Programme no. 156-P
Empowering patients with multimorbodity through patient involvement in general practice consultations. A qualitative study on effects and challenges of patient involvement in general practice.
Alexandra Brandt Ryborg Jønsson*1
1The Research Unit for General Practice,Institute of Public Health, University of Copenhagen & Danish Patients,Copenhagen ,Denmark;Videnscenter for Brugerinddragelse i Sundhedsvæsenet,Danske Patienter,Copenhage,Denmark
* = Presenting author
Objectives: Can patient involvement in general practice consultations empower patients to improve self-care?
Background: Patients with multimorbidity experience a great burden of diseases hence followed by a great burden of treatment and self-care. In Denmark, the prevalence of multimorbidity is high in social deprived areas and among patients with short educational background and low self-care ability. Involving patients with multimorbidity in decision making is thought to empower and influence these patients self-care for the better. Based on a qualitative study this presentation shows first, the type of patient knowledge that should be included in health decisions in general practice and second, points to how and where this could be implemented in consultations.
Results: Initial results show that despite physicians’ willingness towards involving patients they seem to experience difficulties in the case of patients with multimorbidity and poor ability to self-care. These patients on the other hand, are having troubles expressing preferences and both parties find it hard to establish a good dialogue and prioritize problems during the consultation. Often this leads to misunderstandings and patients’ unbeneficial prioritizing of self-care. On the other hand, when a therapeutic alliance is established between patient and physician, patients feel empowered and seem to have better self-care
Material/Methods: The data is in process and is collected through observations of eight consultations in general practice followed by individual semi-structured interviews with both the patients and their GP Patients are then followed in an anthropological fieldwork focusing on how decisions made in consultations are transformed into self-care in every day life. Framework analysis will be applied to analyse the material.
Conclusion: Results for the present study support international literature on effects and challenges of patient involvement in general practice. Our findings identifies furthermore a connection between multimorbidity, empowerment and involvement; suggesting that patients with low ability of self-care can be empowered and improve their self-care through involvement. Further research is necessary to back up these findings in order to improve care and quality of life of the growing number of people with multimorbidity.
Points for discussion:
What are the challenges in involving patients with multimorbidity in decisions regarding treatment and care?
Good examples of how and when to involve patients in consultation with multimorbidity. Which methods are well-suited, experiences of decision aids etc?