Original article
Patient, family and clinician preferences for the intensity and implementation of patient and family participation in healthcare design and delivery in psychiatry
Lucy Whistona,
, Joe Barryb, Veronica O’Keanec, Catherine Darkerb
Corresponding author
lucy.whiston@dcu.ie
Corresponding author. Present address: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin, 9 D09 X984, Ireland.
Corresponding author. Present address: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin, 9 D09 X984, Ireland.
a School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
b Department Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin 24, Ireland
c Department of Psychiatry, School of Medicine, Trinity College Dublin, Trinity Health Sciences Centre, Tallaght Hospital, Dublin 24, Ireland
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Functional activation differences in schizophrenia patients with and without hallucinations" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "7" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1194 "Ancho" => 3175 "Tamanyo" => 247524 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Group-specific task-dependent functional activation compared to rest. (A) Activation for AH (hallucinating patients with schizophrenia) and (B) activation for C (healthy controls). AH show activation in left-sided Broca’s and Wernicke’s areas whereas C only show activation in right-sided homologue of Broca’s area. Thus, no left-sided activation in language-related areas was found for C. Results for NH (non-hallucinating patients with schizophrenia) not shown due to lack of significant results at threshold of uncorrected non-parametric <span class="elsevierStyleItalic">p</span> =  0.001. Faded coloring resembles activation in deeper lying regions. 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Present address: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin, 9 D09 X984, Ireland." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3543 "Ancho" => 3008 "Tamanyo" => 469291 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">DTE sample flow chart. * = Numbers for family members are based on estimates from pilot data collection. + = Further information on the collation of the sampling frame is provided in Chapter 5. # = Round three family member sample size increased as 2 Round 2 non-responders took part in Round 3.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Participation is where people are encouraged to partake in identifying issues, making decisions, designing, developing and implementing policies and delivering services that concern them.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This can occur at the patient level (e.g. decisions about care for individual patients), the service level (e.g. decisions about planning services) and the national level (e.g. decisions about national health policy).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Examples include patient or family inclusion in guideline development<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> or consultation in setting priorities.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The importance of participation in healthcare has been established globally.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Potential benefits from participation include better health and treatment outcomes,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> increased quality of life,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> greater self-dignity and esteem<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> and more responsive, higher quality services.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> However, a mismatch has been identified between rhetoric and action. This is linked with a lack of consensus on the best ways to achieve strong and lasting participation.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Existing research is weak due to heterogeneity in the interventions tested, the patient groups employed and underlying health systems. Interventions tested have included participation through priority setting in primary care services in Canada, participation through an evaluation of mental health services in Ireland<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and participation through citizens’ juries investigating e-health in the United Kingdom.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> There is a divide with research focusing on either participation at the patient<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> or national level<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> with limited focus on participation at the service level. A focus on participation at the service level is of particular importance for psychiatric services where patients have expressed that only those who have experience of mental illness can understand the emotions and consequences which set them apart from the rest of society.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Stemming from the lack of consensus and gap between rhetoric and action the need to focus on defining participation and its components has been acknowledged.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> This study focuses on patient and family participation at the service level. The aim is to identify the most appropriate level of intensity and type of intervention to encourage participation in an outpatient psychiatry service through a Delphi Technique Experiment (DTE).</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Setting</span><p id="par0025" class="elsevierStylePara elsevierViewall">An adult outpatient psychiatry service in a deprived suburb of Dublin, Ireland. Approximately 2200 patients attend. The service is run by a multidisciplinary team (MDT) including psychiatrists, nurses, psychologists and allied health professionals.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Delphi Technique Experiments</span><p id="par0030" class="elsevierStylePara elsevierViewall">A three-round DTE was conducted with 31 participants from an outpatient psychiatry service.</p><p id="par0035" class="elsevierStylePara elsevierViewall">DTEs are a method of achieving consensus through multiple iterations of a questionnaire completed anonymously by a panel of experts.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In each round, participants complete a questionnaire that is returned to the researcher. The researcher removes questions in which stable group consensus has been achieved. The remaining questions are returned to the participants with controlled feedback, including an overview of the answers provided by the panel as a whole, with the option to change their answer or leave it the same<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> (see Supplementary file). This process continues until a stable group consensus is obtained, determined by predefined stopping criteria.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Conventionally, a 15% change or lower between rounds<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> with levels of agreement above 51%<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> are deemed acceptable stopping criteria. The stopping criteria employed for this study were less than 15% change in opinions between rounds and more than 65% of panellists in agreement. Likert scales with four answer categories were employed. For scoring and analysis answer categories were collapsed with ‘1’ and ‘2’ together and ‘3’ and ‘4’ together to give two answer categories.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Sampling</span><p id="par0045" class="elsevierStylePara elsevierViewall">The selection of participants for DTEs depends on the expertise of the panellists in the area being examined.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Panellists were experts in the disease and service attended, not patient and family participation, which is the topic of the DTE. Previous research in the same service has illustrated that patient and family participation in healthcare design and delivery does not occur beyond the provision of information.