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      An empirically based conceptual framework for fostering meaningful patient engagement in research

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          Abstract

          Background

          Patient engagement in research ( PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data.

          Objective

          To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective.

          Methods

          We conducted a qualitative secondary analysis of in‐depth interviews with 18 patient research partners from a research centre‐affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team.

          Results

          Participants’ experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team.

          Conclusions

          The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient‐researcher partnerships are led by researchers with little experience of engaging patients in research.

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          Most cited references19

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          Coding In-depth Semistructured Interviews: Problems of Unitization and Intercoder Reliability and Agreement

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            Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

            Background Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. Methods A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher’s perspectives by means of document review and participatory observation. Results Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Conclusions Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.
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              Evaluating patient and stakeholder engagement in research: moving from theory to practice.

              Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects. This paper synthesizes the literature on hypothesized impacts of engagement, shares what has been evaluated and identifies steps needed to reduce the gap between engagement's promises and the underlying evidence supporting its practice. This assessment provides explicit guidance for better alignment of engagement's promised benefits with evaluation efforts and identifies specific areas for development of evaluative measures and better reporting processes.
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                Author and article information

                Contributors
                Role: Post‐Doctoral Fellowchamilton@arthritisreseach.ca
                Role: Clinical ProfessorRole: Knowledge Translation Specialist
                Role: ProfessorRole: Senior Scientist
                Role: Patient Research Partner
                Role: Patient Research Partner
                Role: Patient Research Partner
                Role: Professor
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                06 October 2017
                February 2018
                : 21
                : 1 ( doiID: 10.1111/hex.2018.21.issue-1 )
                : 396-406
                Affiliations
                [ 1 ] Department of Physical Therapy University of British Columbia Vancouver BC Cananda
                [ 2 ] Arthritis Research Canada Richmond BC Canada
                [ 3 ] BC SUPPORT Unit Vancouver BC Canada
                [ 4 ] Arthritis Patient Advisory Board Arthritis Research Canada Richmond BC Canada
                [ 5 ] Department of Occupational Science & Occupational Therapy University of British Columbia Vancouver BC Canada
                Author notes
                [*] [* ] Correspondence

                Clayon B. Hamilton, Arthritis Research Canada, Richmond, BC, Canada.

                Email: chamilton@ 123456arthritisreseach.ca

                Author information
                http://orcid.org/0000-0002-6852-3436
                Article
                HEX12635
                10.1111/hex.12635
                5750689
                28984405
                5a17636d-474c-491c-b9ca-eb4353d1f5b0
                © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 September 2017
                Page count
                Figures: 1, Tables: 2, Pages: 11, Words: 7520
                Funding
                Funded by: Michael Smith Foundation for Health Research Trainee Award
                Funded by: Harold Robinson/Arthritis Society Chair
                Funded by: Canada Research Chair Program
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12635
                February 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.8 mode:remove_FC converted:15.01.2018

                Health & Social care
                conceptual framework,patient and public involvement,patient engagement in research,patient‐oriented research

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