Development of Conceptual Framework from the View of Patients and Professionals on Patient Engagement: A Qualitative Study in Hong Kong SAR, China

Abstract

Objective: To investigate patient engagement to gain understandings of professional and patient’s views and inform the development of a patient engagement conceptual framework for further development of a valid and reliable evaluated measure. Method: 17 selected hospitals from Hong Kong East Cluster, Hong Kong West Cluster, Kowloon Central Cluster, Kowloon East Cluster and New Territory East Cluster of Hospital Authority Hong Kong involved in the study. Focus groups were conducted with 37 medical staffs, which included 15 doctors and 22 nurses, and 33 patients. Semi-structured qualitative interview study, with purposive sampling and constant comparative analysis. Results: Data were analyzed using a qualitative approach of latent content analysis. Patient engagement is a multi-dimensional concept. Five hierarchical themes separately from the patient and medical staff’s perspectives containing different conceptions and attitudes related to patient engagement have been identified and summarized. Through analyzing both professional and patients’ perspectives, a hierarchical framework incorporating patients-professional dynamically fluctuating relationship was built. The framework divides engagement into five levels and five stages. Conclusions: Patient engagement is recognized by more patients and professionals as a means and a cornerstone to build the foundation of patient-centered-care. Our framework encourages that patient engagement related to not only an individual patient’s behavior but a reciprocal, dynamic and pluralistic relationship with their professionals and healthcare systems. Understand this relationship can help us better conceptualizing, evaluating, and implementing interventions to improve the population’s health.