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Similar research has also included participants who had not yet taken part in participation.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">This study included 31 participants: 13 patients, 9 family members, and 9 clinicians. This is reflective of previous research which supports a maximum panel size of 30 as larger panels seldom improve results and can result in low response rates.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> The breakdown of the sample by stakeholder groups is also within the convention of having 5–10 members in a panel from the same grouping.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Patients and family members</span><p id="par0055" class="elsevierStylePara elsevierViewall">Family members were defined as those who attended the service with patients in a caring or supportive capacity. The sampling frame for the patient and family member sample consisted of participants from previous studies in the same research that consented to be invited to take part in future research. Further detail on this sampling frame is provided in a previous publication.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> A random sample of patients and family members was selected. To allow for refusals oversampling was conducted. Oversampling was based on response rates for a previous study in the same service.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Oversampling has been identified as a useful recruitment approach when working with a list of names, particularly within healthcare research.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> This process is illustrated in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Clinicians</span><p id="par0060" class="elsevierStylePara elsevierViewall">All members of the MDT who were in employment within the service for at least three months were invited to take part (see <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Round 1 questionnaire</span><p id="par0065" class="elsevierStylePara elsevierViewall">The Round 1 questionnaire was a structured questionnaire informed by a literature review, Arnstein’s Ladder of Participation,<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> the CLEAR Framework<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> and interviews with patients (<span class="elsevierStyleItalic">n</span> = 20), family members (<span class="elsevierStyleItalic">n</span> = 20), clinicians (<span class="elsevierStyleItalic">n</span> = 24) and policy leaders (<span class="elsevierStyleItalic">n</span> = 15) from the same services. It is an acceptable and common modification in the DTE process to use a structured questionnaire in Round 1 based upon an extensive literature review or prior qualitative data collection.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,14,16</span></a> A patient and family member representative provided feedback on the questionnaire. A pilot was conducted using a ‘Think Aloud’ methodology<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> with a separate sample of patients (<span class="elsevierStyleItalic">n</span> = 8) and family members (<span class="elsevierStyleItalic">n</span> = 4) and clinicians (<span class="elsevierStyleItalic">n</span> = 3) external to the service.</p><p id="par0070" class="elsevierStylePara elsevierViewall">There were 65 questions in the Round 1 questionnaire. Topics included opinions on participation, intensity and frequency of participation and implementation (see Supplementary file). To ensure all relevant answer options were provided non-standardised questions included an ‘other’ category.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Round 2 and Round 3 questionnaires</span><p id="par0075" class="elsevierStylePara elsevierViewall">Questions that reached a stable group consensus were removed.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,16</span></a> All ‘other’ options were removed. Where an ‘other’ option was suggested by two or more participants this was added in as a new answer option in Round 2. For each question controlled feedback was provided. The answers of the group as a whole was depicted in a histogram, the participant’s answer was circled in red and participants were given the opportunity to change their answer or leave it the same. If a participant chose to remain outside of the group consensus they were asked to explain why (see Supplementary file).</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Procedures</span><p id="par0080" class="elsevierStylePara elsevierViewall">Data collection was conducted by the author (LW) between June and August 2016 with a two-week turnaround time between rounds.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Unique identifier numbers (UIN) were employed for anonymity. Questionnaires took ten to fifteen minutes to complete. Informed written consent was obtained. Ethical approval for this research was granted by the St James’ Hospital/Adelaide and Meath Incorporating the National Children’s Hospital Research Ethics Committee, Reference Number 2015-03.</p><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Patients and family members</span><p id="par0090" class="elsevierStylePara elsevierViewall">The research and DTE process was explained over the phone with an invitation to participate. When a patient or family member agreed to participate, they were sent a Round 1 pack in the post. This included an invitation letter, information sheet, consent form, DTE instructions, Round 1 questionnaire and a stamped addressed return envelope. Instructions included a step-by-step guide on how to complete the questionnaire, how the DTE process works, definitions of key words used in the questionnaire and a ‘frequently asked questions’ section. Follow-up phone calls were made 3 days later to ensure the pack had been received and to provide participants with an opportunity to ask questions. A reminder text message was sent, or phone call made to those who had not returned a questionnaire after one week.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Clinicians</span><p id="par0095" class="elsevierStylePara elsevierViewall">A presentation on the research and DTE process was made to the full MDT with an invitation to participate. Clinicians who expressed an interest in taking part were provided with the Round 1 pack. A reminder text message was sent to those who had not returned a questionnaire after one week.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The same procedures were followed for Round 2 and Round 3.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Findings were presented to clinicians who participated and distributed via the post to patient and family participants. No contradictory feedback was provided on the findings.</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Analysis</span><p id="par0110" class="elsevierStylePara elsevierViewall">Descriptive statistics with percentages and counts are presented. All analysis was completed using SPSS (version 22; SPSS Inc; Chicago, IL, USA).