Perspectives of low-income chronically ill patients on complex care management.
Perspectives of low-income chronically ill patients on complex care management.
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低收入慢性病患者对复杂护理管理的看法。
DOI：
10.1037/fsh0000260
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Davis,Elizabeth
中科院分区：
文献类型：
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作者：
Mao,AliceY;Willard-Grace,Rachel;Dubbin,Leslie;Aronson,Louise;Fernandez,Alicia;Burke,NancyJ;Finch,Julia;Davis,Elizabeth
介绍低收入，慢性病的成年人不成比例地经历健康状况不佳，尽管增加了医疗保健的使用和成本。复杂的护理管理（CCM）计划是一种创新的方法，以改善这些患者的结果，但鲜为人知的是，在CCM安全网初级保健settings. MethodTheauthors进行了半结构化的采访，13 CCM参与者在一个安全网初级保健诊所，探讨他们的健康和他们的经验与CCM的看法。访谈记录，转录，独立编码，并通过一个迭代的过程中使用扎根理论的方法来确定主题的参与者的experience.ResultsFrom我们的访谈，3个主题出现-（a）参与者哀悼的身体功能和社会福祉的损失，由于健康状况不佳;（B）参与者报告增加健康相关的动机，由于与护理团队的关系;和（c）参与者经历了一个新发现的控制感，作为改善护理导航和自我管理的结果。DiscussionComplex的护理管理改善了健康相关的动机，并提供了一个新的控制感的研究参与者，谁正在经历的身体功能和社会福利的损失，由于他们的慢性疾病。这些发现支持了以关系为中心的护理模式在低收入慢性病患者项目中的重要性。未来的研究应该集中在确定和传播最佳实践，有效地使患者感到更能控制自己的健康。（PsycInfo数据库记录（c）2020阿帕，保留所有权利）
IntroductionLow-income, chronically ill adults disproportionately experience poor health outcomes despite increased health care use and costs. Complex care management (CCM) programs are an innovative approach to improving outcomes for these patients, but little is known about the patients’ experiences in CCM programs in safety net primary care settings.MethodThe authors conducted semistructured interviews with 13 CCM participants in a safety net primary care clinic to explore their perceptions of their health and their experiences with CCM. Interviews were recorded, transcribed, independently coded, and analyzed through an iterative process using grounded theory methodology to identify themes in the participants’ experiences.ResultsFrom our interviews, 3 themes emerged—(a) participants mourned the loss of physical function and social well-being as a result of poor health;(b) participants reported increased health-related motivation due to relationships with the care team; and (c) participants experienced a newfound sense of control as a result of improved care navigation and self-management.DiscussionComplex care management improved health-related motivation and provided a renewed sense of control for study participants, who were experiencing the loss of physical function and social well-being due to their chronic diseases. These findings support the importance of relationship-centered care models in programs for low-income, chronically ill patients. Future research should focus on identifying and spreading best practices that effectively empower patients to feel more in control of their health.(PsycInfo Database Record (c) 2020 APA, all rights reserved)