User employment in hospital institutions - A qualitative study of physicians’ point of view
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Background and aim User involvement in delivering and planning health services is recommended and said to be useful to improve the quality of health services. Studies have shown that managers and health professionals are willing to involve users, but there is a lack of experience in how to make them active participants. One solution is to employ experienced patients, but no studies on user employment in somatic health systems are found. Therefore, the aim of this study is to investigate what physicians working in somatic hospitals think of the idea user employment. Method A qualitative study using individual semi-structured interviews with eight physicians working in somatic hospitals in Central Norway was conducted in the fall/spring of 2017. The informants were asked about their thoughts about user employment, possible positive and challenging aspects, ideas to how it could work and their experiences with user involvement. The data was analyzed according to the method of systematic text condensation. Results None of the participants had experience with user employment, but they were familiar with the concept of user involvement. Some thought user employment was a good idea, considering it would take care of patients’ rights, improve information, understanding and motivation among patients, in addition to take care of the duty of confidentiality. Others were in doubt whether employing users could work in practice and was worried about them giving incorrect information. They were all concerned about economy and the scarcity of resources in health service. There was a disagreement about working circumstances for employed users and if the user should be generic or specialized, but everyone envisioned it being most suitable as an additional support for persons with chronic illness. Conclusion The findings in this study indicates that there is a lack of experience with user employment in somatic health service. The interviewed physicians were positive to the idea, but they need more guidelines and knowledge about the subject, and when it is effective. There were also physicians who were sceptical to employing users. Given the scarcity of research in this area, more studies are needed, especially on the experience of having employed users as part of the staff in hospital departments.