Measuring outcomes in genitourinary medicine: involving service users in the measurement of outcomes

Abstract

Recently there has been increased emphasis on the user perspective in health care. At the same time the concern with effective health care is making us look more critically at the outcomes of treatment and other interventions, and the evidence available to us to make sense of effectiveness. This paper addresses the involvement of genitourinary medicine service users in outcome measurement through 3 linked questions: (1) What do we mean by outcomes? (2) What do we mean by users? and (3) What do we mean by involving?

Discrepancies between patients and professionals in the assessment of patient needs: a quantitative study of Norwegian mental health care

“…Studies have revealed that minimizing mortality, symptom reduction, achieving successful discharge and patient satisfaction dominate the general professional conception of successful outcome. Patients are more inclined to emphasize reduction of symptoms, relieving pain, living independently, feeling positive and loss of stigma (Gann 1997, Repper 2000). As indicated, the health workers' main priority may be for patients to get well.…”

“…Some patients might not have the knowledge, language or motivation that user involvement requires. User preparation and training in assertiveness, confidence‐building, group work and knowledge of service organization are suggested as fundamental means to enhance a more active participative patient role (Bowl 1996, Gann 1997).…”

“…Within the context of need assessment and decisionmaking, these directives can be understood to direct health workers towards listening to and obtaining the patient view, and acknowledging his/her uniqueness; this to be accomplished through skilful empathy and perspective-taking (Olson & Hanchett 1997, Widdershoven 1999, Yegdich 1999, Cheston et al 2000. Moreover, professionals must acknowledge the validity of patient expertise (Gann 1997, Repper 2000 and respect alternative choices and lifestyles, which are at times in conflict with medical and professional advice (Rodwell 1996). The logical consequence is that health workers need to trust patients' ability to make choices and to be willing to try new, less validated and more risky approaches to treatment (Myers & MacDonald 1996, Rodwell 1996.…”

“…2000). Moreover, professionals must acknowledge the validity of patient expertise (Gann 1997, Repper 2000) and respect alternative choices and lifestyles, which are at times in conflict with medical and professional advice (Rodwell 1996). The logical consequence is that health workers need to trust patients' ability to make choices and to be willing to try new, less validated and more risky approaches to treatment (Myers & MacDonald 1996, Rodwell 1996).…”

Measuring outcomes in genitourinary medicine: an introduction

“…Bob Gann's paper in particular, emphasized the need to re¯ect on the outcomes desired by users and how they might be involved in the measurement of outcomes in genitourinary medicine 8 . Similarly, Johnson argues that purchasers and providers view outcomes from very different perspectives, with purchasers focused on their local populations but providers usually viewing population outcomes from a wider multi-district or national perspective.…”