The role of primary care providers in patient activation and engagement in self-management: a cross-sectional analysis
The role of primary care providers in patient activation and engagement in self-management: a cross-sectional analysis
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DOI：
10.1186/s12913-016-1328-3
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发表时间：
2016-03-11
影响因子：
2.8
通讯作者：
Overton, Valerie
中科院分区：
文献类型：
--
作者：
Alvarez, Carmen;Greene, Jessica;Overton, Valerie
背景：慢性病的负担越来越重，凸显了自我护理的重要性，并从等级和父权模式转向伙伴关系。初级保健提供者(PCP)在支持患者自我管理、激活和支持慢性护理方面发挥着重要作用。我们探讨了PCP对患者角色重要性的信念与他们报告参与与患者合作和建立伙伴关系行为的频率之间的关系。方法：使用临床医生对患者激活的支持测量(CS-PAM)来测量PCP的信念。我们还评估了PCP的CS-PAM评分是否与患者的患者激活测量(PAM)评分的变化呈正相关。参与者包括来自明尼苏达州一家负责任的护理组织的181名儿科医生，他们完成了一项在线调查。结果：CS-PAM得分高的PCP比CS-PAM得分低的PCP更倾向于采取支持性自我管理和患者行为改变的方式，如让患者参与议程设置、问题解决和协作性设定行为目标。PCP对患者自我管理角色的信念越积极，患者活跃度越高。结论：PCP对患者自我管理角色的更积极信念与倾向于提高患者活跃度的PCP行为密切相关。
Background: The increasing burden of chronic illness highlights the importance of self-care and shifts from hierarchical and patriarchal models to partnerships. Primary care providers (PCPs) play an important role in supporting patients in self-management, enabling activation and supporting chronic care. We explored the extent to which PCPs' beliefs about the importance of the patients' role relate to the frequency in which they report engaging in collaborative and partnership-building behaviors with patients.Methods: PCPs' beliefs were measured using the Clinician Support for Patient Activation Measure (CS-PAM). We also assessed whether PCPs' CS-PAM scores were positively associated with changes in their patients' Patient Activation Measure (PAM) scores. Participants included 181 PCPs from a single accountable care organization in Minnesota who completed an online survey. We conducted bivariate analyses and multivariate regression models to examine relationships between CS-PAM and PCP self-management support behaviors and changes in level of patient activation.Results: PCPs with high CS-PAM scores were much more likely to engage in supportive self-management and patient behavior change approaches, such as involving the patient in agenda-setting, problem-solving, and collaboratively setting behavioral goals, than were PCPs with low CS-PAM scores. More positive PCPs' belief in the patients' role in self-management was positively correlated with improvements in their patients' level of patient activation.Conclusions: More positive PCP beliefs about the patients' role in self-management was strongly related to PCP behaviors geared towards increasing patient activation.