Empowerment: qualitative underpinning of a new clinical genetics-specific patient-reported outcome

Recent qualitative research developed a new construct labelled Empowerment describing a new patient outcome from using clinical genetics services that included four dimensions: Knowledge and Understanding, Decision-Making, Instrumentality and Future-Orientation. The aim of this study was to explore the validity, relevance and importance of the Empowerment construct for use as a patient-reported outcome (PRO) for clinical genetics services, and to refine the construct if necessary. Qualitative research (interviews and focus groups) was conducted in the UK with 12 patients, 15 representatives from patient support groups, 10 genetics clinicians and 4 service commissioners. Participants were asked to (1) describe what they think are the patient benefits from using clinical genetics services and (2) critique the Empowerment construct as a PRO. Interviews and focus groups were transcribed in full and analyzed using grounded theory. Findings confirmed the relevance and importance of the Empowerment construct, and identified Emotional Regulation as a further dimension of Empowerment. Data analysis also resulted in refinement of the construct, by renaming the other four dimensions to be Cognitive Control, Decisional Control, Behavioural Control and Hope. Empowerment has the potential to be a useful PRO to evaluate interventions in clinical genetics, and for use in clinical practice to generate data for continuous quality improvement. A study is underway to operationalise Empowerment by developing a psychometrically sound PRO measure that will take the form of a short questionnaire.

Aim

The aims in the present study were to (1) explore the validity, relevance and importance of the Empowerment construct and refine the construct as necessary and (2) inform the decision whether or not to develop a clinical genetics-specific PROM of Empowerment.

Contributors

McAllister, Marion; Dunn, Graham; Todd, Chris.

Publication

Journal: European Journal of Human Genetics
Volume: 19
Issue: 2
Pages: 125 - 30
Year: 2011
DOI: 10.1038/ejhg.2010.160.

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): Medical Research Council. Ethical approval was provided by Central Manchester NHS Research Ethics Committee (ref.07/ H1008/226).


Health Area

Disease Category: Genetic disorders

Disease Name:

Target Population

Age Range: 0 - 100

Sex: Either

Nature of Intervention: Not specified

Stakeholders Involved

- Service commissioners
- Clinical experts
- Consumers (patients)
- Patient/ support group representatives

Study Type

- Patient perspectives

Method(s)

- Focus group(s)
- Interview

Patients were asked to participate in a focus group, but also had the option to be interviewed. Genetics clinicians were recruited through professional networks, and were only asked to participate in a focus group. Participants were asked to describe their views about the benefits and harms of using clinical genetics services, and then given a page describing the Empowerment construct, with its four dimensions, and the dimension definitions. Participants were asked to read and critique
this, in particular to identify any benefits / harms of using a clinical genetics service that were missing.