</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Response and attrition rates</span><p id="par0115" class="elsevierStylePara elsevierViewall">The refusal rate was 14% (<span class="elsevierStyleItalic">n</span> = 4) for patients, 12% (<span class="elsevierStyleItalic">n</span> = 2) for family members and 0% (<span class="elsevierStyleItalic">n</span> = 0) for clinicians. The response rate for Round 1 was 72% (<span class="elsevierStyleItalic">n</span> = 39/54), 79% (<span class="elsevierStyleItalic">n</span> = 31/39) for Round 2 and 82% (<span class="elsevierStyleItalic">n</span> = 31/37) for Round 3. The attrition rate between Round 1 and Round 3 was 23% (<span class="elsevierStyleItalic">n</span> = 8) (see <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Demographic description</span><p id="par0120" class="elsevierStylePara elsevierViewall">A total of 42% (<span class="elsevierStyleItalic">n</span> = 13) of the sample were patients, 55% (<span class="elsevierStyleItalic">n</span> = 17) were female and 42% (<span class="elsevierStyleItalic">n</span> = 13) had a level of education of degree or above (see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Consensus</span><p id="par0125" class="elsevierStylePara elsevierViewall">A total of 65 questions were asked. Stable consensus was achieved in 50/65 questions in Round 1, 53/65 questions in Round 2 and 60/65 questions in Round 3. The 65% level of agreement for consensus was met in the remaining 5 questions (see <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Support for and preferred intensity of participation</span><p id="par0130" class="elsevierStylePara elsevierViewall">The vast majority of participants supported patient participation in healthcare design and delivery (97%; <span class="elsevierStyleItalic">n</span> = 38). The preferred amount of intensity was for patients to be involved to the point of being involved in the decision making process, having a ‘vote’ when changes are being made (87%; <span class="elsevierStyleItalic">n</span> = 27) at all times (73%; <span class="elsevierStyleItalic">n</span> = 22). Family participation was also supported by the majority of participants (85%; <span class="elsevierStyleItalic">n</span> = 33) with a preference for family participation as problems arise to the point of involvement in discussions.</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Process</span><p id="par0135" class="elsevierStylePara elsevierViewall">There was agreement that patient representatives should represent patients (84%; <span class="elsevierStyleItalic">n</span> = 26) and family members representatives should represent family members (72%; <span class="elsevierStyleItalic">n</span> = 23). Characteristics identified as important to take into account when selecting representatives included: capacity to dedicate time for all representatives, patient’s health and length of service attendance for patient representatives and frequency of attendance for family representatives.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Strong consensus supported training for patients, family members and clinicians. It was agreed that this should include: how to work with others, communication skills and why patients/family members should be involved. Patients and family members also need training in how the service works and how changes are made.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Patients and family members should be involved at all stages of the decision-making process from suggestions for changes being put forward, to decisions being made and implemented. The individual experience of the representative, conversations with other patients and family members and pre-identified lists of what is important to patients and family members should all be taken into account when representatives are providing input.</p><p id="par0150" class="elsevierStylePara elsevierViewall">There was agreement that it is important for patient and family member opinions to be communicated to those involved in the decision-making process, decisions contrary to patient or family member opinions need to be justified and patients and family members updated on how their opinions were included.</p></span></span></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">This is the first DTE to include patients, family members and clinicians in the identification of the intensity and implementation of participation in healthcare design and delivery. Previous DTEs have included a variety of combinations of groups including: policy leaders, representatives, clinicians, experts, consumers and advocates.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,18</span></a> Patients, family members and clinicians are the three key groups that would be involved in participation at the service level. As such, the inclusion of their preferences is key to ensuring feasible and sustainable participation. This is in line with Medical Research Council (MRC) Guidelines for developing complex health interventions and the Matrix of Service User Participation, which highlights that appropriate participation methods may differ by service and issue.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,24</span></a> It also reflects the triangle of care. This is a holistic methodology that brings together families, service users and professionals to promote safety and recovery for people with mental health issues and to encourage their wellbeing by including and supporting families.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Arnstein’s Ladder of Participation plots the intensity of participation from being provided with information to taking on responsibility with more meaningful participation at the top of the ladder.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Using this ladder there is a preference for patients in a psychiatric service to be involved to the point of being involved in the decision making process, but not taking on full responsibility for decisions. There is a preference for family members to be involved to the point of taking part in discussions. This is reflective of work conducted in England that points towards a preference for a consultative role for patients. Research with members of the public reported a 68% preference for public involvement at the national level but with decision-making responsibility retained by clinicians.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Greater levels of participation, such as patients taking responsibility for decisions made, do not seem to be supported. This may be due to a recognised limitation of the DTE process ‘watering down’ preferences.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> It may also be related to the level of participation within these services, which is currently limited to the provision of information.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">A key concern within participation is tokenism where patients or family members become involved in healthcare design and delivery but they are not listened to in implementation.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> There was strong agreement that patients and family members need to be updated on how their opinions are used and if the final decision differs from patient or family member opinions this needs to be justified. Agreement was also reached that when providing input patient or family member representatives should use their own experience alongside discussions with other patients and pre-identified lists of what is important to patients or family members. Representatives being associated with their peer groups is supported within the literature as this can boost their competency and participation.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">The CLEAR Framework of Factors Driving Public Participation is a process improvement tool to assess encouragement of public participation and recommendations to tackle problems. Part of the argument on which this is based is the idea that people engage depending on the resources that they have access to as well as the support they are provided with.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> High levels of consensus for training to be given to patients, family members and clinicians for participation are supportive of this. Acknowledged barriers in participation include ‘unspoken rules’ of decision making, use of technical language ‘jargon’ and group and power dynamics.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> Irish research in mental health services identified the need for support for participation to include information on how committees work and the structure of decision-making.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Separately, a review of strategies to involve patients concluded that clinicians needed opportunities to develop their competencies in this area, particularly their communication skills.