Pomey Marie-Pascale, Ghadiri Djahanchah P, Karazivan Philippe, Fernandez Nicolas, Clavel Nathalie
École de santé publique, University of Montreal, Montreal, Quebec, Canada.
Department of Management, HEC Montreal, Montreal, Quebec, Canada.
PLoS One. 2015 Apr 9;10(4):e0122499. doi: 10.1371/journal.pone.0122499. eCollection 2015.
To advocate for patients to be more actively involved with the healthcare services they receive, particularly patients living with chronic illness, the Faculty of Medicine of the University of Montreal and its affiliated hospitals developed the Patients as Partners concept where the patient is considered a full-fledged partner of the health care delivery team and the patient's experiential knowledge is recognized. This study aims to show how patients view their engagement with healthcare professionals regarding their direct care. Using theoretical sampling, 16 semi-structured interviews were conducted with patients with chronic illness who were familiar with the concept of Patients as Partners. Data analysis followed a constructivist grounded theory approach. Patients describe themselves as proactively engaging in three types of practice, regardless of health professionals' openness to their role as partners. The first is a process of continuous learning that allows them to acquire experiential knowledge about their health, as well as scientific information and technical know-how. The second involves their assessment of the healthcare they receive, in terms of its quality and how it aligns with their personal preferences. It includes their assessment of the quality of their relationship with the health professional and of the latter's scientific knowledge and technical know-how. The third type, adaptation practices, builds on patients' learning and assessments to compensate for and adapt to what has been perceived as optimal or non-optimal health or healthcare circumstances. Patients appear to play a more active and less docile role in their own direct care than suggested so far in the literature, regardless of the degree of reciprocity of the partnership or the degree to which the health professional seeks to encourage patient engagement.
为倡导患者更积极地参与他们所接受的医疗服务，尤其是慢性病患者，蒙特利尔大学医学院及其附属医院提出了“患者即伙伴”的理念，即患者被视为医疗服务团队的正式伙伴，其经验性知识得到认可。本研究旨在展示患者如何看待他们在直接护理方面与医护人员的互动。通过理论抽样，对熟悉“患者即伙伴”理念的慢性病患者进行了16次半结构化访谈。数据分析采用建构主义扎根理论方法。患者描述自己积极参与三种类型的实践，无论医护人员对他们作为伙伴的角色持何种开放态度。第一种是持续学习的过程，使他们能够获得有关自身健康的经验性知识，以及科学信息和技术诀窍。第二种是对所接受医疗服务的评估，包括服务质量以及是否符合他们的个人偏好。这包括他们对与医护人员关系质量的评估，以及对后者科学知识和技术诀窍的评估。第三种是适应实践，基于患者的学习和评估，以补偿和适应被认为是最佳或非最佳的健康或医疗状况。无论伙伴关系的互惠程度如何，也无论医护人员寻求鼓励患者参与的程度如何，患者在自己的直接护理中似乎比迄今文献中所表明的发挥着更积极、更不温顺的作用。
