I’m not sure if parenting has always been this way, with a three year old I still consider myself a newer parent, but it seems like it has become a competitive sport. I see a lot of one upping from parents who try to prove their parental skill by judging other parents. One of the biggest sources of contention I see among parents is regarding screen time. Many will flat out tell you that letting children use screens – television, computer or handheld – is lazy parenting that makes children dumb, fat, unmotivated, violent, etc.
I have friends who are are very adamant in their opinions about screen time. I know this because they post rants against it on their Facebook pages a few times a week. I find this, shall we say interesting, since they need to use some type of screen or handheld device to get their anti-screen time message out there, but to each their own. The latest piece of support for their opinion I’ve seen circulating is this post from the Huffington Post “10 Reasons Why Handheld Devices Should Be Banned for Children Under the Age of 12.”
Unlike some of my friends, I don’t think kids love of screens is necessarily a result a of “bad parenting” but more a result of screens, or at least the things presented on the screen, being designed to be engaging. They’re colorful, they come with songs and they’re interactive. I mean, you can use a catapult to launch an irate bird and a bunch of bright green pigs. That’s pretty engaging and entertaining. Thanks to an app from PBS Kids, my daughter has learned concepts like matching, counting and problem solving. Of course, I teach her these concepts in other non-screen ways as well, but a little time playing her “games” on my Nook help reinforce the concepts she’s learned in the real world.
The concept of engagement is a hot topic in health care. We hear the terms “patient engagement” and “engaged patients” frequently though there is some disagreement on what the terms actually mean. There was a 2012 article in the Journal of Participatory Medicine called The Many Faces of Patient Engagement that tried to help define the concept. The authors wrote that the task was more challenging than they first realized and patient engagement was defined differently by different groups. They also noticed that the terms involvement, engagement, and participation are often used interchangeably in regards to patient engagement.
To me an engaged patient is someone who is interested in his or her health and health outcomes and is willing to work with their healthcare provider to achieve a set of mutually established goals. Patient engagement is the act of getting a patient involved in being an active participant in his or her own health care.
As a healthcare professional and a patient, I’ve seen both engaged and non-engaged patients. Some patients are very interested in outcomes and will come with research, ideas and a desire to achieve those goals. Other patients don’t seem at all interested and might actually be pessimistic about achieving goals and outcomes.
Take, for example, patients who are ready manage their blood pressure by taking personal responsibility and dedicating themselves to a walking program to help them lose weight. They are very engaged in their care. Then there are the patients who don’t seem at all interested in making lifestyle changes to improve their blood pressure readings and just continue with life as usual. I wouldn’t label this group as engaged.
The study “Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores‘” published in the February 2013 issue of Health Affairs examined the relationship between “patient activation levels” (which could also be called patient engagement) and care costs. In a companion piece to the study the authors wrote that “patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care (also known as “patient activation,” measured by the Patient Activation Measure) had health care costs that were 8 percent lower in the base year and 21 percent lower in the next year compared to patients who lacked this type of confidence and skill.”
Basically, engaged patients had better outcomes and cost less to care for. So how do we get patients who are not engaged to become more participatory and invested in their care? In my next post, two weeks from now, I’ll discuss the concept of Interactive Patient Care and how it can affect engagement and outcomes.
Jennifer Thew, RN, MSJ
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