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> This is supported by this research which agreed that training for all stakeholders for participation needs to include how the service and decision making-process works, how to work with others and communication skills.</p><p id="par0175" class="elsevierStylePara elsevierViewall">This is also the first DTE to focus on the role of family members in healthcare design and delivery. Family participation was favoured through family member representatives to the point of being involved in discussions. Families play a diverse number of roles including providing emotional, social and financial support, monitoring health and well-being, providing professionals with information about the individual as well as advocating for individuals.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> As a result it is argued by some in the literature that families should be considered at all stages of care-planning, decision-making and delivery, with the same thought and attention as for patients.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Despite this, data about ‘carers’ contact with health systems is not routinely collected<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and previous research on this topic has not focused on the role of family members.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a></p><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Strengths and limitations</span><p id="par0180" class="elsevierStylePara elsevierViewall">A key strength of this research is the DTE methodology employed, which has been shown to be suitable for addressing real-world issues, such as participation. This methodology overcomes issues associated with group process research. Data collection was conducted anonymously through the post, with controlled feedback reducing the effects of noise that occurs in a group process.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The attrition rates of 23% is similar or lower than attrition rates reported for DTEs conducted on similar topics of 25.2%,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> 41% and 23%.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> This research adds to the existing literature with a focus on participation at the service level, the role of family members and identification of intensity and implementation of participation from patients, family and clinicians together. Guidelines for the reporting of DTE research to ensure all necessary information is provided have been employed.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Stable consensus was not achieved for all questions. Four questions remained below the required 65% level of agreement. All are above 50% and most are close to the pre-defined criteria for consensus of 65%. These questions primarily relate to the criteria that should be employed in the selection of those that should represent patients and family members and as such point towards an area requiring further research. However, all questions not achieving consensus has been reported in other similar DTEs.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> The sample is highly educated (see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). This is due to the inclusion of a cohort of clinicians. This is important to note due to the reported association between a high level of education and support for participation<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and the potential for the DTE process to mould opinions.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Being aware of this the author (LW) took time in each round to discuss the importance of honesty, acceptability of staying outside the consensus and included an opportunity for participants to explain why they felt it was important to stay outside the consensus. In addition, information on further demographic factors of the sample are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and based on available information are in line with the characteristics of the wider population such as age and gender. However, information on previous experiences, expectations and the impact of stakeholder power differences identified as impacting on opinions on participation were not captured.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p></span></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conclusion</span><p id="par0190" class="elsevierStylePara elsevierViewall">There is strong support for patient and family participation in healthcare design and delivery within a psychiatric service with patients involved in the decision-making process and family members being involved in discussions. All stakeholders, including clinical, should receive training. DTEs are a successful method of achieving consensus on the level of intensity and implementation of participation with a sample of patients, family members and clinicians.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Further research needs to be conducted to develop and test behaviour change interventions to encourage participation based on the consensus gained from stakeholder groups. Research needs to be expanded to additional service settings to establish if similar patterns of preferences are reflected in other service areas. Services need to assess preferences and implement standardised, effective and meaningful processes and procedures to involve patients and family members in healthcare design and delivery. This needs to be supported by policy to provide necessary essential resources and leadership required for sustainable and effective participation, avoiding tokenism. All stakeholders, clinical as well as service users, should be involved in every stage of this process.</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflict of interest</span><p id="par0200" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interest.</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Funding</span><p id="par0205" class="elsevierStylePara elsevierViewall">This work was funded by the <span class="elsevierStyleGrantSponsor" id="gs0005">Irish Research Council</span> [<span class="elsevierStyleGrantNumber" refid="gs0005">EPBPPG/2014/19</span>]; and the <span class="elsevierStyleGrantSponsor" id="gs0010">Adelaide Health Foundation</span>.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1135301" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1067405" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Setting" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Delphi Technique Experiments" ] 2 => array:3 [ "identificador" => "sec0025" "titulo" => "Sampling" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Patients and family members" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Clinicians" ] ] ] 3 => array:3 [ "identificador" => "sec0040" "titulo" => "Materials" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Round 1 questionnaire" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Round 2 and Round 3 questionnaires" ] ] ] 4 => array:3 [ "identificador" => "sec0055" "titulo" => "Procedures" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0060" "titulo" => "Patients and family members" ] 1 => array:2 [ "identificador" => "sec0065" "titulo" => "Clinicians" ] ] ] 5 => array:2 [ "identificador" => "sec0070" "titulo" => "Analysis" ] 6 => array:2 [ "identificador" => "sec0075" "titulo" => "Response and attrition rates" ] ] ] 4 => array:3 [ "identificador" => "sec0080" "titulo" => "Results" "secciones" => array:1 [ 0 => array:3 [ "identificador" => "sec0085" "titulo" => "Demographic description" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0090" "titulo" => "Consensus" ] 1 => array:2 [ "identificador" => "sec0095" "titulo" => "Support for and preferred intensity of participation" ] 2 => array:2 [ "identificador" => "sec0100" "titulo" => "Process" ] ] ] ] ] 5 => array:3 [ "identificador" => "sec0105" "titulo" => "Discussion" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0110" "titulo" => "Strengths and limitations" ] ] ] 6 => array:2 [ "identificador" => "sec0115" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0120" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "sec0125" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "xack386416" "titulo" => "Acknowledgements" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-05-17" "fechaAceptado" => "2018-07-04" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1067405" "palabras" => array:5 [ 0 => "Patient participation" 1 => "Family participation" 2 => "Public and patient involvement" 3 => "Delphi technique" 4 => "Psychiatry" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objectives</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patient and family participation is when the views and experiences of patients and family are sought and taken into account in healthcare. This research identifies patient, family and clinician preferences for the intensity and implementation of patient and family participation in healthcare design and delivery in an adult outpatient psychiatry service.