Patient engagement is recognized as essential for the quality of services for chronic diseases. The paper aims to explore the socio-organizational dynamics associated with the promotion of patients' engagement and their transformation from passive consumers of medical services to partner. We present a collaborative study conducted with two health care services of a large hospital in Northern Italy, where patients and healthcare personnel cooperated to evaluate and reorient the clinical pathways towards participated processes centered on the patient. Practices were analyzed through a revised version of proactive analysis (HFMEA) and the psycho-social analysis of decision nodes of the clinical pathway, applied in the context of focus groups with mixed composition (patients, physicians, nurses, psychologists, social workers). Results revealed different representations of the nature of engagement and its nature as a changing and unstable process. In addition, the study highlighted professional assumptions and values that can give rise to an apparent participation. The study offers indications for designing collaborative practices in managing clinical pathways.
L’engagement dei pazienti è riconosciuto come un elemento essenziale per la qualità dei servizi per le patologie croniche. Il contributo si propone di esplorare le dinamiche socioorganizzate che favoriscono l’engagement dei pazienti e la loro trasformazione da consumatori passivi di cura a partner. Sarà presentata una ricerca collaborativa, realizzata con due servizi di un grande ospedale del Nord Italia, in cui pazienti e personale sanitario hanno cooperato per valutare e riorientare i percorsi diagnostico-terapeutici verso processi di lavoro partecipati centrati sul paziente. Strumenti di analisi delle pratiche sono stati l’analisi proattiva del rischio clinico (HFMEA) e l’analisi psicosociale degli snodi decisionali, applicati nell’ambito di focus group misti (pazienti, medici, infermieri, psicologi, assistenti sociali). I risultati hanno consentito di evidenziare l’intrecciarsi di aspetti clinici e organizzativi nelle rappresentazioni della natura dell’engagement e la sua caratterizzazione come un processo oscillante e instabile. Inoltre, attraverso l’analisi del processo d’indagine, è stato possibile identificare assunti e valori professionali che rischiano di dar vita ad una partecipazione apparente. La ricerca offre indicazioni per la progettazione di pratiche di gestione collaborativa dei percorsi di cura.
Guglielmetti, C., Gilardi, S., Casati, S., Monti, P. (2014). Promoting engagement in chronic illness patients: A collaborative research pathway [Promuovere l'engagement dei pazienti con malattie croniche: Un percorso di ricerca collaborativa]. PSICOLOGIA DELLA SALUTE, 2014(3), 58-79 [10.3280/PDS2014-003004].
Promoting engagement in chronic illness patients: A collaborative research pathway [Promuovere l'engagement dei pazienti con malattie croniche: Un percorso di ricerca collaborativa]
Monti, Paolo
2014
Abstract
Patient engagement is recognized as essential for the quality of services for chronic diseases. The paper aims to explore the socio-organizational dynamics associated with the promotion of patients' engagement and their transformation from passive consumers of medical services to partner. We present a collaborative study conducted with two health care services of a large hospital in Northern Italy, where patients and healthcare personnel cooperated to evaluate and reorient the clinical pathways towards participated processes centered on the patient. Practices were analyzed through a revised version of proactive analysis (HFMEA) and the psycho-social analysis of decision nodes of the clinical pathway, applied in the context of focus groups with mixed composition (patients, physicians, nurses, psychologists, social workers). Results revealed different representations of the nature of engagement and its nature as a changing and unstable process. In addition, the study highlighted professional assumptions and values that can give rise to an apparent participation. The study offers indications for designing collaborative practices in managing clinical pathways.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.