{"id":2243,"date":"2021-07-14T14:02:35","date_gmt":"2021-07-14T14:02:35","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2243"},"modified":"2025-11-04T14:10:04","modified_gmt":"2025-11-04T14:10:04","slug":"if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/da\/2021\/07\/if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement\/","title":{"rendered":"Hvis medicin er et holdspil, skal patienterne v\u00e6re med p\u00e5 holdet: et psykologisk perspektiv p\u00e5 patient engagement"},"content":{"rendered":"<p><strong>Af G. Graffigna, Universit\u00e0 Cattolica del Sacro Cuore, Italien<\/strong><\/p>\n<p>Sundhedspersonale skal under hele behandlingsforl\u00f8bet samarbejde og koordinere deres indsats for, at sundhedssystemer fungerer effektivt. Med andre ord kr\u00e6ver medicinsk behandling teamwork for at lykkes. Hvis vi k\u00f8ber ind p\u00e5 princippet om teamwork, b\u00f8r vi \u2013 for at bruge en sportsmetafor &#8211; betragte patienten som en medspiller! Begrebet patient engagement anerkender dette og er en vigtig ingrediens, hvis sundhedsv\u00e6senets effektivitet og b\u00e6redygtighed skal forbedres.<\/p>\n<p><!--more--><\/p>\n<p><strong>Hvad er patient engagement? <\/strong><\/p>\n<p><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/252269\">Patient engagement<\/a> betragter mennesker som mere end blot &#8220;modtagere af pleje&#8221; og placerer dem som vigtige akt\u00f8rer i planl\u00e6gning og levering af sundhedsydelser. Der er tale om en proces, hvor folk bliver aktivt involveret i relevante problemstillinger omkring deres behandling. Desuden skal de tr\u00e6ffe beslutninger om faktorer, der p\u00e5virker deres liv samt v\u00e6re involverede i at designe og implementere politikker, planl\u00e6gge, udvikle og levere tjenester og arbejde mod at opn\u00e5 adf\u00e6rds- og livsstils\u00e6ndringer. Patienters holdninger, motivation, f\u00f8lelser og parathed til at engagere sig i sundhedspleje er af afg\u00f8rende betydning for denne proces.<\/p>\n<p>I 2017 beskrev og videnskabeligt validerede vores gruppe en psykosocial model til at diagnosticere og fremme patient engagement: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6056150\/\">Patient Health Engagement Modellen<\/a>. Denne nye evidensbaserede psykologiske teori sigter mod at beskrive, hvordan patient engagement udvikler sig ud fra patienternes perspektiv. Patient Health Engagement-modellen beskriver patient engagement som en dynamisk og udviklende proces, hvorigennem folk kan genvinde deres evner til at v\u00e6re m\u00e5lrettede og gennemf\u00f8re personlige projekter &#8211; selvom de lever med en sygdom.<\/p>\n<p>Modellen l\u00e6gger v\u00e6gt p\u00e5 patienternes personlige valg om at \u00e6ndre deres tilgang til sundhedssystemet, fra passiv modtager, til partner og co-pilot i behandlingen. Denne \u00e6ndring i den enkeltes rolle er en funktion af en dynamisk udvikling i patienters tilpasning og modstandsdygtighed over for deres sundhedsm\u00e6ssige tilstand. Fuldt patientengagement er et resultatet af en r\u00e6kke f\u00f8lelsesm\u00e6ssige bestr\u00e6belser p\u00e5 at omdefinere sin helbredstilstand, patientrolle og identitet og er afg\u00f8rende for at opretholde patienters compliance og vilje til selvadministration samt for med succes at opretholde \u00e6ndring i adf\u00e6rd og livsstil. Patient Health Engagement-modellen indeholder fire faser, og sundhedspersonale kan underst\u00f8tte patientengagement i hver fase.<\/p>\n<ul>\n<li>Fase 1: <em>Blackout<\/em>. I denne fase oplever patienter en f\u00f8lelse af psykisk s\u00e5rbarhed som f\u00f8lge af en kritisk begivenhed, oftest en diagnose. Sundhedsprofessionelle b\u00f8r yde f\u00f8lelsesm\u00e6ssig st\u00f8tte for at hj\u00e6lpe patienter med at tilpasse sig deres nye helbredstilstand. Fokus b\u00f8r v\u00e6re p\u00e5 at hj\u00e6lpe patienter med at udvikle en ny f\u00f8lelse af handlefrihed og kontrol over deres sygdom. Med andre ord kan patienter st\u00f8ttes og hj\u00e6lpes til at f\u00f8le, at deres handlinger kan f\u00f8re til effektiv sygdomskontrol.<\/li>\n<li>Fase 2: <em>A<\/em><em>rousal<\/em>. I denne fase f\u00e5r patienter en begyndende forst\u00e5else for deres helbredstilstand, men de har stadig kun overfladisk viden om, hvordan den h\u00e5ndteres effektivt. I denne fase er det almindeligt, at patienter fraviger plejeprocessen. I denne periode er sundhedsudbydere afg\u00f8rende referencepunkter for patienter. De skal ogs\u00e5 st\u00f8tte patienter i at h\u00e5ndtere deres sygdomme og dermed forhindre at patienterne falder fra behandlingen.<\/li>\n<li>Fase 3: <em>Adhesion<\/em>. I denne fase har patienter udviklet en accept af deres sygdom og har overvundet de st\u00f8rste psykiske problemer forbundet med diagnosticeringen. Sundhedspersonale kan st\u00f8tte patienter i denne fase ved at hj\u00e6lpe dem med at opretholde en adaptiv sundhedsadf\u00e6rd, selv i stressede eller uvante situationer.