Patient empowerment in theory and practice: polysemy or cacophony?

Patient Educ Couns. 2007 Apr;66(1):13-20. doi: 10.1016/j.pec.2006.09.008. Epub 2006 Nov 2.


Objective: This paper examines how the term "empowerment" has been used in relation to the care and education of patients with chronic conditions over the past decade.

Methods: Fifty-five articles were analysed, using a qualitative method of thematic analysis.

Results: Empowerment is more often defined according to some of its anticipated outcomes rather than to its very nature. However, because they do not respect the principle of self-determination, most anticipated outcomes and most evaluation criteria are not specific to empowerment. Concerning the process of empowerment, our analysis shows that (i) the educational objectives of an empowerment-based approach are not disease-specific, but concern the reinforcement or development of general psychosocial skills instead; (ii) empowering methods of education are necessarily patient-centred and based on experiential learning; and (iii) the provider-patient relationship needs to be continuous and self-involving on both sides.

Conclusion: Our analysis did not allow for the unfolding of a well-articulated theory on patient empowerment but revealed a number of guiding principles and values.

Practice implications: The goals and outcomes of patient empowerment should neither be predefined by the health-care professionals, nor restricted to some disease and treatment-related outcomes, but should be discussed and negotiated with every patient, according to his/her own particular situation and life priorities.

Publication types

  • Review

MeSH terms

  • Attitude to Health*
  • Chronic Disease* / prevention & control
  • Chronic Disease* / psychology
  • Communication
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Life Change Events
  • Life Style
  • Models, Educational
  • Patient Education as Topic / organization & administration*
  • Patient Participation / methods
  • Patient Participation / psychology
  • Patient-Centered Care / organization & administration
  • Personal Autonomy
  • Power, Psychological*
  • Practice Guidelines as Topic
  • Problem-Based Learning
  • Psychological Theory*
  • Psychology, Educational
  • Qualitative Research
  • Reinforcement, Psychology
  • Research Design
  • Self Care / psychology
  • Self Efficacy