scholarly journals What patient involvement means to new patients at two HIV clinics: A longitudinal, qualitative study

2019 ◽  
Vol 102 (8) ◽  
pp. 1535-1540 ◽  
Author(s):  
Jennifer Freytag ◽  
Zhixin J. Jiang ◽  
Thomas P. Giordano ◽  
Robert A. Westbrook ◽  
Sheryl A. McCurdy ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Patient Involvement

Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

2021 ◽  
Author(s):  
Veena Graff ◽  
Justin T. Clapp ◽  
Sarah J. Heins ◽  
Jamison J. Chung ◽  
Madhavi Muralidharan ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Shared Decision ◽  
Structured Interviews ◽  
Primary Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how patients should participate in decisions. Evaluating the feasibility and desirability of carrying out shared decision-making in anesthesia requires better understanding of preoperative conversations. The objective of this qualitative study was to characterize how preoperative consultations for primary knee arthroplasty arrived at decisions about primary anesthesia. Methods This focused ethnography was performed at a U.S. academic medical center. The authors audio-recorded consultations of 36 primary knee arthroplasty patients with eight anesthesiologists. Patients and anesthesiologists also participated in semi-structured interviews. Consultation and interview transcripts were coded in an iterative process to develop an explanation of how anesthesiologists and patients made decisions about primary anesthesia. Results The authors found variation across accounts of anesthesiologists and patients as to whether the consultation was a collaborative decision-making scenario or simply meant to inform patients. Consultations displayed a number of decision-making patterns, from the anesthesiologist not disclosing options to the anesthesiologist strictly adhering to a position of equipoise; however, most consultations fell between these poles, with the anesthesiologist presenting options, recommending one, and persuading hesitant patients to accept it. Anesthesiologists made patients feel more comfortable with their proposed approach through extensive comparisons to more familiar experiences. Conclusions Anesthesia consultations are multifaceted encounters that serve several functions. In some cases, the involvement of patients in determining the anesthetic approach might not be the most important of these functions. Broad consideration should be given to both the applicability and feasibility of shared decision-making in anesthesia consultation. The potential benefits of interventions designed to enhance patient involvement in decision-making should be weighed against their potential to pull anesthesiologists’ attention away from important humanistic aspects of communication such as decreasing patients’ anxiety. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Patient involvement in French Lung cancer guidelines: A qualitative study

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 7603-7603
Author(s):  
A. Bataillard ◽  
J. Carretier ◽  
H. Cazeneuve ◽  
B. Fervers
Keyword(s):  
Lung Cancer ◽  
Qualitative Study ◽  
Patient Involvement ◽  
Cancer Guidelines

Is patient involvement possible when decisions involve scarce resources? A qualitative study of decision-making in primary care

2004 ◽  
Vol 59 (1) ◽  
pp. 93-102 ◽  
Author(s):  
Ian Rees Jones ◽  
Lee Berney ◽  
Moira Kelly ◽  
Len Doyal ◽  
Chris Griffiths ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Patient Involvement ◽  
Scarce Resources

scholarly journals Discharge from the acute hospital: trauma patients’ perceptions of care

2016 ◽  
Vol 40 (6) ◽  
pp. 625 ◽  
Author(s):  
Lara A. Kimmel ◽  
Anne E. Holland ◽  
Melissa J. Hart ◽  
Elton R. Edwards ◽  
Richard S. Page ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Trauma Patient ◽  
Patient Involvement ◽  
Acute Hospital ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Lack Of Information ◽  
Follow Up Care