<\/li>\n<li>Fase 4: <em>Eudaimonic-project<\/em>. I denne sidste fase er patienterne fuldt orienterede om deres sygdom og dens implikationer. De har \u00e6ndret livsstilsvaner i overensstemmelse med terapeutiske krav, og de bliver aktive medspillere i fors\u00f8get p\u00e5 at opn\u00e5 positiv og tilfredsstillende livskvalitet p\u00e5 trods af at de lever med en kronisk lidelse. P\u00e5 dette stadium betragtes sundhedspersonale som p\u00e5lidelige allierede, og patienter b\u00f8r st\u00f8ttes i at se sig selv som aktive medlemmer af plejeteamet.<\/li>\n<\/ul>\n<p>Overgangen fra en passiv tilgang til en aktiv og effektiv kontrol over eget helbred er resultatet af en kompleks proces med menings- og identitetsskabelse. Den subjektive og undertiden irrationelle opfattelse, som enkeltpersoner har om sig selv, og de unikke linser, gennem hvilke individer vurderer deres livskvalitet, er &#8211; efter vores mening &#8211; basis for at skabe engagement. Sundhedspersonale kan indarbejde disse indsigter i deres egne health engagement modeller.<\/p>\n<p>Den beskrevne Patient engagement modellen <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5487073\/\">har vist sig at pr\u00e6diktere<\/a>, behandlingsadherence og empowerment. Ved at benytte en psykosocial tilgang til at definere og m\u00e5le patientengagement \u00f8ger vi i h\u00f8j grad vores forst\u00e5else af, hvordan folk i l\u00f8bet af deres sygdomsforl\u00f8b beslutter at \u00e6ndre deres rolle, s\u00e5 de bliver bedre engageret i egen sundhedspleje.<\/p>\n<p>For at opsummere spiller f\u00f8lelsen af mental kontrol over egen sygdom en vigtig rolle i forhold til hvor godt man h\u00e5ndterer denne. Jo bedre disse f\u00f8lelser og roller forst\u00e5s, jo bedre er patientens mulighed for effektivt at engagere sig i egen behandling. Sundhedspersonale har en n\u00f8glerolle at spille i hver af overgangene, fra diagnosetidspunkt til at patienten bliver en fuldt informeret og engageret person, der er aktivt involveret i egen behandling.<\/p>\n<p><strong>Praktiske r\u00e5d<\/strong><\/p>\n<ul>\n<li><strong>Vurder patient engagement: <\/strong>the <a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.00274\/full\">Patient Health Engagement Scale<\/a> kan hj\u00e6lpe med systematisk at m\u00e5le niveauet af engagement p\u00e5 tv\u00e6rs af behandlinger og tidsrammer for herved at g\u00f8re det muligt at skabe personrettede strategier og interventioner til at fremme engagementet.<\/li>\n<li><strong>Opbyg tillid:<\/strong> Brug personlig kommunikation (dvs. patient-l\u00e6ge kommunikation, offentlig kommunikation, social markedsf\u00f8ringskommunikation), der er tilpasset de m\u00e5lte niveauer af patientengagement.<\/li>\n<li><strong>\u00c5ben sundhedskultur: <\/strong>Medicinske afsnit og uddannelser b\u00f8r s\u00f8ge at implementere uddannelsesprogrammer der giver sundhedspersonale den n\u00f8dvendige viden samt kommunikative og relationelle kompetencer til at fremme patient engagement.<\/li>\n<li><strong>Fremme patientens entusiasme<\/strong>: Hj\u00e6lp patienterne med at se tingene fra den lyse side. At tilskynde til optimisme og til at fokusere p\u00e5 det positive, kan hj\u00e6lpe folk til at abstrahere fra nogle af de d\u00e5rlige eller nedsl\u00e5ende nyheder, der kan p\u00e5virke motivationen til at engagere sig.<\/li>\n<\/ul>\n<p>[oversat af Elisabeth Ginnerup-Nielsen]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Healthcare professionals along the whole care journey must collaborate and coordinate their efforts for healthcare systems to function effectively. In other words, medicine requires teamwork to be successful. If we agree on this principle, then \u2013adopting a sports metaphor \u2013the patient too should be considered a player in the team!<\/p>\n","protected":false},"author":1,"featured_media":2268,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[43],"tags":[],"class_list":["post-2243","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-engagement"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"da","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","sr","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":true},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":false,"content":false,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":true,"content":true,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"sr":{"title":false,"content":false,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.8 - aioseo.com -->\n\t<meta name=\"description\" content=\"Healthcare professionals along the whole care journey must collaborate and coordinate their efforts for healthcare systems to function effectively. 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