Current status of implementation of patient involvement in health care to improve quality of care among chronic obstructive pulmonary disease：a scoping review postprint

Abstract: Background  In patient involvement，patients are transforming from mere recipients to collaborators in medical services by integrating their experiences and needs throughout the entire healthcare process into medical practice. This aims to enhance the effectiveness，efficiency，and quality of healthcare services. However，the implementation of proven patient#2;centered strategies for patient involvement in the quality improvement among chronic obstructive pulmonary disease（COPD）in our country remains to be explored.Objective  This scoping review systematically reviews and analyzes the existing strategies for patient involvement among patients with COPD to provide a reference for implementation that in China.Methods  Employing the scoping review guidelines of Joanna Briggs Institute in Australia as the methodological framework，the relevant studies on patient involvement among patient with COPD were searched by computer on PubMed，Embase，Cochrane Library，CNKI，Wanfang Database，China Biology Medicine disc. A thematic analysis was methodically applied to distill and synthesize findings. Results  A total of 37 articles were included in this review. The categorization of patient involvement was divided into three types：direct involvement in medical care，organizational-level，and clinical research. Based on the intensity of involvement，categories were further classified into three levels：consultation，engagement，and collaborative leadership. A nine-category matrix of patient involvement behaviors was constructed through intensity and type. The implementation of COPD patient engagement was primarily reflected in five categories encompassing eight behaviors，including：integration in direct medical care（patients expressing their preferences and wishes regarding treatment plans）；consultation at the organizational management level（assessing patient treatment experiences and organizing discussions around patients' concerns）；as well as involvement in clinical research，including consultation（listening to patient needs）and engagement（expressing preferences and wishes for interventions，involved in the development of assessment tools，and in discussions about research design and implementation）. Assessing patient treatment experiences（10 articles，27.03%）and expressing patient preferences and wishes regarding interventions（10 articles，27.03%）were the two most frequently implemented behaviors of patient involvement in COPD. Conclusion  There are numerous measures for patient involvement in the improvement of medical quality，but there is still limited practice in the field of COPD. Very few studies have assessed the impact of patient involvement on clinical outcomes and quality of life，indicating that the practice of patient involvement in China requires further exploration.