University of Oulu

Paukkonen, L, Oikarinen, A, Kähkönen, O, Kyngäs, H. Patient participation during primary health-care encounters among adult patients with multimorbidity: A cross-sectional study. Health Expect. 2021; 24: 1660– 1676.

Patient participation during primary health-care encounters among adult patients with multimorbidity : a cross-sectional study

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Author: Paukkonen, Leila1,2; Oikarinen, Anne1,2; Kähkönen, Outi1,2;
Organizations: 1Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
2Medical Research Centre, Oulu, Finland
3Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-11-23


Background: Patient participation is essential for achieving high-quality care and positive outcomes, especially among patients with multimorbidity, which is a major challenge for health care due to high prevalence, care complexity and impact on patients‘ lives.

Objective: To explore the patient participation related to their own care among patients with multimorbidity in primary health-care settings.

Methods: A cross-sectional survey was conducted among adult multimorbid patients who visited primary health-care facilities. The key instrument used was the Participation in Rehabilitation Questionnaire. Data representing 125 patients were analysed using various statistical methods.

Results: The respondents generally felt patient participation to be important, yet provided highly varying accounts regarding the extent to which it was realized by professionals. Information and knowledge and Respect and encouragement were considered the most important and best implemented subcategories of participation. Several patient-related factors had a statistically significant effect on patient perceptions of participation for all subcategories and as explanatory factors for perceptions of total participation in univariate models. Most patients reported active participation in health-care communication, positively associated with patient activation and adherence. Gender, perceived health, patient activation and active participation were explanatory factors for total importance of participation in multivariate models, while patient activation was retained for realization of participation.

Conclusions: Multimorbid patients require individualized care that promotes participation and active communication; this approach may further improve patient activation and adherence. Poor perceived health and functional ability seemed to be related to worse perceptions of participation.

Patient and public involvement: The study topic importance was based on the patients‘ experiences in author‘s previous research and the need to develop patient-centred care.

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Series: Health expectations
ISSN: 1369-6513
ISSN-E: 1369-6513
ISSN-L: 1369-6513
Volume: 24
Issue: 5
Pages: 1660 - 1676
DOI: 10.1111/hex.13306
Type of Publication: A1 Journal article – refereed
Field of Science: 316 Nursing
Funding: This work was funded by the University of Oulu Graduate School, UniOGS, Health and Biosciences Doctoral Programme, the Finnish Nursing Education Foundation and State Hospital District Research Funding. The funding bodies had no role in the design of the study, in the collection, analysis and interpretation of data, or in the writing or decision to submit the article for publication.
Copyright information: © 2021 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.