Communication and self-management education at nurse-led COPD clinics in primary health care
Communication and self-management education at nurse-led COPD clinics in primary health care
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DOI：
10.1016/j.pec.2009.03.033
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发表时间：
2009-11-01
影响因子：
3.5
通讯作者：
Fossum, Bjoorn
中科院分区：
文献类型：
--
作者：
Efraimsson, Eva Osterlund;Klang, Birgitta;Fossum, Bjoorn
目的：本研究旨在探讨基层医疗机构护士主导的慢性阻塞性肺病（COPD）门诊患者首次就诊的沟通结构、内容和自我管理教育。方法：对7名注册护士的30次就诊进行录像；使用彭德尔顿咨询地图分析了咨询的结构和内容。从谈话内容来评估护士的自我管理教育情况：是否提供了重要且相关的信息和自我管理教育，以及如何进行调查。结果：每次咨询持续时间平均为37.53分钟。关于就诊原因的沟通主要涉及医疗和身体问题以及一定程度上患者的看法。关于自我管理和戒烟的教学内容丰富。两次会诊均以达成共识结束，没有一位患者获得个体化治疗方案。结论：护士很少单独规划会诊，也很少在自我管理教育和戒烟中使用动机对话。实践意义：研究结果可帮助护士反思如何改进访视结构、自我管理教育、戒烟和患者沟通。 (c) 2009 Elsevier Ireland Ltd. 保留所有权利。
Objective: The aim of the study was to explore the structure, content in communication and self-management education in patients' first consultations at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary healthcare.Method: Thirty consultations performed by seven registered nurses were videotaped; structure and content in the consultation was analyzed using Pendleton's Consultation Map. Nurses' self-management education was assessed from the content of the conversation: whether important and relevant information and self-management education was given, and how investigations were performed.Results: Each consultation lasted for a mean time of 37.53 min. Communication about reasons for consultations concerned mainly medical and physical problems and to a certain extent patients' perceptions. Teaching about self-management and smoking cessation was of an informative nature. Two consultations ended with shared understanding, and none of the patients received an individual treatment-plan.Conclusion: Nurses rarely planned the consultations on an individual basis and rarely used motivational dialogue in self-management education and in smoking cessation.Practice implications: The findings could be used to help nurses to reflect on how to improve the structure of the visit, self-management education, smoking cessation and patient communication. (c) 2009 Elsevier Ireland Ltd. All rights reserved.