Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

Abstract

Background and objectiveThe Individual Care Plan (ICP) was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP]) was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles.MethodsData were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model.ResultsUsers and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users’ own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred.ConclusionUse of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care documentation and planning tools.

Person‐directed care planning in nursing homes: A scoping review

“…Limited time for care planning and a lack of awareness of the value of PDCP are barriers across diverse care settings (Bjerkan, Vatne, & Hollingen, 2014). Furthermore, in LTC, many—perhaps most—staff are not trained in communication approaches that might engage residents in care planning (Børøsund, Ruland, Moore, & Ekstedt, 2014; Savundranayagam, 2014).…”

“…Adoption of health information technology that supports individuals’ engagement in care planning, or communication across individuals and care providers, also facilitates PDCP (Baumann, LupPlace, & Quasey, 2010; Bjerkan et al, 2014). Using simple tools, Lankarani‐Fard et al (2010) found that a card‐sorting game can be effective in identifying individuals’ values and priorities for end‐of‐life care.…”

Modular ICT-based patient empowerment framework for self-management of diabetes: Design perspectives and validation results

“…In the various self-management interventions also the relationship among patients and healthcare professionals is challenged. Bjerkan et al [6] examined the impact of an ICT based collaboration tool in individual care planning and realized that in some cases, a power transition took place in the care process, which led to patient empowerment. On the other hand, the study of Urowitz et al [5] about the impact of a diabetes self-management portal in patients revealed a grey area in the roles that the physicians should play in the facilitation of disease management.…”

Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions

“…A wide range of theories and tools emerging in technical and social sciences [17–20] and positive computing [21] may aid in examining recovery-relevant issues such as self-esteem, stigma, power, self-disclosure, self-regulation, writing therapy and help-seeking behavior [13–15] and how connecting with others through Internet may enable users to shape the nature of the services in line with recovery principles [17]. However, the opportunities provided by these theories and tools need to be incorporated into studies that specifically address how they may advance recovery processes.…”

“…Literature suggests that Internet can facilitate empowerment processes on a personal, interpersonal, group and citizen level [13] exemplified by increased access to social support and reduced stigma [14], power transitions between providers and service users [15] and person-centered services by allowing flexible and individually tailored services in homes and daily lives [16, 17]. At the same time, Internet-related technologies such as self-help apps, social media and virtual reality are developing so rapidly that there is a need to proactively identify and assess ways to exploit their benefits and limit their pitfalls.…”