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A three round Delphi Technique Experiment (DTE) with 31 participants from an outpatient psychiatry service. Patients, family members and clinicians were included.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">There was a strong level of agreement reached between patients, family members and clinicians with consensus achieved in 60/65 questions. Patient participation to the point of being involved in the decision making process (87%; <span class="elsevierStyleItalic">n</span> = 27/31) at all times (73%; <span class="elsevierStyleItalic">n</span> = 22/30) was supported. Family participation to the point of being involved in discussions (66%; <span class="elsevierStyleItalic">n</span> = 23/35) as problems arise (67%; <span class="elsevierStyleItalic">n</span> = 21/31) was supported. Participants agreed on the use of patient and family representatives with factors such as ability to dedicate time considered during selection. Personal experience, discussions with wider populations and pre-identified priorities should contribute to representative input. Training was identified as necessary for all stakeholders, including clinicians.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">This is the first time that patients, family members and clinicians have all been included in a DTE on this topic. The inclusion of these groups is essential for the development of long-lasting sustainable participation. The focus on preferences for family participation is also novel. Given the role of family members in care and management of chronic illnesses, identification of their role is key.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0220" class="elsevierStylePara elsevierViewall">The following are Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0135" ] ] ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3543 "Ancho" => 3008 "Tamanyo" => 469291 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">DTE sample flow chart. * = Numbers for family members are based on estimates from pilot data collection. + = Further information on the collation of the sampling frame is provided in Chapter 5. # = Round three family member sample size increased as 2 Round 2 non-responders took part in Round 3.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">– not applicable.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Demographic \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Round 1</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Round 2</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Round 3</th></tr><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> = 39 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">100% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> = 31 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">100% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> = 31 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">100% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Stakeholder</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Family member \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clinician \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Age</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>18–39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>40–59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>60+ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Education</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Junior Cert<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> or less \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leaving Cert<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>/non degree \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Degree or above \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Duration of attendance/employment</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≤5 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6–9 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥10 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1936806.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">State examinations. Junior certificate at aged 15 and leaving certificate at aged 18.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Less than 5 participants.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sample description by DTE round.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Answer \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Should patients be involved in planning services?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38/39 (97.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">In planning services patients should be…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Told about changes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asked what they think \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Involved in discussions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32/39 (82.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Have a vote \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27/31 (87.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Make decisions on their own \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/39 (76.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">How often should patients be involved?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Always \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22/30 (73.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">How important is it for patients to be involved in the following stages of planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Suggestion of ideas for change \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34/39 (87.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before decisions are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/35 (85.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After decisions are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/39 (78.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Who should represent patients?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Patient reps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26/31 (83.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">How should patients be picked for participation?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">All interested picked \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22/32 (68.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following factors are when picking patients to participate in planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Health \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38/39 (97.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32/39 (82.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Level of education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12/19 (63.2)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29/39 (74.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Length of service attendance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20/31 (64.5)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Frequency of service attendance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17/31 (54.8)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ability to dedicate time \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34/39 (87.