Partnering with patients - a concept ready for action

This paper is a report of a concept analysis of partnership within the context of a professional-patient relationship. The concept of partnership has been previously characterized as immature, with a need for further consensus and consistency. Critical attributes previously reported include relationship, power sharing and negotiation, with empowerment as the primary consequence. Rodgers' evolutionary method of analysis for concept development was used to re-examine the concept of partnership. Historical documents and previously published conceptual papers were reviewed for context. A search of multidisciplinary literature published between 2000 and 2004 was undertaken using the keywords of 'partnership' and 'partnering', combined with nurse/professional/physician-client relationship. Attributes, uses, antecedents and consequences were inductively derived from the citations analysed (n = 62). Previous authors affirmed that partnership involves a process and a consistent set of eight attributes. Relationship, shared power, shared decision-making and patient autonomy are attributes that distinguish partnership from other related concepts. Most of the literature, however, consisted of expert opinion or descriptive research. Little progress has been made in applying theory, developing tools to test the process, identifying when partnerships are needed and what specific outcomes occur when they are present. Partnerships between healthcare providers and patients develop over time. They are created to support patients in having a greater voice in their care and to empower them in self-management. A descriptive model of partnership is proposed to support researchers in generating or applying existing theory to the development of research designs and tools that could test how this process actually works.