November 9, Leave a comment 09 November 6.
This article has been cited by other articles in PMC. Abstract Background There is worldwide interest in managing the global burden of long-term conditions. Current health policy places emphasis on self-management and supporting patient participation as ways of improving patient outcomes and reducing costs.
However, achieving genuine participation is difficult. This paper describes the development of an intervention designed to promote participation in the consultation and facilitate self-management in long-term conditions.
In line with current guidance on the development of complex interventions, our aim was to develop and refine the initial intervention using qualitative methods, prior to more formal evaluation. Methods We based the intervention on published evidence on effective ways of improving participation.
The intervention was developed, piloted and evaluated using a range of qualitative methods.
Firstly, focus groups with stakeholders 5 patients and 3 clinicians were held to introduce the prototype and elucidate how it could be improved. Results The literature highlighted that effective methods of increasing participation include the use of patient reported outcome measures and values clarification exercises.
The intervention called PRISMS integrated these processes, using a structured form which required patients to identify problems, rate their magnitude and identify their priority. A number of different functions of PRISMS were identified by patients including its use as an aide-memoire, to provide a focus to consultations, to give permission to discuss certain issues, and to provide greater tailoring for the patient.
The challenge encountered by patients in completing PRISMS may encourage exploration of these issues within the consultation, complementing the more 'task focussed' aspects of consultations resulting from introduction of clinical guidelines and financial incentives.
Further research is required to provide a rigorous assessment of the ability of tools like PRISMS to achieve genuine change in the process and outcome of consultations. Background The global burden of disease is shifting to long-term conditions,[ 1 ] and there is worldwide interest in the development of models of service delivery to manage these changing needs[ 2 ].
UK Government policy places emphasis on self-management as a means of improving long-term conditions, and supporting patient participation in healthcare is seen as a key mechanism to improve self management[ 34 ].
Participation in health care has been defined as: This acknowledges the patient as 'co-producer' of their health and integrates them as a key participant in the care process[ 6 ].
In this paper we describe the development of an intervention intended to promote participation in the consultation and facilitate self-management in long-term conditions.
The development of the intervention described in the paper is set in the context of a larger study - the WISE approach Whole Systems Informing Self-management Engagement [ 8 ] designed to improve the way primary care services provide self care support for patients with long-term conditions, particularly for those who live in disadvantaged areas[ 9 ].Focusing is listening to what the client is bringing, and then choosing an area to focus down on, pushing the rest of it aside for now.
So we lead or invite the client to explore in more depth the area where we feel the focus should be. Focusing involves making decisions about what issues the client wants to deal with.
The client may have mentioned a range of issues and problems, and focusing allows the counsellor and client together to clear away some of the less important surrounding material and concentrate on the central issues of concern.
Nov 09, · Identify the helpee’s needs. I have to remember that I am helping and the conversation is about the helpee not me. I will ask what they want to talk about and develop the conversation around there needs.
The conversation will develop in a manner that the helpee wishes and will not be led by me. Focusing involves making decisions about what issues the client wants to deal with. The client may have mentioned a range of issues and problems, and focusing allows the counsellor and client together to clear away some of the less important surrounding material and concentrate on the central issues of concern.
Enable The Helpee To Identify And Focus On Their Concerns Explore The Difficulties Of Verbalising Concerns And Prioritising Them Concerns of inclusion: Teachers may not know much about student’s disabilities education of disabilities. Rather, the focus is on respondents verbalising their ongoing thoughts during a task, as a way of accessing their decision making processes[17,18].
The function is to examine the content and order of information processing during the task.