Objective The involvement of orthopaedic trauma patients in the decision-making regarding discharge destination from the acute hospital and their perceptions of the care following discharge are poorly understood. The aim of the present study was to investigate orthopaedic trauma patient experiences of discharge from the acute hospital and transition back into the community. Methods The present qualitative study performed in-depth interviews, between October 2012 and November 2013, with patients aged 18–64 years with lower limb trauma. Thematic analysis was used to derive important themes. Results Ninety-four patients were interviewed, including 35 discharged to in-patient rehabilitation. Key themes that emerged include variable involvement in decision-making regarding discharge, lack of information and follow-up care on discharge and varying opinions regarding in-patient rehabilitation. Readiness for discharge from in-patient rehabilitation also differed widely among patients, with patients often reporting being ready for discharge before the planned discharge date and feeling frustration at the need to stay in in-patient care. There was also a difference in patients’ perception of the factors leading to recovery, with patients discharged to rehabilitation more commonly reporting external factors, such as rehabilitation providers and physiotherapy. Conclusion The insights provided by the participants in the present study will help us improve our discharge practice, especially the need to address the concerns of inadequate information provision regarding discharge and the role of in-patient rehabilitation. What is known about the topic? There is no current literature describing trauma patient involvement in decision-making regarding discharge from the acute hospital and the perception of how this decision (and destination choice; e.g. home or in-patient rehabilitation) affects their outcome. What does this paper add? The present large qualitative study provides information on patients’ opinion of discharge from the acute hospital following trauma and how this could be improved from their perception. Patients are especially concerned with the lack of information provided to them on discharge, their lack of involvement and understanding of the choices made with regard to their discharge and describe concerns regarding their follow-up care. There is also a feeling from the patients that they are ready to leave rehabilitation before their actual planned discharge date, a concept that needs further investigation. What are the implications for practitioners? The patient insights gained by the present study will lead to a change in discharge practice, including increased involvement of the patient in the decision-making in terms of discharge from both the acute and rehabilitation hospitals and a raised awareness of the need to provide written information and follow-up telephone calls to patients following discharge. Further research into many aspects of patient discharge from the acute hospital should be considered, including the use of rehabilitation prediction tools to ensure patient involvement in decision-making and a discharge and/or follow-up coordinator to ensure patients are aware of how to access information after discharge.

scholarly journals Patient involvement for improved patient safety: A qualitative study of nurses’ perceptions and experiences

Nursing Open ◽  
2017 ◽  
Vol 4 (4) ◽  
pp. 230-239 ◽  
Author(s):  
Janna Skagerström ◽  
Carin Ericsson ◽  
Per Nilsen ◽  
Mirjam Ekstedt ◽  
Kristina Schildmeijer
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Patient Involvement ◽  
Nurses Perceptions

scholarly journals Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Caroline Trillingsgaard Mejdahl ◽  
Liv Marit Valen Schougaard ◽  
Niels Henrik Hjollund ◽  
Erik Riiskjær ◽  
Kirsten Lomborg
Keyword(s):  
Qualitative Study ◽  
Patient Involvement ◽  
Methodological Approach ◽  
Patient Activation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Phone Call ◽  
Structured Interviews ◽  
Patient Reported

Abstract Background This article addresses patient-reported outcome (PRO)-based follow-up used as a substitute for regularly scheduled follow-ups. In PRO-based follow-up, patients’ PRO data filled in by the patients at home are used by clinicians as a decision aid to identify those who need clinical attention based on an automated PRO algorithm, clinical attention being either a phone call or a physical consultation. A physical consultation in the outpatient clinic prompted by the patient’s PRO is termed a “PRO consultation.” In this multi-perspective qualitative study, we explored the influence of patients’ self-reported data on patient-clinician interaction during PRO consultations in epilepsy outpatient clinics. Interpretive description was the methodological approach, applying data from participant observations, informal interviews with clinicians, and semi-structured interviews with clinicians and patients. Results We found that application and deliberate use of patients’ PRO measures can affect patient-clinician interaction, promoting patient involvement in terms of improved communication and increased patient activation. These findings reflect the general patterns that have been reported in the literature. In addition, we found that PRO measures also may induce unmet expectations among some patients that can have a negative effect on patients’ experiences of the interaction and their follow-up experience in general. We extracted two thematic patterns that represent PRO measures’ potential for patient involvement in the patient-clinician interaction. The first pattern represents enablers, and the second pattern represents barriers for PRO measures to affect patient involvement. Conclusions Applying PRO measures in clinical practice does not automatically enhance the patient-clinician interaction. To strengthen the benefits of PRO measures, the following supplementary clinical initiatives are suggested: summarizing and reporting the PRO measures back to the patient, considering carefully which PRO measures to include, training clinicians and assuring that the patients’ introduction to PRO-based follow-up clarifies expectations.

Implementation of patient involvement methods in the clinical setting: A qualitative study exploring the health professional perspective

2019 ◽  
Vol 26 (3) ◽  
pp. 765-776 ◽  
Author(s):  
Marianne Johansson Jørgensen ◽  
Charlotte Gjørup Pedersen ◽  
Helle Max Martin ◽  
Kirsten Lomborg
Keyword(s):  
Qualitative Study ◽  
Health Professional ◽  
Clinical Setting ◽  
Patient Involvement ◽  
Professional Perspective
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