What patient involvement means to new patients at two HIV clinics: A longitudinal, qualitative study.
Jennifer Freytag, Zhixin J Jiang, Thomas P Giordano and 4 others
PMID 30948202WHAT IT FOUND
Patients new to an HIV provider defined involvement differently: following instructions, asking questions, or choosing medication.
They said providers fostered involvement by asking opinions, discussing medication trade-offs, or explaining decisions, and some expectations changed after the visit.
Key findings
01Patients new to an HIV provider defined involvement differently: some meant following instructions, others meant seeking information, and others meant having control over treatment choices.
02Patients said they felt involved when providers asked their opinion, discussed medication side effects and trade-offs, or explained how a treatment decision was reached.
03Some patients' expectations of involvement changed after meeting the provider, moving from following instructions or passive acceptance toward shared decision-making or partnership.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was limited to patients with HIV who were new to a provider at two public clinics, so the themes may not apply to other conditions or care settings. The study included mostly male patients, and a majority of participants were non-Hispanic Black or Hispanic, so the findings may not generalize to other patient groups. Only 34 of the 56 patients completed the third interview, so the evidence about change over time rests on a smaller group. The study reports patients' perceptions and definitions of involvement, not measured effects of any communication strategy on adherence or outcomes.
Declared interests
The study was supported by NIH K23 MH100965; the supplied text gives no competing-interest declaration.
The easy way to misread this
Do not conclude that these provider behaviors improve adherence or outcomes. The study reports patients' perceptions, not tested effects. It also shows some patients felt involved by following instructions rather than speaking up.