Research shows that patients who participate in their own treatment often have better outcomes. In his PhD project, Joachim Sagen has investigated why user participation is important in healthcare. The study looks at how patient participation can make treatment and rehabilitation more successful.
In the photo: Joachim Sagen with his supervisors. From left, Ingvild Kjeken, Joachim Sagen, main supervisor Rikke H. Moe and Hanne Dagfinrud
– Patients who are allowed to set their own goals have a greater chance of good results, says Sagen.
He emphasizes that the same applies when patients participate in making plans for treatment.
Sagen's project was motivated by his desire to understand whether and how user participation can improve healthcare services.
The PhD project, "Patient engagement in the development and delivery of healthcare services", shows how patient participation influences treatment and rehabilitation.
An important finding is that user involvement is of great importance. Patients who set goals together with healthcare professionals were three times more likely to achieve them.
The patient's voice makes a big difference
Sagen has conducted research on patients affiliated with specialized private rehabilitation institutions and user representatives in user committees. His study was divided into four parts:
- Review of literature in the field: Researchers analyzed 37 studies from 2005 to 2022. The results showed that good education is important for user participation. Broad representation among patients, healthcare professionals and managers is also crucial.
- Questionnaire adapted to Norwegian conditions: A Canadian questionnaire on user participation was translated and tested in Norway. The form, called Evaluation Form for User Participation (EBNOR), proved useful for Norwegian conditions.
- Experiences from user representatives: 47 representatives responded to a questionnaire, and 85% believed that user participation improved the institutions. However, they reported little influence in decision-making processes.
- The connection between goals and outcomes: In the large RehabNytte study, 2,113 patients were followed up after rehabilitation. Most participated in setting goals and making plans for their treatment.
The results showed that this resulted in better functioning and a greater chance of achieving the goals.
“User participation gives patients an important voice. When patients are heard, treatment can be better tailored to their needs and wishes,” explains Sagen.
The way forward: More knowledge and focus on user participation
Sagen wants to continue his work to gather and share knowledge about the importance of user participation, both through research and practice.
Joachim Sagen's thesis establishes that user participation results in better healthcare services.
– I am now researching the importance of alternative treatment for people with rheumatic disease. I do this through the Norwegian Rheumatology Association and the National Research Center for Complementary and Alternative Medicine, he says.
The trial lecture
Sagen held the trial lecture, "What are the challenges and opportunities for patient engagement in the evaluation of health services?"
Supported by DAM funds and strong guidance
Sagen has been employed at the Unit for Health Services Research and Innovation (EHI) at Diakonhjemmet while working on his PhD. It is affiliated with OsloMet as an educational institution. The PhD has been possible thanks to research funding from the DAM Foundation from 2020 to 2024.
Supervisors, dissertation supervisor and committee
The main supervisor, Rikke Helene Moe, and the co-supervisors, Ingvild Kjeken and Hanne Dagfinrud, have supervised the work. All at the Unit for Health Services Research and Innovation at Diakonhjemmet Hospital.
The dissertation supervisor was Margret Grotle.
The judging committee consisted of:
- First opponent: Professor Julia Abelson, McMaster University, Canada
- Second opponent: Professor Jonathan Quetzal Tritter, Nord University, Norway
- Committee Chair: Professor Tone Dahl-Michelsen, OsloMet
Recommendations for health services
This PhD strengthens the understanding of how patient involvement can improve treatment outcomes and healthcare services. This is an area that Diakonhjemmet Hospital continues to prioritize.
The doctoral student together with the supervisors and the committee: Ingvild Kjeken, Jonathan Q. Tritter, Julia Abelson, Joachim Sagen, main supervisor Rikke H. Moe, Margreth Grotle and Tone Dahl-Michelsen
