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THE DEEDS PROJECT

THE DEEDS PROJECT. Professionals’ perceptions of patient involvement Rosemary Chesson The Robert Gordon University. Acknowledgements. All study participants Lesley Adams Project Steering Group Grampian Primary Care Trust Clinical Governance Funding. The Wider Context. Demographic trends.

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THE DEEDS PROJECT

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  1. THE DEEDS PROJECT Professionals’ perceptions of patient involvement Rosemary Chesson The Robert Gordon University

  2. Acknowledgements • All study participants • Lesley Adams • Project Steering Group • Grampian Primary Care Trust Clinical Governance Funding

  3. The Wider Context Demographic trends Changes in attitudes towards disabilities Government policies Patient Focus and Public Involvement Consumerist society Research Scientific & technological advances Changes in delivery of health & social care services

  4. DEEDS Project Main Aim To develop and evaluate educational development strategies to support patient involvement [research to underpin development strategy]

  5. Key objectives • establish staffs’ interpretations of involvement • provide baseline data on professionals’ views of patient involvement • identify barriers to patient involvement

  6. Study design Selection of 2 LHCCs (Central Aberdeenshire & Aberdeen & North) Random selection of qualified staff Interviews & Focus Groups Data analysis, draft report, feedback

  7. Study participants • 205 invited 92 participated • Participants included: AHPs GPs Midwives DNs, HVs, PNs, LNs RGNs & SENs (community hospital) Practice managers

  8. Data collection Qualitative methods • interviews • focus groups • small group discussion • Tape-recording and transcription

  9. Findings

  10. Definitions of involvement • responses covered a broad spectrum • some staff (especially GPs) saw patient involvement encompassing one-to-one clinical consultations to large scale consultation exercises. • many related the term solely to public involvement • language reflected need for professional consent for patient involvement • in rural areas, some staff felt professionals could act as proxies for patients

  11. What does patient involvement mean? ‘patients being informed, communicated with and you know, maybe having a say ...... us listening to them’ Practice Manager ‘well, patient involvement ... to me the thing that springs to mind is focus groups’ Nurse ‘probably allowing patients to give their opinions’ GP ‘Its getting them to make decisions and understanding that’s the only way, and, well, for them to understand what the problem is, as opposed to saying take this and you’ll be okay’ GP

  12. To what extent should patients be involved in decision making? • responses focused on current situation • mostly discussed in terms of public involvement lack of continuity in involvement activities general perception patients not significantly involved (belief most are apathetic/unwilling)

  13. Should patients be involved? Conditional on: • age • education • disabilities • The PATIENT’S BEST INTEREST

  14. Should patients be involved? ‘I think it would very much depend on the patient’ Practice Manager ‘it depends on their depth of knowledge’ Health Visitor ‘I think they should be fully allowed, as long as they know the pros and cons of their decision’ Nurse ‘it is difficult when we’ve got this duty of care ......’ Nurse

  15. Barriers to patient involvement • some staff saw no barriers • more commonly, several identified - time - finance - lack of skills - previous training and experience - lack of strategic direction

  16. Training and experience ‘we were brought up to stay in control, you had to inspire confidence’ Health Visitor ‘I think we were trained to hold onto power, definitely. There’s this whole thing about sharing power and giving power as opposed to enabling a person. (you need to look) as if you are in control always and not make the patient feel ... you were unsure and create an air of uncertainty’ Health Visitor ‘I think we have to change our service to suit the people we are treating. For many years we have just served ourselves and thought about ourselves’ AHP

  17. Changing behaviour ‘I think it’s nice to listen to other people’s opinions ... But I don’t know that it would actually change what I did in a consulting room ...(as) we’ve been GPs for 20 years. I’m not saying you can't change that, but it would be unlikely though’ GP ‘I think the biggest training thing would be how to actually consult with them. Not so much (about) a meeting ... a questionnaire but maybe attitude change, behaviour change and the skill of doing it’ Lead Nurse

  18. Changing behaviour cont.... ‘I don’t know if we’ve changed as much as the patients have ... I don’t know if its changed that dramatically to what the patients have. Maybe that’s the problem’ Practice Manager

  19. Implications for: • patient/professional relationships • practice across professions/specialisms • identifying the needs of more ‘challenging’ groups of patients • future research • other policy agenda i.e. social inclusion • future education and training

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