Engaging marginalised patient groups in decision-making: How can we ensure all voices are heard?

Introduction to patient engagement

Patient engagement has been a key theme in modern healthcare in recent years. It is widely recognised that patients who actively participate in their own care experience better health outcomes and are more satisfied with their treatment. But while progress has been made in involving patients in general, certain groups are still underrepresented in decision-making processes. This is especially true for marginalised groups such as ethnic minorities, LGBTQ+ people, the elderly and people with low socio-economic status. This article explores how we can ensure that all patients' voices are heard and integrated into healthcare decision-making processes.

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Barriers to engaging marginalised groups

One of the biggest challenges in engaging marginalised groups is the structural barriers that prevent their active participation. Research shows that ethnic minorities often experience language barriers and cultural dissonance, making it difficult to communicate effectively with healthcare professionals. LGBTQ+ people can face discrimination or a lack of understanding of their particular needs, which can make them feel invisible in the treatment process.

Older patients, especially those with cognitive or physical disabilities, may find that their needs are overlooked due to age bias or lack of accessible facilities . People with low socio-economic status often face financial barriers that can prevent them from accessing healthcare or fully participating in decision-making processes .

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Consequences of disengagement

Failure to engage these groups can have serious consequences. Research has shown that when patients do not feel heard or understood, they are less likely to adhere to treatment plans, which can lead to poorer health outcomes. Furthermore, inequalities in healthcare can be reinforced when marginalised groups are not represented in decision-making processes, creating a vicious cycle where their specific healthcare needs remain unaddressed.

Best practices for engaging marginalised groups

However, there are innovative approaches and best practices that can help break these barriers and ensure more inclusive patient engagement. For example, some health centres have implemented interpretation services and cultural brokerage programmes to help ethnic minorities navigate the healthcare system. LGBTQ+ healthcare organisations have developed inclusive care guidelines that can help healthcare professionals better understand and meet the needs of this group.

Older patients can benefit from technological solutions, such as telemedicine and easy-to-use digital tools that make it easier for them to communicate with healthcare professionals and participate in their own care. For patients with low socioeconomic status, measures such as free healthcare programmes and advice on financial support schemes can be crucial for their access to care and participation in decision-making processes.

Recommendations for the future

To create a healthcare system that is truly inclusive, we must continue to focus on breaking the barriers that hinder the participation of marginalised groups. This can include:

• Educating healthcare professionals: Regular cultural competency and diversity training can help healthcare professionals understand and respond to the unique needs of different patient groups.
• Adapting communication strategies: The use of different communication tools, including digital platforms and visuals, can help reach patients who would otherwise have difficulty understanding or accessing information.
• Empowering patient organisations: By working more closely with patient organisations that represent marginalised groups, healthcare systems can ensure that the voices of these groups are heard and considered in decision-making processes.

Engaging marginalised patient groups is not just a matter of fairness; it's a necessity to ensure that the healthcare system works optimally for everyone. By identifying and addressing the barriers that prevent the participation of these groups, we can create a healthcare system that is more inclusive and effective, ensuring better health outcomes for all patients.

Feel free to share your experiences and perspectives in the comments below, both as a patient and as a professional.

// Lisbeth

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