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important for patient representatives to take into account when providing input to planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Their own experience \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35/39 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Discussions with other patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35/39 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>A list of what is identified as important by patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important in training patients for participation…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How the service works \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How changes are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36/39 (92.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How to work with others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Why patients should be involved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36/39 (92.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Communication skills \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important in training clinicians for patient participation…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How to work with others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39/39 (100.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Why patients should be involved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Communication skills \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38/39 (97.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Decisions need to be justified if different from patient’s opinions</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Patient opinions need to be passed on to those in the decision-making process</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39/39 (100.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Patients need to be updated on how their opinions were included</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31/39 (79.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1936808.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Consensus was not reached in this answer as the level of agreement is below 65%.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Preferences for patient participation.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Answer \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Should family members be involved in planning services?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">In planning services family members should be…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Told about changes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32/35 (91.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asked what they think \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32/35 (91.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Involved in discussions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23/35 (65.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Have a vote \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19/31 (61.3)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Make decisions on their own \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/35 (85.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">How often should family members be involved?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">As problems arise \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21/31 (67.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">How important is it for family members to be involved in the following stages of planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Suggestion of ideas for change \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31/39 (79.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before decisions are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/39 (76.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After decisions are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23/32 (71.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Who should represent family members?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Family reps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23/32 (71.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">How should family members be picked for participation?</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">All interested picked \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24/31 (77.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following factors are important when picking family members to participate in planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Level of education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21/31 (67.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28/29 (71.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Length of service attendance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21/31 (67.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Frequency of service attendance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17/31 (54.8)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ability to dedicate time \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important for family representatives to take into account when providing input to planning services…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Their own experience \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30/39 (76.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Discussions with other family members \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (79.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>A list of what is identified as important by family members \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36/39 (92.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important for training family members for participation…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mental health illnesses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35/39 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How the service works \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34/39 (87.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How changes are made \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34/39 (87.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How to work with others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35/39 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Why family should be involved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Communication skills \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/39 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Which of the following are important in training clinicians for family member participation…</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>How to work with others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36/39 (92.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Why family members should be involved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35/39 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Communication skills \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34/39 (87.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Decisions need to be justified if different from family member opinions</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31/39 (81.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Family member opinions need to be passed on to those in the decision-making process</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Important \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37/39 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Family members need to be updated on how their opinions were included</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28/39 (71.