Conceptualizing patient participation in psychiatry: A survey describing the voice of patients in outpatient care

精神病学中患者参与的概念化:一项描述门诊患者心声的调查

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Abstract

BACKGROUND: While increasingly discussed in somatic care, the concept of patient participation remains unsettled in psychiatric care, potentially impeding person-centred experiences. OBJECTIVE: To describe outpatient psychiatric care patients' conceptualization of patient participation. DESIGN: An exploratory survey. SETTING AND PARTICIPANTS: Patients in four psychiatric outpatient care units. VARIABLES: Patients conceptualized patient participation by completing a semi-structured questionnaire, including optional attributes and free text. Data were analysed using statistics for ordinal data and content analysis for free text. RESULTS: In total, 137 patients (69% of potential respondents) completed the questionnaire. The discrete items were favoured for conceptualizing patient participation, indicating a primary connotation that participation means being listened to, being in a reciprocal dialogue, learning about one's health care and managing one's symptoms. Additional free-text responses acknowledged the attributes previously recognized, and provided supplementary notions, including that patient participation is about mutual respect and shared trust. DISCUSSION: What patient participation is and how it can be facilitated needs to be agreed in order to enable preference-based patient participation. Patients in outpatient psychiatric care conceptualize participation in terms of both sharing of and sharing in, including taking part in joint and solo activities, such as a reciprocal dialogue and managing symptoms by yourself. CONCLUSION: While being a patient in psychiatric care has been associated with a lack of voice, an increased understanding of patient participation enables person-centred care, with the benefits of collaboration, co-production and enhanced quality of care. PATIENT CONTRIBUTION: Patients provided their conceptualization of patient participation in accordance with their lived experience.

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