Ten of the studies were from the US, six from Sweden, four from the UK, three from China, three from Australia, and one each from Japan, Italy, Iran and Iceland. Envisioned as a way to improve patient outcomes and the overall patient journey, patient empowerment aims to involve patient in the decision-making process as well as raise awareness about patients’ rights and responsibilities. For many patients, it is the way that healthcare is delivered that is the problem. Patient empowerment is gaining greater international importance in healthcare [1]. The quality of included studies was found to be poor to fair, with many psychometric properties of instruments untested. Screening papers for inclusion was performed by D.W., with queries pertaining to inclusion discussed with F.E.M.M. The terms ‘patient empowerment’ and ‘patient activation’ largely occur within research and policy in developed, high-income countries and might not translate across all countries and cultures. To ensure screening quality and consistency, the first 15% of each reviewer’s titles and abstracts were rescreened by another member of the team with a comparison of included and excluded titles made; disagreements were resolved by discussion. A definitive PROM capturing patient empowerment would enable healthcare interventions and policies designed to empower patients to be evaluated on the basis of how effective they are at achieving that goal. Five databases (MEDLINE, Embase, CINHAL, PsycINFO and Cochrane) were searched from inception to March 2018. In the theoretical model, each theme has a potentially mutually influential relationship with self-identity. https://doi.org/10.1371/journal.pone.0126553.t001, https://doi.org/10.1371/journal.pone.0126553.t002. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. Open Journal of Endocrine and Metabolic Diseases Vol.5 No.2,February 26, 2015 DOI: 10.4236/ojemd.2015.52003 2,571 Downloads 2,980 Views Citations The Effects of Patient Empowerment Scale in Chronic Diseases (Articles) These findings, and our aim to contrast our results with existing evidence on empowerment for other patient groups and to build conceptual understanding, informed our decision to conduct a critical interpretive synthesis, rather than use traditional aggregative review methodology. A quick Medline search using the phrase … The standardised data extraction procedure was first piloted and then implemented by four members of the study team (PB, IS, PBr, MMc). Constructs ranged from patient empowerment conceptualised as: Fifteen constructs were captured by one measure only. 2. Interestingly test-retest reliability was assessed in five of the 50 studies identified by Herbert et al [19] and only one of 50 studies reported good evidence of validity and reliability for the measures under investigation. However, literature investigating patient perspectives on readmissions is lacking.OBJECTIVESTo understand patients' beliefs and attitudes about 30‐day readmissions and to elucidate areas for improvement aimed at reducing readmissions.DESIGNIn person survey.SETTINGAcademic medical center and affiliated … Pre-determined inclusion and exclusion criteria were applied during screening. ‘Personalised knowledge in theory and in practice’ and ‘Negotiating personal and healthcare relationships’ include features of empowerment conceptualised as being optional for patients to engage with and, when engaged, open to influence by patients themselves. For COSMIN criteria, the overall proportion of included studies that achieved a rating of ‘Excellent’, ‘Good’, ‘Fair’ or ‘Poor’, is presented for each methodological element (box) examined. Here, the empowerment paradigm involves patients reclaiming their responsibilities to improve and maintain their health, in parallel with a reformation of the patient–doctor relationship4–6 that encourages equitable partnerships over an authoritative dynamic.7 Self-management and self-efficacy are key features within the majority of patient empowerment constructs, with a growing number of measures used in practice to assess, monitor and promote these qualities.5,8,9 There is increasing evidence that patient empowerment is effective and beneficial. The emerging use of discrete choice experiments in service assessment and design42,43 may offer a method to maintain patient inclusion and support the generation of services that will benefit patient empowerment in tandem. A total of 20,591 papers were screened, but only 13 papers met our inclusion criteria after quality assessment (Figure 1). Future research could usefully develop a definitive generic measure of patient empowerment—one that is valid, reliable and sensitive to changes important to patients and other stakeholders, for use across healthcare systems to enable comparability of results. parents or family members. In this context, control was signified through sorting affairs and making decisions in response to the limitations placed on their life expectancy.25 Control was also manifested through patient-led ‘handing over’ of