Health‐care professionals' experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy.

Background: Patient participation is a key concern in health care. Nevertheless, older patients often do not feel involved in their rehabilitation process. Research states that when organizational conditions exert pressure on the work situation, care as a mere technical activity seems to be prioriti...

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Publicado en:Health Expectations Vol. 22; no. 5; pp. 921 - 931
Autores principales: Kvæl, Linda Aimée Hartford, Debesay, Jonas, Bye, Asta, Bergland, Astrid
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2019
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      pub: Wiley-Blackwell
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        atl: Health‐care professionals' experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy.
      aug:
        au:
          Kvæl, Linda Aimée Hartford
          Debesay, Jonas
          Bye, Asta
          Bergland, Astrid
        affil: Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo Norway
      sug:
        subj:
          Consumer Participation In Old Age
          Subacute Care In Old Age
          Attitude of Health Personnel
          Work Experiences
          Rehabilitation, Geriatric
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Norway
          Nursing Homes
          Multidisciplinary Care Team
          Semi-Structured Interview
          Professional Boundaries
          Individualized Medicine
          Quality of Health Care
          Patient Satisfaction
          Qualitative Studies
          Descriptive Statistics
          Audiorecording
          Data Analysis Software
          Thematic Analysis
          Conceptual Framework
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Patient participation is a key concern in health care. Nevertheless, older patients often do not feel involved in their rehabilitation process. Research states that when organizational conditions exert pressure on the work situation, care as a mere technical activity seems to be prioritized by the health‐care staff, at the expense of patient involvement. Objective: The aim of this article is to explore how health‐care professionals experience patient participation in IC services, and explain how they perform their clinical work balancing between the patient's needs, available resources and regulatory constraints. Design: Using a framework of professional work and institutional logics, underpinned by critical realism, we conducted semi‐structured interviews with 18 health‐care professionals from three IC institutions. Results: IC appears as an important service in the patient pathway for older people with a great potential for patient participation. However, health care staff may experience constraints that prohibit them from using professional discretion, which is perceived as a threat to patient participation. Further, they may adopt routines that simplify their interactions with patients. Our results call for more emphasis on an individualized rehabilitation process and a recognition that psychological and social aspects are critical for patient participation in IC. Conclusion: Patients interact in the face of conflicting institutional priorities or protocols. The study adds important knowledge about the practice of patient participation in IC from a front‐line provider perspective. Underlying mechanisms are identified to understand and recommend how to facilitate patient participation at different levels in narrowing the gap between policy and clinical work in IC.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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