New cultural competences needed for healthcare teams as a priority in treatment of chronic diseases

Technological changes and higher prevalence of chronic diseases require changing patients’ and healthcare professionals’ position with more participation in healthcare organization, and more implication in their relationships. Based on the Canadian ‘patient-as-partner in healthcare’ approach, our aims were to identify and categorize cultural values underlying this term in Luxembourg, and to characterize a set of cultural competencies needed for its practical application. Method: A qualitative study using a semi-directive guide developed within an INTERREG project was conducted among 30 healthcare professionals. A categorical thematic content analysis was realized using N'Vivo software. Results: For some professionals, the word ‘partner’ is not appropriate in Luxembourgish, but they defined it as a companion who engages in a mutual cooperation, structured collaboration and sharing of information with a common goal: Quality of healthcare. For others, a ‘partner’ is an associate who takes part in decision making, discussions, negotiations and evaluations. This partner approach would allow processes of change, bringing autonomy (surveillance, self-education, and monitoring treatment) to the patients, provided that professionals partly cede their traditional power. Trust and respect would be the main start of this process. Difficulties in communication and relationships would arise when helping the patients understand their disease, adhering to instructions, and giving a balanced place to the information found on Internet. Conclusion: This ‘collaborative accompaniment’ appears to allow decisional balance, an interdisciplinary method which requires training for all partners (physicians GP or specialists, patients and psychologist) and not only case-managers to help patients acquire self-efficacy for behavioral changes