According to the World Health Organization (1998), patient empowerment, or patient participation is a social, cultural, psychological, or political process through which individuals or social groups gain greater control over decisions and actions affecting their health. The process involves communicating needs, developing strategies for engagement in decision-making, and achieving action to make progress (WHO, 1988). WHO (2009) reports essential components of patient participation as follows: patient understanding of his/her role, patient attainment of sufficient knowledge to be able to engage with their healthcare provider, and the presence of a facilitating environment.
Andersson et al. (2012) found that patients of a larger integrative medicine study in Sweden receiving care for neck and back pain perceived conventional management to focus on the disease with a lack of accessibility and guidance. Conversely, integrative care was described as holistic, whole-person management that facilitated increased treatment response and autonomy. Empowerment, support, and relaxation were the central themes identified by surveying patients at Solaris Care cancer support centers in Western Australia who accessed drop-in complementary and integrative therapies (CIT) including relaxation massage, reflexology, Reiki, and library/lounge (Furzer et al., 2014). Patients often communicated an improved perception of well-being immediately following CIT which was clinically associated with lower cortisol levels (Furzer et al., 2014). Therefore, researchers suggest that these improvements may lead to improved physical symptoms and treatment tolerance (Furzer et al., 2014).
In the United States, changes from volume-based to value-based healthcare regulations focus on patient characteristics and functional status instead of service quantity and intensity. One important measure of service quality in a hospital system is readmissions. Acute and post-acute care OT services address significant contributors to readmission including basic activities needed to take care of oneself, health management, household management, community mobility, fall risk, functional cognition, social participation, and safety (Roberts et al., 2020). Occupational therapy practitioners use professional reasoning, empathy, and a client-centered, collaborative approach to service delivery. (AOTA, 2020). The profession’s practice framework defines engagement as “the result of choice, motivation, and meaning within a supportive context” (AOTA, 2020). Therefore, the inclusion of OT services across all levels of care would be the best practice for a healthcare organization based on an integrative model (Roberts et al., 2020). More information on value-based OT and the implications for quality and practice can be found at https://www.aota.org/value.
References
American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process, Fourth Edition. American Journal of Occupational Therapy, 74(Supplement_2), 1-87. https://www.doi.org/10.5014/ajot.2020.74S2001.
Andersson, S., Sundberg, T., Falkenberg, E., & He, T. (2012). Patients’ experiences and perceptions of integrative care for back and neck pain. Alternative Therapies in Health & Medicine, 18(3), 25–32.
Furzer, B. J., Petterson, A. S., Wright, K. E., Wallman, K. E., Ackland, T. R., & Joske, D. J. L. (2014). Positive patient experiences in an Australian integrative oncology centre. BMC Complementary & Alternative Medicine, 14(1), 1–17. https://doi.org/10.1186/1472-688214-158.
Roberts, P., Robinson, M., Furniss, J., & Metzler, C. (2020). Health policy perspectives: Occupational therapy’s value in the provision of quality care to prevent readmissions. American Journal of Occupational Therapy, 74, 1-9. https://doi.org/10.5014/ajot.2020.743002.
World Health Organization. (1998). Health promotion glossary. Retrieved from https://www.who.int/healthpromotion/about/HPG/en/
World Health Organization. (2009). Patient empowerment and health care. Guidelines on hand hygiene in health care: First global patient safety challenge. https://www.ncbi.nlm.nih.gov/books/NBK144013/pdf/Bookshelf_NBK144013.pdf.