Enabling primary healthcare service development with patient participation: a qualitative study of the internal facilitator role in Norway.

AIM: To explore how primary healthcare professionals (HCPs) tasked with facilitating primary healthcare service development with patient participation perceived their role. INTRODUCTION: Patient participation in health service development is a recognized means of ensuring that health services fit the public's needs. However, HCPs are often uncertain about how to involve patient representatives (PRs), and patient participation is poorly implemented. Inspired by the Promoting Action on Research Implementation in Health Services framework, we address the innovation (patient participation), its recipients (PRs, HCPs, supervisors, and senior managers), and its context (primary healthcare at a local and organizational level). METHODS: We conducted semi-structured individual interviews with six HCPs working as internal facilitators in primary healthcare in four Norwegian municipalities. The data were analyzed by applying Braun and Clarke's reflexive thematic analysis. FINDINGS: The themes show that to develop primary healthcare services with patient participation, facilitators must establish a network of PRs with relevant skills, promote involvement within their organization, engage HCPs favorable toward patient participation, and demonstrate to supervisors and senior managers its usefulness to win their support. Implementing patient participation must be a shared, collective responsibility of facilitators, supervisors, and senior management. However, supervisors and senior management appear not to fully understand the potential of involvement or how to support the facilitators. The facilitator role requires continuous and systematic work on multiple organizational levels to enable the development of health services with patient participation. It entails maintaining a network of persons with experiential knowledge, engaging HCPs, and having senior management's understanding and support.

Primary healthcare professionals' experience with patient participation in healthcare service development: A qualitative study.

Objective: How healthcare professionals experience patient participation in health service development impacts its use. This participatory study explores primary healthcare professionals' perceptions of developing health services with patient representatives. Methods: Four focus group interviews with primary healthcare professionals (n = 26) were conducted. We analyzed data by applying Braun and Clarke's reflexive thematic analysis. Results: The healthcare professionals perceived having a complementary interprofessional relationship with the patient representatives and regarded them as colleagues. However, the professionals navigated between a position of authority and collaboration, reconciling the need for participation with its challenges, e.g., to identify the representatives' collective representation among their personal experience, to ensure a more evidence-informed result that they and their colleagues would endorse. Conclusions: Regarding patient representatives as colleagues can blur the line between professionals and representatives' positions and functions and further complicate health service development. Our results indicate a need for skilled facilitators to lead the process. Innovation: This study identifies issues that professionals are uncertain about when collaborating with representatives to develop primary healthcare services; difficulties that professionals must overcome to collaborate constructively with representatives. Our findings can inform healthcare professionals' education about patient participation on all levels. We have suggested topics to address.

The empowering value of introducing CST in vocational rehabilitation.

Objectives: The topic of this article is the value of introducing compensatory technology in vocational rehabilitation. The study describes the social work-related effort of introducing compensatory technology to job seekers with cognitive disabilities, focusing on the value of the actual introduction and the value that the participants believe this has for their future mastery of working life.Methods: The data are taken from a two-year ethnographic fieldwork study at two vocational rehabilitation companies. Both companies placed special focus on introducing technology in the vocational rehabilitation process and invested in developing compensatory technology for job seekers with cognitive disabilities.Results: The study shows that the introduction of compensatory technology has been valuable both in the individual empowerment process and for the participants upon completion of the vocational rehabilitation programme. The value of introducing technology has been both motivating and empowering. The article describes the motivational value associated with CST in a vocational rehabilitation perspective.Implications for rehabilitationBeing able to solve challenges with technology is empowering for the participants in vocational rehabilitation programmes, regardless of the frequency of use.To be able to introduce concrete apps is a tool in the social workers counselling efforts to develop the participants' ability to master life situations.The process of introducing compensatory technology has had an inherent value in the individual participant's empowerment process through the vocational rehabilitation programme.