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促进初级保健服务发展的患者参与:挪威内部促进者角色的定性研究。

Enabling primary healthcare service development with patient participation: a qualitative study of the internal facilitator role in Norway.

机构信息

Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway.

VID Specialized University, Center of Diaconia and Professional Practice, Oslo, Norway.

出版信息

Prim Health Care Res Dev. 2023 Sep 27;24:e57. doi: 10.1017/S1463423623000488.

Abstract

AIM

To explore how primary healthcare professionals (HCPs) tasked with facilitating primary healthcare service development with patient participation perceived their role.

INTRODUCTION

Patient participation in health service development is a recognized means of ensuring that health services fit the public's needs. However, HCPs are often uncertain about how to involve patient representatives (PRs), and patient participation is poorly implemented. Inspired by the Promoting Action on Research Implementation in Health Services framework, we address the innovation (patient participation), its recipients (PRs, HCPs, supervisors, and senior managers), and its context (primary healthcare at a local and organizational level).

METHODS

We conducted semi-structured individual interviews with six HCPs working as internal facilitators in primary healthcare in four Norwegian municipalities. The data were analyzed by applying Braun and Clarke's reflexive thematic analysis.

FINDINGS

The themes show that to develop primary healthcare services with patient participation, facilitators must establish a network of PRs with relevant skills, promote involvement within their organization, engage HCPs favorable toward patient participation, and demonstrate to supervisors and senior managers its usefulness to win their support. Implementing patient participation must be a shared, collective responsibility of facilitators, supervisors, and senior management. However, supervisors and senior management appear not to fully understand the potential of involvement or how to support the facilitators. The facilitator role requires continuous and systematic work on multiple organizational levels to enable the development of health services with patient participation. It entails maintaining a network of persons with experiential knowledge, engaging HCPs, and having senior management's understanding and support.

摘要

目的

探讨承担促进以患者参与为基础的初级卫生保健服务发展任务的初级卫生保健专业人员(HCPs)如何看待其自身角色。

简介

患者参与卫生服务的发展是确保卫生服务符合公众需求的一种公认手段。然而,HCPs 通常对如何让患者代表(PRs)参与感到不确定,并且患者参与的实施情况较差。在促进卫生服务实施研究行动框架的启发下,我们将关注创新(患者参与)、其接受者(PRs、HCPs、主管和高级管理人员)及其背景(基层医疗保健在地方和组织层面)。

方法

我们对在挪威四个市的基层医疗保健机构中担任内部促进者的六名 HCPs 进行了半结构化的个人访谈。通过应用 Braun 和 Clarke 的反思性主题分析对数据进行了分析。

结果

主题表明,要想开展以患者参与为基础的初级卫生保健服务,促进者必须建立一个具有相关技能的 PR 网络,在其组织内促进参与,让对患者参与持积极态度的 HCPs 参与进来,并向主管和高级管理人员展示其对赢得支持的有用性。实施患者参与必须是促进者、主管和高级管理层共同承担的集体责任。然而,主管和高级管理人员似乎并没有充分理解参与的潜力,也不知道如何支持促进者。促进者的角色需要在多个组织层面上进行持续和系统的工作,以实现有患者参与的卫生服务的发展。这需要维持一个具有经验知识的人员网络,吸引 HCPs,并获得高级管理层的理解和支持。

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