Research shows that patients who participate in their own treatment often get better results. In his PhD project, Joachim Sagen has investigated why user participation is important in the health service. The study looks at how patients' participation can make treatment and rehabilitation more successful.
In the picture: Joachim Sagen together 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 the patients participate in making plans for the treatment.
Sagen's project was motivated by his desire to understand whether and how user participation can improve the health service.
The PhD project, "Patient engagement in the development and delivery of healthcare services", shows how patients' participation affects treatment and rehabilitation.
An important finding is that user participation 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 researched patients associated 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 training is important for user participation. Broad representation among patients, healthcare personnel and managers is also essential.
- 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 answered a questionnaire, and 85% believed that user participation improved the institutions. Nevertheless, they reported little influence in decision-making processes.
- The connection between goals and results: In the large RehabNytte study, 2113 patients were followed up after rehabilitation. Most participated in setting goals and making plans for their treatment.
The results showed that this gave better function and a greater chance of achieving the goals.
- User participation gives patients an important voice. When the patients are heard, the treatment can be better adapted to their needs and wishes, explains Sagen.
The way forward: More knowledge and focus on user participation
Sagen wants to continue its work in obtaining and sharing knowledge about the importance of user participation. He wants to do this through both research and in practice.
Joachim Sagen's thesis states that user participation results in better healthcare services.
- Now I am researching the importance of alternative treatment for people with rheumatic disease. I do this through the Norwegian Rheumatism 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 by the Unit for Health Services Research and Innovation (EHI) at the Diakonhjemmet while he has been working on his doctorate. It is affiliated with OsloMet as an educational institution. The PhD has been possible thanks to research funds from the DAM foundation from 2020 to 2024.
Supervisors, dissertation supervisor and the committee
Main supervisor, Rikke Helene Moe, assistant supervisors, Ingvild Kjeken and Hanne Dagfinrud have supervised the work. Everyone at the Unit for Health Service Research and Innovation at Diakonhjemmet Hospital.
The debate leader was Margret Grotle.
The assessment committee consisted of
- First opponent: Professor Julia Abelson, McMaster University, Canada
- Second opponent: Professor Jonathan Quetzal Tritter, Nord University, Norway
- Committee leader: Professor Tone Dahl-Michelsen, OsloMet
Recommendations for the health services
With this PhD, the understanding of how patient involvement can provide better treatment results and health services is strengthened. This is an area 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
