Litva Andrea, Canvin Krysia, Shepherd Michael, Jacoby Ann, Gabbay Mark
School of Population, Community and Behavioural Sciences, University of Liverpool, Liverpool, UK.
Health Expect. 2009 Mar;12(1):81-91. doi: 10.1111/j.1369-7625.2008.00530.x.
The aim of this paper is to explore variations in lay perceptions of user involvement in clinical governance.
The English National Health Service has sought to build a dependable health service through enhanced effectiveness, responsiveness and consistency. Clinical governance, a policy for improving service quality, is a key pillar of these reforms. It is a statutory duty of primary care organizations to ensure that users are involved in all service planning and decision making, including clinical governance. Yet surveys indicated that user involvement in clinical governance was underdeveloped and underutilized.
Focus groups were conducted with different types of lay people to explore their perceptions around public involvement in different aspects of clinical governance policy.
Content analysis of the transcripts reveals that different groups of lay people varied in their desired role perspective and preferred type of involvement in different aspects of clinical governance policy. Drawing upon existing models of user involvement, we identified three role perspectives that lay people could take in user involvement - consumer, advocate and citizen. We compared our findings regarding the desired type of involvement with existing models of user involvement, and identified a new type of involvement, overseeing, that is relevant to clinical governance policy.
These findings suggest that to facilitate user involvement in clinical governance, it would be necessary to use different strategies to accommodate the differing role perspectives and types of involvement desired by different groups of lay people.
本文旨在探讨公众对用户参与临床治理的认知差异。
英国国家医疗服务体系试图通过提高有效性、响应性和一致性来建立一个可靠的医疗服务体系。临床治理作为一项提高服务质量的政策,是这些改革的关键支柱。确保用户参与所有服务规划和决策,包括临床治理,是初级保健组织的法定职责。然而,调查表明用户在临床治理中的参与程度较低且未得到充分利用。
对不同类型的普通民众进行焦点小组访谈,以探讨他们对公众参与临床治理政策不同方面的看法。
对访谈记录的内容分析表明,不同群体的普通民众在期望的角色视角以及在临床治理政策不同方面更倾向的参与类型上存在差异。借鉴现有的用户参与模式,我们确定了普通民众在用户参与中可以采取的三种角色视角——消费者、倡导者和公民。我们将关于期望参与类型的研究结果与现有的用户参与模式进行了比较,并确定了一种与临床治理政策相关的新的参与类型——监督。
这些研究结果表明,为了促进用户参与临床治理,有必要采用不同的策略来适应不同群体普通民众期望的不同角色视角和参与类型。