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Research shows that patient involvement has a positive effect on clinical outcome as well as on patient satisfaction. Patients who have received information about their treatment comply with their treatment to a higher extent, are more satisfied with the treatment, and have better treatment results, and people who consider themselves in control of events respond better to treatment. In addition to this, improved clinical outcome is positively associated with good communication between health care professionals and patients.

 

However, there is a lack of knowledge about how patient involvement is carried out in practice as well as how to strengthen patient involvement. The Danish National Board of Health now opens a debate about this issue, with the report “Patient involvement between ideals and reality - an empirical study of shared decision making and ordinary encounters between patients, doctors and nurses”.

 

The report gives two contributions to the discussion on the design of patient involvement:
1) A special model for patient involvement called Shared Decision Making with an introduction to patient involvement in practice. Focus is for example on the significance of the clinical situation and the potential conflicts between patients and health care professionals’ preferences as well as the professionals’ work routines and information methods – and also patients’ multi-sided effort in relation to information.

 

Based on this model, the empirical study mentioned below examines a number of areas addressed by the model for shared decision making, for example:

2) An empirical case study of patient involvement in treatment decisions in two treatment settings in the Danish health care system. The study investigates approaches, conceptions, and interests of patients and health care professionals concerning patient involvement, understood as patients having influence – an not having influence - on their treatment. The study also discusses the dilemmas and barriers for patient involvement that arise in everyday clinical encounters; at an arthritis out-patient clinic and at a heart rehabilitation unit.

 

What does the report conclude?
The report concludes among other things that more information of a higher quality is not in itself a viable way to increase patient involvement. It is rather how and when the information is given to the patient in each separate unit that should be addressed, and how the parties interpret each other and the situation.

 

The empirical study of this report demonstrates that some parts of the dialogue leading up to treatment decisions take place before the choices are expressed. Course of action and creating explicit dialogue thus seem to be more important areas for patient involvement than the decision making itself. However, when patient preferences are included, fights for their legitimacy often arise. Thus, the power relations between patient and health care professional are challenged, when patients actively engage in the decision making process.

 

However, it is concluded that there seems to be a potential in supporting explicit patient involving dialogue. This requires that the conditions of the meeting are changed, thus giving the patient more insight into what is actually going on. 

 

The central idea is not that the patient knows all and makes his/her own decision about everything regarding the treatment. Rather, following objectives should be central:

You can read much more about patient involvement in the mentioned report (link below).

 

Source
“Patient involvement between ideals and reality - an empirical study of shared decision making and ordinary encounters between patients, doctors and nurses” (English summary), Danish National Board of Health, 2008.

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