Jennifer Freytag1, Zhixin J Jiang2, Thomas P Giordano3, Robert A Westbrook4, Sheryl A McCurdy5, Sarah Njue-Marendes6, Bich N Dang7. 1. Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States; VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, TX, United States. Electronic address: jennifer.freytag@bcm.edu. 2. Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States. Electronic address: Zhixin.Jiang@UTSouthwestern.edu. 3. Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States; VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, TX, United States. Electronic address: tpg@bcm.edu. 4. Jesse H. Jones Graduate School of Business, Rice University, Houston, TX, United States. Electronic address: westbro@rice.edu. 5. Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States. Electronic address: Sheryl.A.McCurdy@uth.tmc.edu. 6. Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States; VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, TX, United States. Electronic address: Sarah.Njue@bcm.edu. 7. Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States; VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, TX, United States. Electronic address: bndang@bcm.edu.
Abstract
OBJECTIVES: This study 1) defines patient involvement from the perspective of patients new to a provider, 2) describes provider communication that patients perceive as promoting involvement, and 3) examines changes in patient definitions of involvement over time. METHODS: We enrolled 56 patients at two HIV clinics in Houston, Texas, from August 2013 until March 2015. We interviewed patients three times during the first year of care and analyzed interviews using content analysis. RESULTS: The mean age was 45 years; 54% were men. Patient definitions of involvement ranged from adherence- to decision-oriented. Analysis revealed three provider communication behaviors that patients perceive as promoting involvement: 1) soliciting patient feedback, 2) discussing treatment options and trade-offs, 3) narrating the decision-making process. Definitions of involvement can change over time as providers reframe the patient's illness as manageable and through perceived partnerships with the provider. CONCLUSION: Provider communication plays a critical role in shaping new patients' perception of involvement and can make patients feel involved even when patients do not actively make medical decisions. PRACTICAL IMPLICATIONS: Finding strategies to make patients feel involved in their care is important, particularly for new patients, even if those strategies do not necessarily promote more talk from the patient. Published by Elsevier B.V.
OBJECTIVES: This study 1) defines patient involvement from the perspective of patients new to a provider, 2) describes provider communication that patients perceive as promoting involvement, and 3) examines changes in patient definitions of involvement over time. METHODS: We enrolled 56 patients at two HIV clinics in Houston, Texas, from August 2013 until March 2015. We interviewed patients three times during the first year of care and analyzed interviews using content analysis. RESULTS: The mean age was 45 years; 54% were men. Patient definitions of involvement ranged from adherence- to decision-oriented. Analysis revealed three provider communication behaviors that patients perceive as promoting involvement: 1) soliciting patient feedback, 2) discussing treatment options and trade-offs, 3) narrating the decision-making process. Definitions of involvement can change over time as providers reframe the patient's illness as manageable and through perceived partnerships with the provider. CONCLUSION: Provider communication plays a critical role in shaping new patients' perception of involvement and can make patients feel involved even when patients do not actively make medical decisions. PRACTICAL IMPLICATIONS: Finding strategies to make patients feel involved in their care is important, particularly for new patients, even if those strategies do not necessarily promote more talk from the patient. Published by Elsevier B.V.
Entities:
Keywords:
HIV infection; Patient involvement; Patient provider communication
Authors: Judith E Arnetz; Ulrika Winblad; Anna T Höglund; Bertil Lindahl; Kalle Spångberg; Lars Wallentin; Yun Wang; Joel Ager; Bengt B Arnetz Journal: Health Expect Date: 2010-06-23 Impact factor: 3.377
Authors: Evelyn C Y Chan; Stephanie L McFall; Theresa L Byrd; Patricia Dolan Mullen; Robert J Volk; John Ureda; Jessica Calderon-Mora; Pat Morales; Adriana Valdes; L Kay Bartholomew Journal: Patient Educ Couns Date: 2011-01-14
Authors: Sara L Swenson; Stephanie Buell; Patti Zettler; Martha White; Delaney C Ruston; Bernard Lo Journal: J Gen Intern Med Date: 2004-11 Impact factor: 5.128
Authors: Sam S Oh; Joshua Galanter; Neeta Thakur; Maria Pino-Yanes; Nicolas E Barcelo; Marquitta J White; Danielle M de Bruin; Ruth M Greenblatt; Kirsten Bibbins-Domingo; Alan H B Wu; Luisa N Borrell; Chris Gunter; Neil R Powe; Esteban G Burchard Journal: PLoS Med Date: 2015-12-15 Impact factor: 11.069