Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
J Clin Nurs. 2019 Mar;28(5-6):997-1009. doi: 10.1111/jocn.14706. Epub 2018 Nov 8.
To explore: (a) the usual patient education in different care services of an integrated-care organisation, (b) the healthcare professionals' experiences with adding a patient engagement support intervention called PHEinAction in the patient education practice and (c) the co-designed activities to assist the implementation.
Including individual support for engaging patients in care into patient education practice is a key effort of integrated-care organisations. However, there is a paucity of studies exploring the implementation of similar efforts.
We conducted a qualitative study of a participatory process with 26 healthcare professionals-mostly nurses (n = 22) with leading roles (n = 12)-of different care services in one Italian integrated-care organisation. Data were collected through multiple sources (observations and shadowing; interviews; documents/artefacts; workshops) during the first 6 months of the implementation of PHEinAction. A thematic analysis using a hybrid approach was performed. COREQ guidelines were followed.
The existing patient education practice of hospital, ambulatory and community healthcare services of the organisation differed in contents, perceived responsibility and focus area. These key aspects of patient education influenced the healthcare professionals' experiences with the implementation. The experiences informed the activities enacted during the participatory process to assist the implementation, from the co-creation of artefacts to the deployment of peer group supervision.
The implementation of a brief intervention for patient engagement support required a process of adjustment to the single settings and a continuous support to healthcare professionals. It also required performing complementary activities to assist the implementation and its adoption in new care services.
This qualitative study contributes to the understanding of the pitfalls and strategies that may surround embedding patient engagement support in the educational practice of complex organisations, potentially facilitating the deployment to other care settings.
探索：(a) 在综合护理组织的不同护理服务中进行常规患者教育，(b) 医疗保健专业人员在患者教育实践中添加名为 PHEinAction 的患者参与支持干预措施的经验，以及 (c) 协助实施的共同设计活动。
将为患者参与护理提供的个别支持纳入患者教育实践是综合护理组织的一项重要工作。然而，很少有研究探讨类似工作的实施情况。
我们对一家意大利综合护理组织中不同护理服务的 26 名医疗保健专业人员（主要是护士[22 名]，其中有 12 名担任领导角色）进行了一项参与式过程的定性研究。数据通过多种来源（观察和影子工作；访谈；文件/人工制品；研讨会）在 PHEinAction 实施的前 6 个月期间收集。采用混合方法进行主题分析。遵循 COREQ 指南。
组织的医院、门诊和社区医疗服务的现有患者教育实践在内容、感知责任和重点领域方面存在差异。这些患者教育的关键方面影响了医疗保健专业人员实施的经验。这些经验为参与式过程中实施的活动提供了信息，从共同创作人工制品到部署同行监督。
实施简短的患者参与支持干预措施需要对单个环境进行调整过程，并为医疗保健专业人员提供持续支持。它还需要执行补充活动以协助实施及其在新护理服务中的采用。
这项定性研究有助于理解在复杂组织的教育实践中嵌入患者参与支持可能面临的陷阱和策略，从而有可能促进在其他护理环境中的部署。
