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Definition
The word empowerment has been broadly defined as an
enabling process through which individuals or communities
take control of their lives and their environment. The word
empowerment builds upon the Latin root passe, from which
we derive both the word power and the word freedom.1
Patient empowerment in the health care context means
to promote autonomous self-regulation so that the individuals potential for health and wellness is maximised. Patient
empowerment begins with information and education and
includes seeking out information about ones own illness or
condition, and actively participating in treatment decisions.
Empowerment requires an individual to take care of ones
self and make choices about care from among the options
identified by the doctor.2
The concept
Jones and Meleis3 describe the concept of empowerment as
a social process of recognizing, promoting, and enhancing
peoples abilities to meet their own needs, solve their own
problems, and mobilize necessary resources to take control
of their own lives. In other words, patient empowerment is
a process of helping people to assert control over factors
that affect their health.
There is a strong link between the concept of empowerment and that of development of the community. The World
Health Organization (WHO) health promotion glossary distinguishes between individual and community empowermentindividual empowerment refers primarily to the
individuals ability to make decisions and have control over
his or her personal life; community empowerment involves
individuals acting collectively to gain greater influence and
control over the determinants of health and the quality of
life in their community.4
Community empowerment becomes an integral element
of the health care reform movement. Given the escalating
costs of health care, the wider involvement of the general
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public in policy-making, as well as taking more responsibility for maintaining their own health, with a move towards
increased public responsibility in health care management,
are also means of cost-containment. The basis underlying
all such involvement is the need for a patient to take an informed stance and make an informed choice. This involves
not only health care professionals interacting with patients,
but also a conscious effort at the policy-making level to
ensure that such informed participation is possible. Patient
charters and patient empowerment acts have been drawn up,
for example in the US, to ensure that people have the right
to self-determination and power over their health decision.
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373
voices of the patients, their carers, and the public are heard
and listened to at every level of the service, which acts as a
lever for change and improvement.
Crossing the quality chasm, a second report from the
US Institute of Medicine in 2001, highlighted the deficiencies in health care quality in the US and made recommendations for improvement.15 Patient centredness is one of the
key dimensions for improvement.
The global change towards patient empowerment and
increased patient involvement is in line with a focus on health
rather than on disease, on prevention and health education
rather than on cure, and on trying to make people aware of
the choices they have in relation to their health. The change
represents a step towards the achievement of a more generalised sense of responsibility of patients and the public.
Locally, more measures can be considered for patient
empowerment and building a good clinician-patient
relationshipimproving the information given to patients,
including treatment options, outcomes, and limitations in
medical care, and encouraging informed choice and shared
responsibility. Strengthening the complaint procedures and
introducing patient forums, patient advocacy, and liaison
are other measures to enable patients perspectives and views
to be known for planning their own care and for service
planning at a strategic level. The outcome will help to promote patient-centred care and hopefully to reduce health
care costs.
Conclusion
References
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