Table 5 Barriers and facilitators to achieving an optimal patient engagement approach

Barriers

 Technological

  • Phone follow-ups

“I had probably relaxed because we did many telephone follow-ups too; in telephone follow-up, it's different, the verbal but also the physical of the patient and what we see” (RN8)

 Organizational

  • Turnover context imposed by the health care system

" …it's easy to judge the person who doesn't show up, to get out of the context of our work schedule, of appointments and of being in a hurry, and that we are wasting time, but to try to, this is part of getting out of the context, that sometimes we drive a little too hard, we work with humans, not with machines.” (RN7)

 Experiential

  • Past negative patient experiences can negatively influence their relationship

"Well, that’s it, like I said, maybe past experiences that have been like more negative with other professionals (…) patients who have not felt listened to, patients who have not felt well taken care of, or patients who feel like they are repeating their story 56 million times, and then they feel like—Look, I just told it, it's been 2 min, to the other person, you're not talking to each other. I think that makes the patient feel good or not." (RN1)

Facilitators

 Patient and family skills

  • Patients motivated to manage their health issues

  • Involvement of families in care

" What is facilitating is that a patient who shows interest, that’s sure that it’s always fun, we see that he is motivated, there are patients who arrive and who are previously aware of their health problem, who have gone to read about it, who are, that is certainly facilitating, and it is also motivating for us too.” (RN1)

"A patient who is like open, when the patients arrive with their spouse also, we see that their loved ones are involved and that they want to help too, I think that is motivating for the sick patient and us as well, we say to ourselves “ My God, he is going to be well surrounded.” (RN1)

 Organizational

  • PCC context

“I think that we have the time here, in addition, in the PCC, to be able to allow ourselves this, all the beautiful approach that we can have and then we have time, and versus me, the urgency that I have the time to do nothing of this” (RN1)