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1936807.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Consensus was not reached in this answer as the level of agreement is below 65%.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Preferences for family participation.</p>" ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.docx" "ficheroTamanyo" => 779086 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for community involvement in health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Health Boards Executive" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2002" "editorial" => "Health Boards Executive" "editorialLocalizacion" => "Dublin, Ireland" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient and citizen participation in health: the need for improved ethical support" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Williamson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Bioethics" "fecha" => "2014" "volumen" => "14" "paginaInicial" => "4" "paginaFinal" => "16" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.M. Kelly" 1 => "A.F. Jorm" 2 => "B.A. Kitchener" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "BMC Psychiatry" "fecha" => "2010" "volumen" => "10" "paginaInicial" => "1" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Involving the general public in priority setting: experiences from Australia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. Wiseman" 1 => "G. Mooney" 2 => "G. Berry" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Soc Sci Med" "fecha" => "2003" "volumen" => "56" "paginaInicial" => "1001" "paginaFinal" => "1012" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic review of involving patients in the planning and development of health care" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Crawford" 1 => "D. Rutter" 2 => "C. Manley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Br Med J" "fecha" => "2002" "volumen" => "325" "paginaInicial" => "1263" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 09.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Nilsen" 1 => "H. Myrhaug" 2 => "M. Johansen" ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2006" "volumen" => "3" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://onlinelibrary.wiley.com/store/10.1002/14651858.CD004563.pub2/asset/CD004563.pdf?v=1&t=jc7xqdl9&s=f79ee1f4fb2148e12eb9ef2169f77e9925a7c29d" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 08.03.17]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Service user involvement in the Irish Health Service: a review of the evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. McEvoy" 1 => "C. Keenaghan" 2 => "A. Murray" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "http://www.lenus.ie/hse/handle/10147/45885" "fecha" => "2008" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "People in control of their own health and care: The state of involvement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Foot" 1 => "H. Gilburt" 2 => "P. Dunn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2014" "editorial" => "The King’s Fund" "editorialLocalizacion" => "London" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 08.03.17]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathways reports: experiences of mental health services from a user led perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Western Health Board" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "http://lenus.ie/hse/bitstream/10147/43779/1/4198.pdf" "fecha" => "2002" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "‘The public is too subjective’: public involvement at different levels of health-care decision making." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Litva" 1 => "J. Coast" 2 => "J. Donovan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Soc Sci Med" "fecha" => "2002" "volumen" => "54" "paginaInicial" => "1825" "paginaFinal" => "1837" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12113438" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Not all patients want to participate in decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "W. Levinson" 1 => "A. Kao" 2 => "A. Kuby" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1497.2005.04101.x" "Revista" => array:7 [ "tituloSerie" => "J Gen Intern Med" "fecha" => "2005" "volumen" => "20" "paginaInicial" => "531" "paginaFinal" => "535" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15987329" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508516355329" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient involvement in primary care mental health: a focus group study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H. Lester" 1 => "L. Tait" 2 => "E. England" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Gen Pract" "fecha" => "2006" "volumen" => "56" "paginaInicial" => "415" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16762122" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Why consider patients’ preferences? A discourse analysis of clinical practice guideline developers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Boivin" 1 => "J. Green" 2 => "J. van der Meulen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MLR.0b013e3181a81158" "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "2009" "volumen" => "47" "paginaInicial" => "908" "paginaFinal" => "915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19543120" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Delphi technique: making sense of consensus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.-C. Hsu" 1 => "B.A. Sandford" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pract Assess Res Eval" "fecha" => "2007" "volumen" => "12" "paginaInicial" => "1" "paginaFinal" => "8" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experiments in Delphi methodology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Scheibe" 1 => "M. Skutsch" 2 => "J.I.V.C. Schofer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Delphi Method Tech Appl" "fecha" => "2002" "paginaInicial" => "257" "paginaFinal" => "281" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Research guidelines for the Delphi survey technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Hasson" 1 => "S. Keeney" 2 => "H. McKenna" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Adv Nurs" "fecha" => "2000" "volumen" => "32" "paginaInicial" => "1008" "paginaFinal" => "1015" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11095242" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Participation of patients and family members in healthcare services at the service and national levels: a lesson learned in Dublin Ireland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Whiston" 1 => "J.M. Barry" 2 => "C.D. Darker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pec.2016.10.025" "Revista" => array:6 [ "tituloSerie" => "Patient Educ Couns" "fecha" => "2017" "volumen" => "100" "paginaInicial" => "583" "paginaFinal" => "591" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27816316" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acceptability and perceived benefits and risks of public and patient involvement in health care policy: a Delphi survey in Belgian stakeholders" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "I. Cleemput" 1 => "W. Christiaens" 2 => "L. Kohn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Value Health Elsevier Sci" "fecha" => "2015" "volumen" => "18" "paginaInicial" => "477" "paginaFinal" => "483" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Delphi technique in health sciences education research" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.R. De Villiers" 1 => "P.J. De Villiers" 2 => "A.P. Kent" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/13611260500069947" "Revista" => array:6 [ "tituloSerie" => "Med Teach" "fecha" => "2005" "volumen" => "27" "paginaInicial" => "639" "paginaFinal" => "643" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16332558" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 