Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education

ABSTRACT

Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional’s profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders’ perspectives (without “blind spots” from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers’ contributions.

KEYWORDS:

• Collaborative practices
• comparison of perception
• health services outcomes
• qualitative methods
• therapeutic patient education

Acknowledgments

The authors acknowledge the work of Emilie Culminique and Sandrine Grandclere for contributing to transcription of interviews. Our thanks also go to Alfousseyni Coly and Marjorie Starck for their help in administrative management of the project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contribution

LR Data curation, Formal Analysis, Methodology, Writing-original draft

LM Formal Analysis, Supervision, Writing-review and editing

JK Investigation, Writing-review and editing

CA Supervision, Writing-review and editing

ACR Conceptualization, Methodology, Supervision

Additional information

Funding

This study was funded by the French Ministry of Health (Programme de Recherche sur la Performance du système de Soins (PREPS). The funding agency played no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; the decision to submit for publication or preparation, review or approval of the manuscript for publication.

Notes on contributors

Laetitia Ricci

Laetitia Ricci is a health psychologist, PhD, researcher at the UMR 1319 INSPIIRE, INSERM, University of Lorraine. Her expertise focuses on the evaluation of public health interventions and on development of Patient Reported Outcomes.

Laetitia Minary

Laetitia Minary, PhD, is a public health researcher at the UMR 1319 INSPIIRE, INSERM, University of Lorraine. Her methodological expertise focuses on the evaluation of public health interventions, particularly those aimed at reducing health-related social and territorial inequalities.

Joëlle Kivits

Joëlle Kivits, PhD, Professor at Paris Cité University (France). Researcher at the UMR 1123 ECEVE, INSERM. Research topics: gender and health inequalities, health promotion, development and evaluation of health population interventions.

Carole Ayav

Carole Ayav, MD, is epidemiologist and has more than 15 years of experience in the study of patient-reported outcome measures in Chronic Kideny Disease (CKD) and in the REIN registry. She was responsible for the CKD-REIN PROM work package (CKD-REIN cohort study) and she was involved in the national scientific board of the REIN registry in the Agence de la Biomédecine. She developped, with the NEPHROLOR network, 4 therapeutic patient education programs for patients with chronic kidney disease. She has actively contribued to the inclusion of patients partner in the conception, in leading sessions with health care providers and in evaluation of therapeutic education program.

Anne-Christine Rat

Anne Christine Rat MD, PHD, head of the rheumatology at Caen University Hospital. Researcher at the University of Caen Normandie, UMR-S 1075 - Mobilités: vieillissement, pathologie, santé – COMETE. Research topics: Perceived health in rheumatology, descriptive and prognostic epidemiology, development and evaluation of interventions improving autonomy, perceived health and empowerment.