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Published on: July 12, 2024
[Patient Participation in Development of Quality Indicators using the Example of National Disease Management
H Herzberg1, K Bernateck1, F Welti2
1Fachbereich Gesundheit, Pflege, Management, Hochschule Neubrandenburg, Neubrandenburg.
Insights
Patients with chronic heart failure accept quality indicators but find they often neglect daily life aspects. A "yes - but" attitude emerges due to a conflict between everyday patient knowledge and medical knowledge orders.
Area of Science:
- Cardiology
- Health Services Research
- Qualitative Research
Background:
- Chronic heart failure (CHF) management relies on established quality indicators.
- Patient perspectives are crucial for refining these indicators.
Purpose of the Study:
- To explore patient relevance of existing quality indicators for CHF.
- To understand how patients perceive the alignment of quality indicators with their daily lives.
Main Methods:
- Qualitative study utilizing 6 group discussions with CHF patients.
- Participants recruited from local heart sports groups.
- Analysis employed a grounded theory-like approach.
Main Results:
- Quality indicators are generally accepted by patients.
- A significant finding is the neglect of patients' everyday life aspects by many indicators.
- Patients exhibit a "yes - but" response, highlighting a conflict between everyday knowledge and medical knowledge orders.
Conclusions:
- Medical knowledge orders must integrate patient knowledge orders for effective CHF care.
- Training patient representatives is essential to confidently voice everyday knowledge in healthcare bodies.
- Failure to integrate patient knowledge risks mere conformation to professional medical standards.
Purpose:
In this qualitative study it was investigated by group discussions with patients suffering from chronic heart failure, how relevant the existing quality indicators of the National Disease Management Guidelines for Chronic Heart Failure are being estimated.
Methods:
6 group discussions were performed. The sample was formed from 4 mixed-gender groups, a male group and a female group. Participants were recruited from local heart sports groups. For the interpretation a method similar to the grounded theory was used.
Results:
The main conclusion is that in principle quality indicators are accepted. However, many of these indicators neglect the everyday aspects of patients' life. Participants show a disposition of "yes - but" regarding the quality indicators. This phenomenon could be theoretically grasped using the concept of order of knowledge. While participants keep referring to an order of everyday knowledge, quality indicators make recourse to a medical order of knowledge. Both orders of knowledge may compete with each other.
Conclusions:
The professional knowledge order of medicine needs to open up to a patients' knowledge order. Patient representatives in health care bodies need to be trained to develop a reflexive point of view to different knowledge orders enabling them to represent patients' everyday knowledge more confidently. Otherwise there is danger of conformation to the professional knowledge order of medicine only for reasons of being recognised as equal partners.
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