consuming and increasing the workload (Arnetz, Winblad, Arnetz, & Höglund, 2008; Arnetz & Zhdanova, 2015; Solbjør & Steinsbekk, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

Sagsveen

Rise

Grønning

et al. 2018

International Journal of Qualitative Studies on Health and Well

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The aim of this study was to explore how professionals experience user involvement at an individual level and how they describe involving users at Healthy Life Centres. Four focus group interviews were conducted with a total of 23 professionals. Data were analysed using systematic text condensation. Four themes were identified: (1) Involving users through motivational interviewing; (2) Building a good and trustful relation; (3) Assessing and adjusting to the user’s needs and life situation; and(4) Strengthening the user’s ownership and participation in the lifestyle change process. Motivational interviewing was described by the professionals as a way to induce and ensure user involvement. However, seeing motivational interviewing and user involvement as the same concept might reduce user involvement from being a goal in itself and evolve into a means of achieving lifestyle changes. The professionals might be facing opposing discourses in their practice and a dilemma of promoting autonomy and involvement and at the same time promoting change in a predefined direction. Greater emphasis should thus be put on systematic reflection among professionals about what user involvement implies in the local Healthy Life Centre context and in each user’s situation. Abbreviations: HLC: Healthy Life Centre; MI: Motivational Interviewing; NCD: Non-communicable diseases; STC: Systematic Text Condensation. SDT: Self-determination theory

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

Sagsveen

Rise

Grønning

et al. 2018

International Journal of Qualitative Studies on Health and Well

View full text Add to dashboard Cite

show abstract

“…Providers need to understand the potential influence of cultural factors on DSM so that they can provide culturally competent DSM education in a context that promotes patient understanding and adherence (2). However, the literature is limited on the role of culture in DSM from the providers’ perspective (3–6), and is even more limited with regard to Arab Americans specifically.…”

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confidence: 99%

“…Proper education is central to effective DSM, and health care providers play a primary role in providing this education (5,6,11). Providers must pay special attention to cultural competence because different cultures view diabetes, and hence DSM, in different ways.…”

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confidence: 99%

Diabetes Is Devastating, and Insulin Is a Death Sentence: Provider Perspectives of Diabetes Self-Management in Arab-American Patients

et al. 2017

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IN BRIEF The purpose of this qualitative study was to examine providers’ perspectives on cultural barriers and facilitators to diabetes self-management (DSM) in Arab Americans to identify factors to enhance DSM education in the Arab-American community. The main barriers to DSM from the providers’ perspective were the disease itself and patients’ denial or refusal to recognize it, reflecting the stigma of the disease. Cultural aspects also included overlapping themes that both facilitated and presented barriers to DSM. These results suggest that DSM education for Arab Americans will be most effective if developed and delivered in a manner consistent with the cultural facilitators and barriers noted by providers.

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“…These low summed involvement scores likely indicate that patients are “generally not” or only “sometimes” involved in their health care relating to a particular medical condition. Most of the existing literature on this topic is more qualitative in nature and studied individual patient’s preferences with the patient’s involvement in care and effectiveness of specific techniques 23–25. This is an important finding because now that we know that patients are not very involved in their health care, we can further study how this lack of involvement affects quality of care, health outcomes, and patient safety.…”

Section: Discussionmentioning

confidence: 99%

Quantifying the relationship between patient characteristics and involvement in developing and implementing a treatment plan

Roy

Ulrich

2017

DHPS

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ObjectiveImproving the patient-physician relationship through patient involvement in the care may lead to improved patient safety and better health outcomes. There exists a gap in knowledge in identifying factors that affect self-reported patient involvement in individualized treatment plans. The objectives of this study were to 1) describe patients’ perceptions of their involvement in the creation and implementation of their treatment plans and 2) determine if patient involvement varied by medical condition or demographic characteristics.MethodsThis study was a cross-sectional analysis of data from the “Quality of Care” module of the 2008 Health and Retirement Study (HRS). The individuals of HRS surveys were older than 50 years. One-way analyses of variance were conducted to determine differences between patient characteristics and involvement in creating a treatment plan. A linear regression was conducted to determine predictors of the summed involvement score.ResultsAverage summed scores for each domain (shared decision-making, counseling, and follow-up) and overall involvement scores were ~50%. Linear regression showed that being non-White, older age, and diagnosed with a psychiatric condition or diabetes were predictors of increased self-reported involvement in the development and communication of a patient’s treatment plan.ConclusionAge, race, and having diabetes or a psychiatric condition were the major predictors affecting patient involvement in care, although overall involvement in care was low for all groups.Practice implicationsPatient involvement in care was lower than expected and should be further studied to determine the effects of involvement on health outcomes.

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‘Managing patient involvement’: provider perspectives on diabetes decision‐making

Abstract: Background Most studies of shared decision-making focus on acute treatment or screening decision-making encounters, yet a significant proportion of primary care is concerned with managing patients with chronic disease.

Cited by 32 publications

References 12 publications

Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

Diabetes Is Devastating, and Insulin Is a Death Sentence: Provider Perspectives of Diabetes Self-Management in Arab-American Patients

Quantifying the relationship between patient characteristics and involvement in developing and implementing a treatment plan

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