15.09.17]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Barriers to recruiting an adequate sample in rural nursing research" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Cudney" 1 => "C. Craig" 2 => "E. Nichols" ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Online J Rural Nurs Health Care" "fecha" => "2012" "volumen" => "4" "itemHostRev" => array:3 [ "pii" => "S0140673613623430" "estado" => "S300" "issn" => "01406736" ] ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://rnojournal.binghamton.edu/index.php/RNO/article/view/201/176" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A ladder of citizen participation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.R. Arnstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Inst Plann" "fecha" => "1969" "volumen" => "35" "paginaInicial" => "216" "paginaFinal" => "224" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 08.03.17]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CLEAR: understanding citizen participation in local government – and how to make it work better" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V. Lowndes" 1 => "L. Pratchett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.523.6104&rep=rep1&type=pdf" "fecha" => "2006" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What sense do people make of a theory of planned behaviour questionnaire? A think-aloud study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.D. Darker" 1 => "D.P. French" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1359105309340983" "Revista" => array:6 [ "tituloSerie" => "J Health Psychol" "fecha" => "2009" "volumen" => "14" "paginaInicial" => "861" "paginaFinal" => "871" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19786512" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 08.03.17]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health Canada policy toolkit for public involvement in decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Health Canada" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/ahc-asc/alt_formats/pacrb-dgapcr/pdf/public-consult/2000decision-eng.pdf" "fecha" => "2000" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Delphi technique: myths and realities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Powell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Adv Nurs" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "376" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12581103" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From tokenism to meaningful engagement: best practices in patient involvement in an EU project" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Supple" 1 => "A. Roberts" 2 => "V. Hudson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s40900-015-0004-9" "Revista" => array:5 [ "tituloSerie" => "Res Involv Engagem" "fecha" => "2015" "volumen" => "1" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29062494" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 09.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective consumer voice and participation for New Zealand: a systematic review of the evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Coney" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "https://www.health.govt.nz/system/files/documents/publications/050511_consumer_report.pdf" "fecha" => "2004" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Service user involvement in clinical guideline development and implementation: learning from mental health service users in the UK" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Harding" 1 => "C. Johnson Pattinari" 2 => "D. Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/09540261.2011.606802" "Revista" => array:6 [ "tituloSerie" => "Int Rev Psychiatry" "fecha" => "2011" "volumen" => "23" "paginaInicial" => "352" "paginaFinal" => "357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22026491" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. McDaid" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Disabil Soc" "fecha" => "2009" "volumen" => "24" "paginaInicial" => "461" "paginaFinal" => "474" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effectiveness of strategies for informing, educating, and involving patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Coulter" 1 => "J. Ellins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.39246.581169.80" "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2007" "volumen" => "335" "paginaInicial" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17615222" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109714022189" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Engaging patients, carers and communities for the provision of coordinated/integrated health services: strategies and tools" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Ferrer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "http://www.euro.who.int/en/health-topics/Health-systems/patient-safety/publications2/2015/engaging-patients,-carers-and-communities-for-the-provision-of-coordinatedintegrated-health-services-strategies-and-tools-2015" "fecha" => "2015" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Public involvement in community health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Campbell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Prim Health Care" "fecha" => "2005" "volumen" => "15" "paginaInicial" => "42" "paginaFinal" => "50" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack386416" "titulo" => "Acknowledgements" "texto" => "<p id="par0210" class="elsevierStylePara elsevierViewall">The advice and expertise that Dr. Emer Barrett provided for this research is gratefully acknowledged. Thank you to the patient representative Carol Cooney for feedback provided. In particular, we would like to thank all of the participants, patients, family members and clinicians, for their time and input without whom this work would not be possible.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/02136163/0000003300000001/v1_201901100612/S0213616318300600/v1_201901100612/en/main.assets" "Apartado" => array:4 [ "identificador" => "64426" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/02136163/0000003300000001/v1_201901100612/S0213616318300600/v1_201901100612/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213616318300600?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 9 | 1 | 10 |
| 2024 September | 28 | 12 | 40 |
| 2024 August | 23 | 6 | 29 |
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| 2024 March | 25 | 5 | 30 |
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| 2024 January | 11 | 7 | 18 |
| 2023 December | 7 | 4 | 11 |
| 2023 November | 10 | 2 | 12 |
| 2023 October | 15 | 1 | 16 |
| 2023 September | 11 | 3 | 14 |
| 2023 August | 10 | 0 | 10 |
| 2023 July | 7 | 3 | 10 |
| 2023 June | 17 | 3 | 20 |
| 2023 May | 41 | 11 | 52 |
| 2023 April | 47 | 3 | 50 |
| 2023 March | 29 | 1 | 30 |
| 2023 February | 21 | 12 | 33 |
| 2023 January | 17 | 12 | 29 |
| 2022 December | 15 | 7 | 22 |
| 2022 November | 15 | 9 | 24 |
| 2022 October | 10 | 4 | 14 |
| 2022 September | 11 | 12 | 23 |
| 2022 August | 11 | 5 | 16 |
| 2022 July | 12 | 7 | 19 |
| 2022 June | 15 | 6 | 21 |
| 2022 May | 15 | 9 | 24 |
| 2022 April | 12 | 8 | 20 |
| 2022 March | 16 | 8 | 24 |
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| 2021 November | 21 | 9 | 30 |
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| 2021 September | 9 | 13 | 22 |
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| 2021 July | 13 | 5 | 18 |
| 2021 June | 9 | 14 | 23 |
| 2021 May | 12 | 14 | 26 |
| 2021 April | 83 | 12 | 95 |
| 2021 March | 36 | 6 | 42 |
| 2021 February | 20 | 7 | 27 |
| 2021 January | 15 | 16 | 31 |
| 2020 December | 15 | 10 | 25 |
| 2020 November | 9 | 5 | 14 |
| 2020 October | 16 | 8 | 24 |
| 2020 September | 11 | 8 | 19 |
| 2020 August | 10 | 11 | 21 |
| 2020 July | 15 | 12 | 27 |
| 2020 June | 17 | 4 | 21 |
| 2020 May | 5 | 7 | 12 |
| 2020 April | 5 | 2 | 7 |
| 2020 March | 14 | 5 | 19 |
| 2020 February | 14 | 4 | 18 |
| 2020 January | 8 | 8 | 16 |
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