Changing relationships: how does patient involvement transform professional identity? An ethnographic study
Autor: | Philippe Karazivan, Marie Leclaire, Marie-Pierre Codsi, Ghislaine Rouly, Antoine Boivin |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Canada
education Pharmacist Identity (social science) Patient-Centred Medicine quality in health care 03 medical and health sciences 0302 clinical medicine Medicine Humans Nurse Practitioners 030212 general & internal medicine Patient participation Health policy Qualitative Research Medical education Social Identification business.industry 030503 health policy & services change management health policy General Medicine Therapeutic relationship medical ethics General partnership Patient Participation 0305 other medical science business Logbook Qualitative research |
Zdroj: | BMJ Open, Vol 11, Iss 7 (2021) BMJ Open |
ISSN: | 2044-6055 |
Popis: | ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities. |
Databáze: | OpenAIRE |
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