Health systems research

Identifying the role of “empowered patients” in health care management

Investigator: Svetla Loukanova

Summary: Ensuring that patients become recognized partners in the ‘health care team’ is vital in delivering health care.  Patient empowerment is a fundamental contributor to patient satisfaction, but also impacts quality though its effects on compliance and self-management. To develop policies to improve empowerment in the general community, however, we need to better understand what empowerment is and how one might measure it. In the last decade, a number of models of empowerment have been introduced, including social and community empowerment, staff empowerment, general illness, and disease-specific empowerment models. There is no existing model that includes the broad range of factors/attributes that characterize the empowerment process and that could be applied for general population.

This study is commenced in April 2005 and is designed in three stages, exploring the existing literature, identifying the major characteristics (items) of patient empowerment and patient empowerment conceptual model development.

The objectives of the study are to:

- To conceptualize the process of patient empowerment.
- To create a definition of patient empowerment suitable for application in the general community and to identify the major characteristics (items) of patient empowerment process.
- To develop a grounded conceptual model of empowered patient as a base for development of an instrument for patient empowerment measurement.

For the first step in the deductive process the existing literature on empowerment for the last 20 years was critically reviewed. Three broad categories of stakeholders in health care were identified: patient (44%), provider (29%) and social empowerment (27%). Over the search period there was a significant rise of the number of papers devoted to patients.

For the second step in the inductive process of the research, open-ended semi structured interviews with key informants form eight countries are collected to explore how patient empowerment is viewed, interpreted, defined and experienced by them in order to refine and validate a definition and model of empowerment. Informants are purposively selected to represent a range professional background, nationalities and professional training.

As a third step, the results of the qualitative study with the whole information for the possible constructs, items, advantages and disadvantages of the process of patient empowerment analysed in order to establish, and refine a grounded conceptual model of patient empowerment.

This work is a step forward in understanding and conceptualizing of the patient empowerment in the general community. The findings from this study have the potential to pave the way toward future work to convert the key constructs of the patient empowerment model (knowledge, support, economics and patient participation) into a scale that can be used to measure empowerment in the community, and to determine whether patients have preferences to be empowered.