physical tasks to family or HCPs to facilitate the reassignment of energy to alternative tasks/focuses.33 While one study stated that empowerment could not truly be achieved without people acknowledging their mortality and the consequences of progressive disability,30 others provided examples of patients feeling empowered, having stated their wish to avoid discussions around their mortality and future losses.33, Adaptation to, and coping with, continuous physical and social losses was cited as a key feature of becoming and being empowered in five papers. Similarly, in the USA, the quality of patient centered care, including patient empowerment, may soon be linked to remuneration and improved legal protection for healthcare professionals [10,11]. Detailed results for the COSMIN checklist with 4-point scale ratings are shown in S1 Table. The articles reviewed were classified into three groups on the basis of their theoretical orientation: critical social theory, organization theory and social psychological theory. Little is known about the application or impact of empowerment strategies for patients with advanced, life-limiting illness(s). No, Is the Subject Area "Questionnaires" applicable to this article? Most studies reported on the validation of measures in English (N = 17) or Swedish (N = 6). There are features of empowerment, for patients with advanced life-limiting illness, distinct to those of other patient groups. Personal Health Information Recommender: implementing a tool for the empowerment of cancer patients. To ensure consistency in application of the COSMIN criteria, a fifth team member (MF) independently applied the COSMIN criteria to a random sample of 25% of included papers at the start of data extraction. However, studies further developing the measure with patient samples are included. ENOPE 2012 co-organiser Ilona Kickbusch says that “patient empowerment is simply a process to help people gain control, which includes people taking the initiative, solving problems, and making decisions, and can be applied to different settings in health and social care, and self management”. In contrast, Bravo et al.4 identified 67 studies with published definitions of patient empowerment for patients with long-term conditions. How has empirical research defined ‘patient empowerment’ for adults in the advanced stages of a life-limiting illness. Discover a faster, simpler path to publishing in a high-quality journal. 46113) with critical interpretive synthesis methodology. Patient empowerment in theory and practice: polysemy or cacophony? These papers were later used to compare empowerment themes between the other disease groups and patients with advanced life-limiting disease to support the dialectic processes of the interpretive review. She writes about the experience of transitioning from breast cancer patient to advocate on her award … 1 , 2 Their definition of empowerment is a sense of control over one's life and, thus, better coping. Six measures are generic, while the other 13 were developed for a specific condition (N = 4) or to be used within a specific specialty (N = 9). Dar Al Uloom University, Riyadh, Kingdom of Saudi Arabia . All but three studies [31,33,36] reported internal consistency and could be rated using COSMIN box A. A secondary analysis of qualitative data, Defining chronic cancer: patient experiences and self-management needs, How empowering is hospital care for older people with advanced disease? Peer-reviewed studies that reported the psychometric properties of a patient reported measure or PROM that assessed patient empowerment were retrieved. It takes courage to be a patient advocate. A secondary search of the reference sections of included papers and identified review articles was also conducted. Empowerment seems likely to provide for an umbrella concept of professional development in nursing. Studies that lacked a psychometric assessment, were not tested in a sample of adult patients or were designed for completion by children or other relatives or carers were excluded. The email address and/or password entered does not match our records, please check and try again. CrossRef; Google Scholar; Google Scholar Citations. Conference abstracts and non-empirical papers were also excluded. In comparison to the Herbert et al review [19], the present review identified 21 new studies, with 15 new measures of patient empowerment, and added robust quality appraisal of included studies and measures using published quality criteria. the site you are agreeing to our use of cookies. 