Health expectations : an international journal of public participation in health care and health policy
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To explore patients' perceptions of health-care built environments, to assess how they perceived health-care built facilities and designs. To develop a set of patient-centred indicators by which to appraise future health-care designs. ⋯ Patients perceived sustainable health-care environments to be supportive of their health and recovery. The design indicators developed from their perspectives and from their considerations for improvements to the health-care built environment were based on their visions of the role of the health-care facilities. These were homely environments that supported normal lifestyle and family functioning and designs that were supportive of accessibility and travel movements through transitional spaces.
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To investigate the characteristics and achievements of cancer partnership groups--collaborative service improvement groups formed of NHS staff and service users--in the 34 cancer networks in England, and in particular to explore the influence that such groups had on local cancer services. ⋯ Partnership groups were established in the majority of cancer networks. Typically, these groups were at network level, been established for less than a year, met once every 2 months, and were populated with both service users and health-care professionals. Five common activities and achievements were identified: establishment of the group itself; acting as a 'reference' group for consultation; networking and representation on other groups; patient information and communication and proactive influencing. Activities progressed in scale and complexity as groups evolved. Groups had learnt the basics of change management and some identified a more sophisticated understanding of change processes in the NHS as essential for the group's motivation and survival. When gauging the impact of involvement strategies it would seem important to subscribe to broad indicators of success that include both process and outcome measures.
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Questionnaires completed respectively by doctor and patient may give conflicting views of what actions the doctor took during a consultation in primary care. This disagreement will affect an assessment of whether patient expectations of care were met, and may itself be influenced by fulfillment of expectations. ⋯ Whether or not a doctor's actions appear to fulfil patient expectations in a primary care consultation depends on whether those actions are reported by the doctor or the patient.
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To obtain consensus on the principles and indicators of successful consumer involvement in NHS research. ⋯ Consensus has been obtained on eight principles of successful consumer involvement in NHS research. They may help commissioners, researchers and consumers to deepen their understanding of this issue, and can be used to guide good practice.
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There have been significant conceptual developments regarding shared decision-making (SDM) and assessments of people's hypothetical preferences for involvement in treatment or care decisions. There are few data on the perceptions of patients and professionals about SDM in actual practice. ⋯ Shared decision-making and RC approaches were helpful in selected consultations and showed no detrimental effects to patients. However, the use of RC and SDM made only small differences to decision-making in consultations within the population studied. Increasing patient participation may be seen as more ethically justifiable than the traditional paternalistic approach but this needs to be set against the additional training costs incurred.