Patient involvement in healthcare professional practice – a question about knowledge

ABSTRACT

The concept of patient involvement is ambiguous and contested in the healthcare systems in Western Europe and North America. Current research indicates that patients only feel moderately involved in their treatment and care. This article builds on a study of chronically ill patients’ perspectives on healthcare practice in Greenland. It discusses the significance of including in healthcare practice knowledge of patients’ everyday lives with illness and their own views on their situations. Research was qualitative and ethnographic. Participants were followed with participant observations and qualitative interviews for 2.5 years during hospital stay in the capital Nuuk and in their homes in towns and settlements during 2010–2013. Results show that patients are concerned about how to manage their life with illness on a daily basis. Their everyday life activities demonstrate the resources they have to live with illness. However, procedures for healthcare practice concentrate on treatment of the physical disease. Knowledge about psychosocial needs for care and rehabilitation tend to be excluded. The study points to potential for improving professional practice through healthcare professionals’ active investigation of patients’ everyday lives and values, integration of this knowledge into their professional practice and developing structures for this kind of involvement.

KEYWORDS:

• Patient involvement
• patient perspective
• chronic illness
• everyday life
• qualitative research
• Greenland

Acknowledgements

The author wishes to thank the following Greenlandic organisations and trust funds for providing support for the research: Sundhedsvæsenets centrale udviklingspulje (The Health Authority Central Development Fund), Videreuddannelsespuljen, Sundhedsdepartementet (The Further Education Fund, Department of Health), Forskningsfremmepuljen, Departementet for Undervisning, Forskning, Kultur og Kirke (The Research Promotion Fund, Department of Education, Research, Culture and Church), Sundhedspuljen, Sundhedsdepartementet (Health Fund, Department of Health), PK’s Kursusfond (Greenland’s Nursing Organisation Peqqissaasut Kattuffiat’s Course Fund), Institut for Sygepleje og Sundhedsvidenskab, Ilisimatusarfik (Institute for Nursing and Health Science, University of Greenland). Thanks also to KVUG’s pulje til arktisk forskning (The Commission for Scientific Studies in Greenland Fund for Studies in the Arctic), Greenland and Denmark. Likewise, the author wants to thank the supervisors of the project, Professor Lise Hounsgaard, University of Southern Denmark and University of Greenland, and senior researcher Tove Borg, University of Aarhus, Denmark. Finally, a heartfelt thanks to all the participants in the research process, without whom it would not have been possible to carry out this study.

Conflict of interest

The author has no conflict of interest.

Notes

¹ The decisions about which patients to follow up with interviews at home and how many times were partly dictated by logistic conditions. Greenland is a huge country with a small population of 56,000 people. Towns and settlements are scattered along the more than 2,000 km inhabited coastline and transportation is time-consuming and expensive. It would have been relevant, but not possible, to follow up on all the patients.

² There are no roads between towns and settlements in Greenland. All transportation is done by ship, aeroplane or helicopter.

Additional information

Funding

Sundhedsvæsenets centrale udviklingspulje (The Health Authority Central Development Fund), Videreuddannelsespuljen, Sundhedsdepartementet (The Further Education Fund, Department of Health), Forskningsfremmepuljen, Departementet for Undervisning, Forskning, Kultur og Kirke (The Research Promotion Fund, Department of Education, Research, Culture and Church), Sundhedspuljen, Sundhedsdepartementet (Health Fund, Department of Health), PK’s Kursusfond (Greenland’s Nursing Organisation Peqqissaasut Kattuffiat’s Course Fund), Institut for Sygepleje og Sundhedsvidenskab, Ilisimatusarfik (Institute for Nursing and Health Science, University of Greenland)