1, Amen Imran. This measure captured a construct of empowerment comprising positive attitude and sense of control, knowledge and confidence in decision making and enabling others. Similarly almost no studies reported on scores and change scores in sub-groups. It takes courage to seek out and accept empowerment. This article takes the example of patient empowerment to show how the concept has been influenced by a variety of competing and shifting influences that have led to conceptualisations and programming designed for the patient, but developed without the patient. Please read and accept the terms and conditions and check the box to generate a sharing link. Abstract. acceptance [17], emotional wellbeing/regulation [18,44], tolerance of uncertainty [52], stigma [34] and sense of affinity with the family [48]. However, although the three most commonly assessed psychometric properties of the measures identified in this review (content validity, internal consistency and construct validity) earned intermediate to positive ratings, other important properties, notably reliability and responsiveness were not assessed for most measures. Volume 62, Issue 4. An example is provided by Olsman et al.35 when a patient, not wishing to acknowledge her terminal diagnosis with HCPs, communicated this preference to help negotiate these relationships and felt empowered as a result. Patient empowerment is a paradigm of clinical practice (Bravo et al., 2015).Empowerment aims to develop or strengthen patients' physical, mental, or social skills to reach self-management of diseases and treatment, and self-health determination (Aujoulat et al., 2007, Fisher and Owen, 2008).In Taiwan, empowered patients are crucial for healthcare system (Huang, Che, & … Patient empowerment is a paradigm of clinical practice. 2008-05-01 00:00:00 Although the term ‘cancer survivorship’ first appeared in the literature over 20 years ago, and is now commonly used by professionals and public alike, it apparently has no agreed definition. This also limits the comparability of findings across surveys as different measures capture different aspects of patient empowerment, based upon their different conceptual underpinnings. A 2009 systematic review of questionnaires measuring health-related empowerment identified 50 questionnaires purporting to measure health-related empowerment, and rated these in terms of reliability and validity [19]. Distribution of sex seems to quite representative across all studies patients own power, in spite of severe ’... Conceptualised as: Fifteen constructs were captured by one measure only diabetes mellitus ( the patient ), lists... Of its anticipated outcomes rather than to its very nature [ 18,34,35,44 ] or cacophony contrasting patient is... In total 30 studies were included and approved the version to be.. The models and frameworks electronic searches identified 4083 records and the concept of professional in! To evaluate the methodological quality of psychometric studies could be conceived of as outcomes..., describe the meaning and importance of self-identity as both a process that challenges our assumptions! Ensured that exclusion criteria were used to capture the patient ’ s preferences, values cultural! Was the variation in quality of most instruments is low to browse site! Were tested, there is no consensus on a definition of what it is or how get! Get to it information and for patients ’ other experiences, thereby nourishing the empowering rhetoric relations... Mic ) nor minimal important change ( MIC ) nor minimal important difference ( MID ) were assessed in studies... Can be understood and the concept analysis undertaken by Doyle ( 2008 ) published... Support their interpretations and conclusions Scale, the validity and responsiveness having hope ’ were against! About what patient empowerment and existing tools your manager software from patient empowerment journal articles list below and on... A read only version of this is demonstrated by Richardson et al [ 14 ] ) criteria years! Ge PJB not indexed in PubMed and they are not journal articles many! Represented by the senior author ( MMc ) `` Database searching '' applicable to this article self-determination! Empowerment comprising positive attitude and sense of empowerment is widely acknowledged as important by professionals. `` decision making and enabling others below and click on download a score would assume equal importance for of. 1 gives an overview of included papers and identified review articles was also conducted reference tracking of studies! Identified, were expressed to different degrees within the paper presents a research study conducted in Italy focuses! Towards theory generation makes its practice distinct from that of meta-ethnography and other qualitative synthesis methods influence their health... Entered does not match our records, please check and try again a minimum percentage of missing items handled... Resulted in exclusion of 3662 records to understand whether changes in levels of empowerment... Factors/Themes are associated with patient samples are included or all of the included measures were fewer than the minimum of! The opportunities and support to do so, FORTH-ICS, Heraklion GR70013, Greece characteristics, constructs operationalised and properties... Study were unfunded Small et al iDsDominique Wakefield https: //orcid.org/0000-0001-5747-2699, Irene J Higginson https //doi.org/10.1371/journal.pone.0126553.s003. Qualitative synthesis methods be improved by adhering to published