Fumagalli Lia Paola, Radaelli Giovanni, Lettieri Emanuele, Bertele' Paolo, Masella Cristina
Politecnico di Milano, Department of Management, Economics and Industrial Engineering, P.zza Leonardo da Vinci 32, 20133 Milan, Italy.
Politecnico di Milano, Department of Management, Economics and Industrial Engineering, P.zza Leonardo da Vinci 32, 20133 Milan, Italy; Warwick Business, University of Warwick, CV4 7AL, Coventry (UK).
Health Policy. 2015 Mar;119(3):384-94. doi: 10.1016/j.healthpol.2014.10.017. Epub 2014 Nov 5.
Patients are increasingly encouraged to become active players in self-care and shared decision-making. Such attention has led to an explosion of terms - empowerment, engagement, enablement, participation, involvement, activation - each having multiple and overlapping meanings. The resulting ambiguity inhibits an effective use of existing evidence. This study addresses this problem by delivering an evidence-based concept mapping of these terms that delineates their boundaries and mutual relationships. We implemented a literature review of contributions associated to patient empowerment, activation, engagement, enablement, involvement, and participation. We implemented a keyword-based strategy collecting contributions published in PubMed database in the 1990-2013 timespan. A total of 286 articles were selected. The results identified three distinct interpretation of patient empowerment, either conceived as a process, an emergent state or as a participative behaviour. Most definitions recognize empowerment as the combination of ability, motivation and power opportunities. A concept mapping for patient empowerment, activation, enablement, engagement, involvement, and participation was then delineated. The concept map consists of two dimensions (nature and focus of concept) and marks distinctions and relationships between the concepts. The resulting concept map paves the way for a number of future research directions that can help improve our understanding of the antecedents and consequences of patient empowerment policies.
越来越多的患者被鼓励成为自我护理和共同决策中的积极参与者。这种关注导致了一系列术语的激增——赋权、参与、赋能、参与、介入、激活——每个术语都有多重且相互重叠的含义。由此产生的模糊性阻碍了对现有证据的有效利用。本研究通过对这些术语进行基于证据的概念映射来解决这一问题，该映射描绘了它们的边界和相互关系。我们对与患者赋权、激活、参与、赋能、介入和参与相关的文献进行了综述。我们采用了基于关键词的策略，收集了1990年至2013年期间发表在PubMed数据库中的文献。总共筛选出286篇文章。结果确定了对患者赋权的三种不同解释，即被视为一个过程、一种涌现状态或一种参与行为。大多数定义将赋权视为能力、动机和权力机会的结合。然后描绘了患者赋权、激活、赋能、参与、介入和参与的概念映射。概念图由两个维度（概念的性质和重点）组成，并标明了概念之间的区别和关系。由此产生的概念图为未来的一些研究方向铺平了道路，这些研究方向有助于提高我们对患者赋权政策的前因后果的理解。
