Table 1.
Factor | Evidence/relevant information | |
---|---|---|
1. Patient‐related | Knowledge/beliefs | The public is concerned about the risk of medical errors if hospitalised, 12, 13 75%feel health care is only moderately safe 12, 13 and 49%feel preventable medical errors are made‘somewhat often’or‘very often’ 14 |
Patients understand the risk of medication errors and hospital acquired infections 15, 16 | ||
59%of the public feel that patients’are‘somewhat often’or‘very often’partially responsible for errors in their own care 14 | ||
Patients feel they have a role in reducing their susceptibility to patient safety incidents, including medication errors 16 | ||
Demographic features | Younger patients generally want more involvement than older patients 18 , 19 , 20 | |
Females want more involvement than males 18 | ||
Highly educated patients opt for a more active role than their less academic peers 18 , 19 , 20 | ||
Emotions and coping style | Patients’ experiences with their illness can trigger negative emotions (e.g. anxiety). 25 | |
Negative emotions may heighten patients’ perceptions of vulnerability to negative life events, 26 , 27 which may catalyse their participation in safety‐related behaviours. | ||
Patients that use more active coping styles express greater preferences for involvement 28 | ||
2. Illness‐related | Stage/severity of illness | Some studies show patients with minor complaints are more likely to prefer an active role than patients with severe disease 18 , 29 but opposing findings show patients with serious illness/whose illness is further progressed, have higher preference for involvement 30 |
Illness symptoms, treatment plan and patients’ health outcomes | Patients’ preferences for involvement may change over time dependent on the symptoms of the illness 31 | |
Preference for involvement may be associated with illness symptoms and how these affect the functionality of the patient | ||
Preference for involvement may be associated with the type of treatment plan for the illness and how much opportunity for involvement this allows | ||
Preference for involvement may be associated with the likely impact that patient involvement will have on the patients’health outcomes | ||
Prior experience | ||
• Illness | Patients’ experience of illness is associated with higher preference for involvement for treatment of that illness. 32 Experience of a patient safety incident may have a similar effect in terms of an increased preference for involvement in safety‐related behaviours | |
• Patient safety incidents | National and international organizations have been founded by victims of patient safety incidents (http://www.mrsasupport.co.uk; http://www.patientsafety.org) | |
3. Health care professional‐related | Knowledge/beliefs | 58% physicians felt that patients were either‘very often’or‘somewhat often’ partially responsible for medical errors in their care. 14 |
Interactions with patients | Clinicians generally express positive views on patient involvement 34 | |
Positive interactions with health professionals can encourage patient participation; 35 , 36 | ||
Negative interactions can act as an inhibitor 37 | ||
HCP’s professional role | 100%patients were willing to ask a nurse whether they have washed their hands, but only 35%were willing to ask a doctor 15 | |
4. Health care setting‐related | Health care setting | Patients have more difficulty communicating with hospital staff than their GP, 35 , 38 so may be less willing to engage in safety‐related behaviours which require direct communication with staff in the hospital setting. |
Emergency patients are typically unsure what is wrong with them so may be less willing to be involved than patients receiving ambulatory Care 39 | ||
5. Task‐related | Challenge to HCPs | It is likely that patients will be more willing to be involved in safety‐related behaviours that do not challenge the health care professionals’ clinical abilities. |
Medical knowledge required | Patients prefer to be more involved in those aspects of their health care that do not require medical knowledge. 40 |
Note – For factors/relevant information: Bold face type indicates direct evidence of effect of factor on patients’ willingness to be involved in safety; Normal type indicates possible effect/indirect evidence and relevant observations drawn from TDM literature and other sources; Italic type indicates suggestive factors that could affect patients’ willingness to participate in safety.