Patient engagement

If medicine is a team game, patients should play too: a psychological perspective on patient engagement

 

By G. Graffigna, Università Cattolica del Sacro Cuore, Italy

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 –adopting a sports metaphor –the patient too should be considered a player in the team!

The concept of patient engagement recognizes this, and it is an important ingredient for enhancing the effectiveness and sustainability of healthcare.

What is patient engagement?

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Communication, Incentives, Motivational interviewing, Social Support

How to support patients to lose weight and better manage their type 2 diabetes

By Leah Avery, Teesside University, UK.

Type 2 diabetes was previously considered a progressive condition, with an inevitable need for insulin therapy, however lifestyle behavioural change research challenges this pessimistic prognosis. As prevalence of type 2 diabetes continues to increase, so does evidence supporting the important role of the food and changing what we eat to successfully manage the condition.

Dietary approaches can largely be divided into two. Those that focus on what we eat (e.g., carbohydrates) to optimise metabolism and glycaemic control via slow and steady weight loss. Others that focus on the amount eaten, such as the low-calorie diet involving significant energy restriction for rapid weight loss.

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Communication, Goal setting

Teaching practitioners Healthy Conversation Skills 

By Wendy Lawrence, University of Southampton

The main causes of death and disease in society today are influenced by our lifestyle choices, and there is a growing focus on ways to improve health behaviours. Front-line practitioners, particularly those working in health, social and community care roles, are a key resource for supporting behavioural change. Routine appointments offer opportunities to initiate conversations about behaviour change every week, but many practitioners feel that they lack the knowledge and skills necessary to provide behaviour change support. This can reduce our confidence for having conversations with clients or patients about potentially sensitive topics, including smoking, weight loss or alcohol intake.

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Automaticity, Habit, Self-efficacy

To eat or not to eat, that is the question: How can health psychology practitioners help people manage food safety?

By Barbara Mullan, Curtin University, Australia

Extent of the problem

Every year, one in 10 people worldwide (approximately 600 million people) become ill after eating contaminated food, and as many as 420,000 people die. There are vast geographical differences in where these instances occur, with African, South-East Asian, and Eastern Mediterranean regions bearing the highest burden of foodborne disease (further detail about the foodborne disease burden by region can be found here). In addition to these geographical differences, there are also vast differences in the types of agents that are responsible for foodborne disease (e.g., viruses, bacteria, parasites).

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Financial Incentives, Smoking cessation

Helping pregnant women quit smoking: sharing best practice from the UK

By Felix Naughton, University of East Anglia, UK

 Between 25-50% of female smokers quit smoking after they discover they are pregnant. But why do the remainder continue to smoke throughout their pregnancy?

 Do they not know that smoking during pregnancy is harmful? They usually do. One of our UK studies, that included pregnant women both motivated and unmotivated to quit, found 99% agreed to some degree with the statement ‘smoking during pregnancy can cause serious harm to my baby’ with around 75% agreeing very much or extremely. Yet less than 10% of them were abstinent 12 weeks later. While making a quit attempt is more likely among those with strong ‘harm beliefs’ about smoking in pregnancy, it does not appear to increase the chances of success. 

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Assessment, Brief behavioural intervention, Goal setting, Habit, Planning

Improving the delivery of brief alcohol advice in primary care: views from both sides of the consultation table

By Amy O’Donnell, Newcastle University, UK

Levels of drinking have fallen recently in some parts of Europe, particularly amongst young people. However, excessive alcohol consumption remains a major risk factor for poor health and early death. Providing simple brief advice to those identified as heavy drinkers can help reduce the amount of alcohol people consume, especially when delivered by primary care clinicians such as general practitioners (GPs) or nurses. Alcohol brief advice involves a short, evidence-based, structured conversation that aims to motivate and support a patient to consider a change in their drinking behaviour to reduce their risk of harm. We still haven’t fully identified the key ingredients of these conversations, but providing personalised feedback on a patient’s alcohol consumption, and encouraging them to self-monitor their drinking, seem to be particularly effective parts of the package.

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Acceptance and Commitment Therapy, Coping, Habit, Mental Health, Planning, Routines, Self-monitoring, SMART Goals

Staying well while staying at home

By Dr Federica Picariello and Professor Rona Moss-Morris, King’s College London, the UK.

Within weeks around the world, daily life dramatically changed, and uncertainty seized our future in the wake of the COVID-19 pandemic. Beyond the immediate and urgent need to slow down the spread of COVID-19 through rapid and widespread behavioural change (i.e., self-isolation, social distancing, and quarantine), the impact on mental and physical wellbeing needs to be considered to allow early intervention and mitigate the longer-term consequences.

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Habit, Motivation, Self-monitoring, Self-regulation

How to maintain health behaviours long term?

By Dominika Kwasnicka, SWPS University, Poland and University of Melbourne, Australia

The ultimate goal of health promotion programmes is to promote long-lasting change and health care professionals can play a role and help patients to improve their health outcomes and maintaining behaviour change. We know that health behaviour change is difficult to initiate and it can be even more challenging to maintain in the long term. One big question in health psychology is why maintenance is so difficult. 

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Self-monitoring

Stop being an ostrich! The benefits of helping people to monitor their progress

By Thomas L. Webb, Department of Psychology, The University of Sheffield, the UK

How are you getting on with your goal to reduce the amount of sugar that you eat and lose 10kg? Chances are that you don’t really know – or even want to know. In situations like these, people tend to behave like ostriches and bury their heads in the sand, intentionally avoiding or rejecting information that would help them to monitor their goal progress. Research on this “ostrich problem” suggests that people often do not keep track of their progress (e.g., step on weighing scales, read the packets of food that they buy), in part, because doing so can make them feel bad about themselves – e.g., they realise that they weigh more than hoped and that they still consume too much sugar. However, theory and evidence suggest that keeping track of progress helps people to identify discrepancies between their current and desired states that warrant action. The implication is that avoiding monitoring makes it difficult to identify the need to act and the most appropriate way to do so. The ostrich problem therefore represents an opportunity for healthcare professionals (and others) to help people to monitor their progress and capitalise on the benefits of so doing. Perhaps not surprisingly then, we found good evidence that prompting people to monitor their progress helps people to achieve goals across a range of domains.

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Communication

Insights from behavioural science for the COVID-19 pandemic

By Shane Timmons, Economic and Social Research Institute, Ireland

Governments worldwide have mobilised to try to control the spread of the novel coronavirus, but the behaviour of individuals will be vital to their success. We – the Behavioural Research Unit at the Economic and Social Research Institute in Dublin – are working with Ireland’s Department of Health to inform their response to the COVID-19 pandemic. As part of this work, we’ve reviewed over 100 scientific papers and have begun testing ways to best communicate with the public, with lessons relevant for health psychology practitioners. In our review, we focus on literature relevant for three areas that have formed the basis for public health messaging in multiple countries: hand hygiene, face touching and isolation. We also address broader literatures on how to motivate helpful behaviour and communicate effectively in a crisis. 

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