Teaching how, not what - The contributions of community health workers to diabetes self-management
Teaching how, not what - The contributions of community health workers to diabetes self-management
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DOI：
10.1177/0145721707304133
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发表时间：
2007-06-01
影响因子：
3.9
通讯作者：
Fisher, Edwin B.
中科院分区：
文献类型：
--
作者：
Davis, Kia L.;O'Toole, Mary L.;Fisher, Edwin B.
目的本研究的目的是描述社区卫生工作者 (CHW) 在各种诊所和社区环境中支持糖尿病自我管理的方式。方法从社区卫生工作者完成的日志中收集描述性定量数据。记录描述社区卫生工作者和患者之间个人接触的模式、地点、类型、持续时间和重点。定性数据是通过对患者的半结构化访谈收集的。访谈于 2006 年 6 月至 8 月在现场进行。受访者特意抽取了 47 名认为受到社区卫生工作者帮助的患者作为样本。结果社区卫生工作者报告说，在 1859 名个人接触者中，大多数人关注的焦点是提供帮助以及教授或练习技能。社区卫生工作者报告提供的援助通常是鼓励/激励。在采访中，患者表示社区卫生工作者有助于展示如何将糖尿病自我管理 (DSM) 纳入他们的日常生活。患者分享的信息还让我们深入了解他们所认为的社区卫生工作者的鼓励/动机。访谈中的引述提供了具体例子，说明社区卫生工作者提供的支持与家人和医疗保健团队成员提供的支持有何不同。结论社区卫生工作者和患者都认为以类似的方式提供援助，并始终强调鼓励/激励。对患者的访谈显示，个人联系、关键资源的可用性和提供以及对自我管理的支持使得社区卫生工作者与患者的互动在 DSM 中取得了成功。示例让我们深入了解社区卫生工作者对 DSM 的宝贵贡献。这种见解应该鼓励制定指南，使社区卫生工作者成为糖尿病护理团队的常规、标准组成部分。
PurposeThe purpose of this study is to describe ways in which community health workers (CHWs) are used in various clinic and community settings to support diabetes self-management.MethodsDescriptive quantitative data were collected from logs completed by CHWs. Logs described mode, place, type, duration, and focus of individual contact between the CHW and the patient. Qualitative data were collected from semistructured interviews with patients. Interviews were conducted on site from June to August 2006. Interviewees included a purposeful sample of 47 patients who perceived being helped by CHWs.ResultsCHWs reported providing assistance and teaching or practicing skills as the focus of most of the 1859 individual contacts. The assistance CHWs reported providing was most often in the forin of encouragement/motivation. During interviews, patients shared that CHWs were helpful in demonstrating how to incorporate diabetes self-management (DSM) into their daily lives. The information patients shared also provided insight into what they perceived as encouragement/motivation from the CHWs. Quotes from interviews provide specific examples of how support from CHWs was different from that received from family and health care team members.ConclusionsBoth CHWs and patients perceived assistance being provided in similar ways, with consistent emphasis on encouragement/motivation. Interviews with the patients revealed that a personal connection along with availability and provision of key resources and Supports for self-management made the CHW-patient interaction successful for DSM. Examples provide insizght into the valuable contributions of CHWs to DSM. This insight Should encourage guidelines that make CHWs a routine, standard part of the diabetes care team.