Level with me! Exploring patient participation in short-term clinical encounters in team-based settings

Background: Patient participation has been described as patients’ opportunities for involvement in different parts of their care. Benefits, including improved patient safety, health outcomes and patient satisfaction have been associated with patient participation. However, although patient participation is promoted in legislation and by international organisations, there are signs of deficits in different healthcare settings. It also appears that patient participation is context dependent and defined differently across contexts. Some healthcare settings, for example, short-term care relationships in team-based contexts, have been less explored. As it appears that greater patient participation is needed in the healthcare system, understanding what it actually means in different contexts is essential to identifying strategies to improve patient participation. Aims: The overall aims of this thesis were, first, to contribute to knowledge and understanding about patient participation in short-term clinical encounters in team-based settings, and second, to provide and evaluate strategies to enable patient participation for such settings. Methods: In this thesis, two different Swedish clinical settings characterised by short-term care encounters were explored: gastrointestinal (GI) endoscopy in a university hospital and rural emergency care in which telemedicine is used to connect a physician to the rest of the team (i.e. ‘tele-emergency’). Qualitative methods were used to explore patients’ (Study II) and healthcare professionals’ (HCP’s) (Study III) attitudes, experiences and perceptions of patient participation in the respective settings. Semi-structured interviews were performed individually or in groups. Interview transcripts were analysed using qualitative content analysis. For the GI endoscopy setting, a safety checklist with a person-centered approach was developed and introduced (Study I). A cross-sectional design was used to evaluate the checklist intervention (before-after). Data collection included ...