From support to boundary: A qualitative study of the border between self-care and professional care
From support to boundary: A qualitative study of the border between self-care and professional care
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DOI：
10.1016/j.pec.2009.07.015
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发表时间：
2010-04-01
影响因子：
3.5
通讯作者：
Pinnock, Hilary
中科院分区：
文献类型：
--
作者：
Kielmann, Tara;Huby, Guro;Pinnock, Hilary
目的：虽然全球医疗保健系统正在促进自我保健，但患者对政策转变的看法仍然相对未被探索。我们的定性研究探讨了护理组织如何在处理呼吸系统疾病时塑造患者的感知和自我护理经验。方法：我们招募了31人，代表了不同的年龄和呼吸条件，并通过疾病日记、电话访谈和焦点小组讨论生成数据。使用框架方法对数据进行转录、分析和三角测量。结果：患者意识到对自我护理的日益关注，但觉得这个词是不协调的，因为它描述了他们已经在做什么。虽然许多受访者认为增加了临床责任，但有些人觉得被专业人士“抛弃”了。为了成为护理中的积极合作伙伴，他们需要灵活地访问值得信赖的医疗保健专业人员，这些专业人员尊重患者对其病情的了解和对管理的偏好。结论：向自我护理的转变需要以整个系统的变革为基础。专业人员需要沟通技巧，以便作为护理合作伙伴与患者接触，在提供灵活获得支持性护理的系统内工作。实践意义：长期病患者的护理系统需要确保在自我护理和专业支持之间的灵活获取。简化系统、明确的标示以及由一名值得信赖的关键专业人员协调病人的个人护理是必不可少的。2009爱思唯尔爱尔兰有限公司版权所有。
Objective: While healthcare systems globally are promoting self-care, patients' perceptions of the policy shift remain relatively unexplored. Our qualitative study explored how organisation of care shaped patients' perceptions and experiences of self-care in dealing with their respiratory illnesses.Methods: We recruited 31 people, representing a range of ages and respiratory conditions and generated data using illness diaries, telephone interviews and focus group discussions. Data were transcribed, analysed and triangulated using the framework approach.Results: Patients were aware of the increasing focus on self-care, but felt that the term was incongruous as it described what they were already doing. While many respondents appreciated increased clinical responsibility some felt 'abandoned' by professionals. To be active partners in care, they needed flexible access to trusted healthcare professionals who respected patients' knowledge about their condition and preferences for management.Conclusion: The shift to self-care needs to be underpinned by a whole system change. Professionals need communication skills to engage with patients as partners in care, working within systems that offer flexible access to supportive care. Practice implications: Systems of care for people with long-term conditions need to ensure flexible access between self-care and professional support. Simplification of systems, clear sign-posting and coordination of individual patient care by a key trusted professional are essential. (C) 2009 Elsevier Ireland Ltd. All rights reserved.