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. 2020 Jul 19;6:43. doi: 10.1186/s40900-020-00214-5

Table 4.

Examples of challenges and considerations of doing PPI

Challenges of doing PPI in research Examples of considerations from the researcher perspective Examples of considerations from the PRPs’ perspective
Funding - Where to apply and how to budget PPI - None in this case
- Changing the level of PPI requires additional funding
- Travel expenses and salary
Recruitment of patient representatives - Which patient representatives (gender, age, patients or relatives, pointed out and asked at the hospital or an open invitation through the patient association) - Worries about living up to certain expectations must be put aside in order to sign up for engagement
- Worries about asymmetric dialogues between academic people and layman must be put aside
- Number of patient representatives (represent the entire patient group, balanced with the number of researchers)
Level of PPI - Consultation, collaboration, co-creation, user-led - Openness about abilities and feelings of inadequacy
- Change of level over time according to research question and request and abilities among patient representatives
Administrative investment - Money investment (costs of meetings, salary, and reimbursements for PRPs, teaching needed in the analysis, funding for participation in a conference) - The costs PPI may have on everyday life (e.g. time spend, confrontations with hard feelings) must be acceptable
- Time and place of meetings to accommodate wishes from both patient representatives and researchers - Alignment of PPI-activities with relatives
- Arranging meals and snacks to pay back to patient representatives and to maintain a cozy atmosphere
- Constant follow-up at meetings or by e-mail on how a task or homework has been received by the patient representatives
- Balance time between small talk and work. Both are essential when doing PPI
- Individual introduction to new members and encouragement to active and equal participation
Intellectual investment - Inclusion and discussion of all thoughts and ideas – even when these do not match each other - Sharing of sensitive topics
- Offering yourself in discussions
- Respect and trust in each other in order to capture true experiences - Willingness to be honest
- Listen to, acknowledge and consider all comments - Dealing with insights that might be difficult to separate from your own situation
- Addressing and maintaining an agreed-upon division of tasks and responsibilities
- Worries about own contributions
- Avoiding information harm - Direct reference to PPI contributions by PI is the easiest way to recognize own impact as a patient representative
- Concerns about work or responsibility overload for the patient representatives
- Concerns about conference participation (performance on panel presentation, understandable topics, welcoming atmosphere)
Progression of disease or death of patient representatives - Respect for a patient representative’s choice to cut down on activities or to stop completely - Open dialogue
- Open dialogue in the group