Patient-reported experiences with first-time naturopathic care for type 2 diabetes.
Patient-reported experiences with first-time naturopathic care for type 2 diabetes.
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DOI：
10.1371/journal.pone.0048549
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Cherkin DC
中科院分区：
文献类型：
--
作者：
Oberg EB;Bradley R;Hsu C;Sherman KJ;Catz S;Calabrese C;Cherkin DC
不同的医疗保健提供者促进健康行为改变和成功的糖尿病自我护理的有效性差异很少受到关注。由于自然疗法医学（NM）的培训强调以患者为中心的方法，健康促进和常规使用健康和预防的临床咨询，自然疗法医生（ND）可能特别准备好促进行为改变。然而，患者的经验与NM还没有得到很好的研究。这项研究首次报告了2型糖尿病患者对其糖尿病自然疗法护理的首次体验的看法。在他们参与了一项为期一年的前瞻性队列研究，连续自然疗法护理糖尿病，22例患者接受了采访，他们的经验与自然疗法医生。采用内容分析方法，确定了九个主要主题。三个主题表征了ND-患者互动的性质：1）以患者为中心，2）整体健康而不是以糖尿病为中心，3）协作。五个主题的内容特点的临床遭遇：1）个性化和详细的健康促进，2）咨询，促进自我效能，3）务实和实用的自我保健建议，4）新的治疗方案，促进健康，和5）病人教育，解决糖尿病自我保健和一般健康。第九个主题是横向的：ND护理和传统医疗护理之间的对比。结果表明，ND使用的常规临床方法与行为改变理论和临床策略一致，发现在提高自我效能和改善临床结局方面最有效。
Differences in the effectiveness of diverse healthcare providers to promote health behavior change and successful diabetes self-care have received little attention. Because training in naturopathic medicine (NM) emphasizes a patient-centered approach, health promotion, and routine use of clinical counseling on wellness and prevention, naturopathic physicians (NDs) may be particularly well-prepared for promoting behavior change. However, patients’ experiences with NM have not been well studied. This study provides the first report of the perceptions of persons with type 2 diabetes of their first experiences with naturopathic care for their diabetes. Following their participation in a one-year prospective cohort study of adjunctive naturopathic care for diabetes, twenty-two patients were interviewed about their experiences working with a naturopathic physician. Using a content analysis approach, nine dominant themes were identified. Three themes characterized the nature of the ND-patient interaction: 1) patient-centered, 2) holistic health rather than diabetes focused, and 3) collaborative. Five themes characterized the content of the clinical encounter: 1) individualized and detailed health promotion, 2) counseling that promoted self-efficacy, 3) pragmatic and practical self-care recommendations, 4) novel treatment options that fostered hopefulness, and 5) patient education that addressed both diabetes self-care and general health. A ninth theme was cross-cutting: the contrast between ND care and conventional medical care. Results indicate that the routine clinical approach used by NDs is consistent with behavior change theory and clinical strategies found most effective in promoting self-efficacy and improving clinical outcomes.