Informal work and formal plans: articulating the active role of patients in cancer trajectories

<strong>Introduction:</strong> Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of pa...

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Bibliographic Details
Main Authors: Rikke Juul Dalsted, Marius Brostrøm Kousgaard, John Sahl Andersen, Bibi Hølge-Hazelton
Format: Article
Language:English
Published: Ubiquity Press 2012-12-01
Series:International Journal of Integrated Care
Subjects:
Online Access:http://www.ijic.org/articles/822
Description
Summary:<strong>Introduction:</strong> Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.   <strong>Methods and theory</strong>: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included. <strong> </strong> <strong>Results:</strong> Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.  Patients presented problems to the healthcare professionals in order to get proper help when needed. <strong> </strong> <strong>Discussion:</strong> Work done by patients was invisible and not perceived as work. The patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients´ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed. <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabel - Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Cambria","serif"; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} > <! [endif] > <p class="MsoNormal" style="margin-bottom: 0.0001pt; line-height: 200%;" mce_style="margin-bottom: 0.0001pt; line-height: 200%;"><span class="hps"><strong><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Introduction: </span></strong></span><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Formal pathway models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.</span> <p class="MsoNormal" style="line-height: 200%;" mce_style="line-height: 200%;"><span class="hps"><strong><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Methods and theory: </span></strong></span><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included.</span><span class="hps"><strong></strong></span> <p class="MsoNormal" style="line-height: 200%;" mce_style="line-height: 200%;"><span class="hps"><strong><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Results: </span></strong></span><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.<span>  </span>Patients presented problems to the healthcare professionals in order to get proper help when needed.</span><span class="hps"><strong></strong></span> <p class="MsoNormal" style="line-height: 200%;" mce_style="line-height: 200%;"><span class="hps"><strong><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Discussion: </span></strong></span><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">Work done by patients was invisible and not perceived as work. The patients’ requests were not sufficiently supported in the professional organisation of work or formal planning. Patients’ insertion and use of information in their trajectories challenged professional views and working processes. And t</span><span style="font-size: 12pt; line-height: 200%; font-family: " mce_style="font-size: 12pt; line-height: 200%; font-family: " lang="EN-GB">he design of the formal pathway models limits the patients´ active participation. W<span class="hps">hen looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed.</span></span>< ><strong>Introduction:</strong> Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.   <strong>Methods and theory</strong>: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included. <strong> </strong> <strong>Results:</strong> Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.  Patients presented problems to the healthcare professionals in order to get proper help when needed. <strong> </strong> <strong>Discussion:</strong> Work done by patients was invisible and not perceived as work. The patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients´ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed.<-->
ISSN:1568-4156