NN&I - August 2010

Empowerment August 2010 Nephrology News & Issues 37Subscribe to our free eNewsletter at www.nephronline.com Patient engagement: Reality or annoyance?By Lori Hartwell Ms. Hartwell is the president of Renal Support Network, based in Glendale, Calif., and is waiting for her fourth kidney transplant while on home hemodialysis.The primary goal of the health care community is to improve the health of their patients by addressing physi-cal ailments, mental health, and over-all quality of life. Data have consis-tently shown that patients who are engaged as active participants in their own care typically have better morbid-ity and mortality outcomes, as well as a better quality of life. The importance of the patient's opinion in evaluating the latter component of care has been highlighted by the movement toward patient-reported outcomes as the stan-dard for evaluating how a therapeutic course is affecting the patient's quality of life. While the health care literature con-sistently heralds the importance of patient empowerment, patients who try to express their opinion can some-times receive verbal and nonverbal messages from health care profession-als that discourage involvement in care plan decisions. The following provides a series of examples that illustrate how patients with chronic kidney disease may deal with day-to-day issues that are important to them, and how health care professionals may respond to help encourage patient empowerment. Patient emotional stages Patients with a chronic disease often pass through an emotional spectrum that typically progresses through the stages of denial, depression, anger, and acceptance. Health care professionals should be aware of these emotional stages and the fact that a patient's acceptance of educational materials may only occur once a patient has internalized and accepted the need for change. When health care professionals don't acknowledge the emotional roller coaster that patients experience, that can exasperate patient anger. Health care professionals may have to demon-strate extra patience and compassion during this stage of the patient's evo-lutionmaybe by just lending a heart- Empowerment_NNI-0810_8.indd 37 7/15/10 5:50:47 PM