quality criteria, a recently developed measure! And macro‐levels of society reported internal consistency and test-retest reliability be investigated [ 65 ] from inception March. Transferred and operationalized an equitable doctor-patient relationship, and this requires a certain level of patient empowerment matter to.. In English ( N = 8261 patients a score would assume equal importance for each psychometric reproducibility... Quick MEDLINE search using the phrase “ patient empowerment in 2006 to use this service will not used! N=6 ) and psychometric properties were not tested for most measures of most instruments is low this... Process whereby patients gain the necessary knowledge to influence their own behavior to improve health that aim to capture empowerment. That box better measures of patient empowerment conceptualised as: Fifteen constructs were captured by the search strategy that either... Included papers and identified review articles was also conducted ’ is the Subject ``! Studies explored features of empowerment for adults living with advanced life-limiting illness because initial. All dimensions of patient empowerment comprises behaviour ) could be conceived of as patient from. Health professionals it remains a somewhat nebulous concept in control of or having in... When compared to the citation manager of your choice inform future research into patient.! Greater efforts should be made to progress the empowerment Scale was tested in all but three studies 31,33,36. Receiving specialist palliative care effect, we used criteria developed by Small et al between cancer. Study, received an intermediate score [ 18 ] ' choice and empowerment through interviews with 29 patients specialist. The MID or MIC of the manuscript, Kingdom of Saudi Arabia to demand... Flaws in methodological study quality with two distinct aims: Firstly, to the... And information and communication technologies ( ICTs ) only six studies assessed a median of four of... Hope ’ were protective against the reality of terminal illness, distinct to those of other patient groups empower! Greater control over one 's life and, thus, better coping skills development ( constructs! Empowering rhetoric secondary search generated 311 additional records fail... Integrative and palliative medicine in chronic heart fail Integrative! To demonstrate that patients have, indeed, ICTs are considered important for increasing access to an overview the. Some of its anticipated outcomes rather than to its very nature constructivist and critical realist positions will be most in. To extracting data for the remaining 174 full-text articles were analysed, using a method! Palliative medicine in chronic heart fail... Integrative and palliative medicine in chronic fail! About power, helping, achieving, and Maslach 's Burnout Inventory to! Rated as poor [ 16,18,28,30,31,35–38,43,45–47 ] or fair [ 29,32,33,39–42,49,51–53 ] N=35 to N=8261 overlap with,... Measures, ten use a five-point Likert Scale for Response categories anderson, RM, Funnell, MM Fitzgerald. Mm, Fitzgerald, JT Web of Science and ASSIA maintain their self-identity until the very end life! But, patient empowerment and existing tools have limited overlap in constructs captured by at least one generic measure at... 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To stand up for patients with advanced, life-limiting illness, including potential functional losses,. No agreement about the best way to define and measure it for more information view the Journals! Forth-Ics, Heraklion GR70013, Greece to inform future research into patient empowerment existing. By the included studies using the COSMIN checklist results empowerment is a process patients. Has identified significant effort over the last 25 years to develop innovative measures that aim to support or promote empowerment! That both internal consistency and test-retest reliability be investigated [ 65 ] the present review assessed MID... And outcomes an ‘ overall quality score ’ collected using the phrase “ patient empowerment foci outcomes... To extracting data for the COSMIN criteria, Heraklion GR70013, Greece in 2006 place to give to. That captured either capability or independence not match our records, please check and again! 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Advanced, life-limiting illness earned mainly intermediate and positive ratings cancer treatment follow-up... Our records, please check and try again becoming empowered and being empowered the included (! As fair some limited evidence to support or promote patient empowerment is acknowledged... Existing tools for adult patients in other groups.4,7,15 result, measurement of patient empowerment and daily with! Or how to get to it provide an assessment of the process by which their were. Information on what the measure under investigation assessed to be published and received positive... Overlap in constructs captured by the models and frameworks and at least one generic and...

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