Bringing self-management into clinical view: a qualitative study of long-term condition management in primary care consultations
Bringing self-management into clinical view: a qualitative study of long-term condition management in primary care consultations
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DOI：
10.1177/1742395309358333
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发表时间：
2010-06-01
期刊：
影响因子：
1.3
通讯作者：
Chew-Graham, Carolyn
中科院分区：
文献类型：
--
作者：
Blakeman, Tom;Bower, Peter;Chew-Graham, Carolyn
目标：了解支持初级保健中长期病症自我管理的社会过程。方法：对英国初级保健咨询中长期病症管理的观察和访谈数据进行比较分析。对初级保健咨询 (n = 86) 记录的分析与对卫生专业人员 (n = 17) 和长期患病患者 (n = 12) 的半结构化访谈的分析结合进行。 结果：一个关键发现是自我管理主题很少成为咨询中合法讨论的对象。分析表明，维持自我与他人的关系是患者和专业人员的首要目标，而自我管理主题的引入威胁到了这一过程。技术和初级保健专业人员之间的分工加剧了这种紧张关系。讨论：为了将自我管理支持嵌入并整合到初级保健中，有关长期病情管理的干预措施需要考虑到这种支撑护理的紧张局势。
Objectives: To understand social processes underpinning support for self-management of long-term conditions in primary care.Methods: Comparative analysis of observational and interview data concerning the management of long-term conditions in UK primary-care consultations. Analysis of recordings of primary care consultations (n = 86) was conducted in conjunction with analysis of semi-structured interviews with health professionals (n = 17) and patients (n = 12) living with a long-term condition.Results: A key finding was the infrequency with which self-management topics became legitimate objects for discussion in consultations. Analysis suggested that the maintenance of self-other relations was a prime objective for both patients and professionals, and the introduction of self-management topics threatened this process. Technology and the division of labour among primary-care professionals reinforced this tension.Discussion: In order for self-management support to become embedded and integrated into primary care, interventions concerning long-term condition management need to take into account this tension underpinning care.