Patient EMPOWERMENT for self-management in chronic conditions Wp1C: EQuiP WORKING GROUP WONCA Istanbul, 24 october 2015

Group Membership Adrian Rohrbasser (Switzerland) Andree Rochfort (Ireland) Ayşe Çaylan (Turkey) Ernesto Mola (Italy) Ilkka Kunnamo (Finland) Isabelle Dupie (France) Janecke Thesen (Norway) Jochen Gensichen (Germany) Tina Eriksson (Denmark) Zalika Klemenc-Ketiš (Slovenia) Zlata Ozvacic Adzic (Croatia)

AIM Exploration of Concepts of Empowerment, including clinician perspective and to include the patient perspective.

European Definition of GP Person-centred care …is contextual, based on : a. Understanding the context of doctors and the environment in which they work, including their working conditions, their community, culture, financial and regulatory frameworks. b. Attitudinal: Based on the doctor’s professional capabilities , values and ethics c. Scientific: Adopting a critical and research based approach to practice and maintaining this through continuing learning and quality improvement.

Factors in GP/FM that can facilitate patient empowerment Longitudinal care A multidisciplinary approach A strong relationship based on a unique consultation process and on trust A person-centred approach These factors can be helpful for a continuous educational process aimed to empower the patient.

Therefore: General Practice / Family medicine is in a strategic position to promote the goals of patient empowerment and self-management.

Patient Empowerment in Europe EQuiP sought to agree a definition that can be interpreted and is useful throughout Europe in terms of language and culture. There is no direct translation of the word “empowerment”, in many languages for example in Norwegian, French and German There are also several closely related terms to “empowerment” such as “enablement” and “self- management”.

Patient Empowerment is: An educational process The beginning… We began to explore “patient empowerment” (PE) from the starting point of the definition in the European Journal of General Practice (EJGP) article by Ernesto Mola: Patient Empowerment is: An educational process …to help /support the patient …to develop knowledge skills attitudes, self- awareness …to assume effective responsibility for health related decisions.

Further exploration of this definition added the following: PE is something that helps patients do something. PE has to come from within, from inside, it is not something that is permitted by another. It is the internal power and desire to act. PE is the ability to set one’s own goals, to make own choices.

The patient is active in the process of PE PE is a continuous process. It is not a once-off intervention or process. PE is about acquiring a critical consciousness of being motivated to take action PE is about patient participation in a defined negotiated and agreed health plan PE is a process whereby a patient gains mastery over their own behaviours and skills

PE includes different perspectives The patient The health professional Primary health care Public health Organisations for patients with a specific illness

PE needs to be supported By the patients’ family and peers By the patients GP/FP By other health professionals By health service systems and processes By other sources and resources …PE involves collaboration and cooperation!

PE involves decision making This implies that before PE happens and during the process the patient must be aware of their options. The patient is free to make a choice.

Next steps… Working Group meets at EQuiP Assembly Meeting in Zagreb Croatia on 12-14th November 2015 Tell us if you would like to share information or to input! www.equip.ch equip.we@gmail.com Thank you!