Conceptualizing patient engagement in healthcare:a thematic software-based analysis.

Engaging patients in their own healthcare is now widely acknowledged as a critical ingredient for high-performance health system as it may improve quality of care, health outcomes and patient satisfaction. Within the health research field, patient engagement is receiving increasing attention as it reflects the collective aspiration to build a health care system able to make patients and families active participant and co-producer of their health. Despite the growing popularity of the term “patient engagement” (PE), few authors have attempted to define this concept. As a consequence, the term PE remains conceptually and empirically undeveloped. The aim of this study is twofold: (1) to explore the main dimensions associated with “patient engagement” in the health academic literature by conducting a qualitative explorative and systematic content analysis; (2) to highlight the thematic elements most associated with the word “patient engagement” across different health disciplines (medicine, nursing, psychology, social science…). The key-word “patient engagement” was searched on May 11st, 2012 using the databases more likely to cover the core research publication in health issues (SCOPUS, PUBMED, PsychINFO), within the peer-reviewed literature in the years 2000-2012. A study was eligible for inclusion in the analysis if it describes (a) PE generally, (b) intervention to promote PE, (c) determinants of PE or (d) outcomes of PE and (e) measures of PE. T-lab software-based content analysis (Thematic Analysis of Elementary Context, Word Association Analysis and Correspondence Analysis) were performed on titles, abstract and key-words of the selected studies. Out of 216 studies, 155 were consistent with the eligibility criteria. The result of the analysis has highlighted that the concept of patient engagement is indeed extremely complex, multifaceted and dynamic in its nature thus suggesting the need to assemble a comprehensive theoretical framework and to develop reliable and valid measures for assessing the full range of dimensions that may be implicated in such engagement. Moreover, the study highlighted distinct attitudes towards the concept of patient engagement within different health disciplines thus showing an urgent call for a deeper understanding of patient engagement in order to contribute to hard knowledge development useful both for clinical practice and health policies orientation.