Promoting patient and caregiver engagement in self-management of chronic illness.
Promoting patient and caregiver engagement in self-management of chronic illness.
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DOI：
10.1155/2013/180757
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发表时间：
2013
影响因子：
1.9
通讯作者：
Davidson PM
中科院分区：
文献类型：
--
作者：
Devito Dabbs A;Song MK;De Geest S;Davidson PM
作为一名护理专业人士，您无疑意识到慢性病患者的患病率不断上升，以及他们在互动和获得旨在处理急性问题的医疗保健系统支持方面所面临的问题。心脏病、中风、癌症、呼吸系统疾病和糖尿病等慢性疾病是迄今为止世界上发病和死亡的主要原因[1]。此外，超过一半患有一种慢性病的人患有多种慢性病，这增加了管理其健康的复杂性和负担。慢性病需要终身护理。支持患者的自我管理是慢性病患者护理的重要组成部分，以保证良好的结果。自我管理被定义为个人管理慢性病所固有的症状、治疗、身体和心理社会后果以及生活方式改变的能力[2]。在与医疗保健提供者正式接触期间，患者和家属往往处于管理慢性病的第一线。慢性病的有效自我管理需要患者和家属在面对疾病状况、复杂性、症状、负担、支持和应对资源的动态变化时参与护理。疾病过程中会出现某些事件和过渡点，当患者和家属进行自我管理和维持生活质量的能力受到威胁时，他们会变得更加脆弱。由于慢性病的动态性，患者和家属对技能、信息和支持的需求在不同的时间、环境和情况下会有所不同。由于患有慢性疾病的动态现实，他们需要一套自我管理技能来应对不可预测和突然的变化。本期特刊中的所有论文都讲述了自我管理的科学知识。一些作者采用了综合审查和荟萃分析技术，其中包括 Altman Klein 及其同事，他们的审查发现需要对糖尿病的自我管理采取更具反应性和动态的教育干预措施； GS Rasmussen 及其同事对青春期牛皮癣相关问题和脆弱性的综合审查； E. Kendall 及其同事进行的研究指出，需要一种更加生态化的疾病管理模式，让消费者积极参与社会关系，并解决他们的生活（和疾病）发生的背景； S. Barello 及其同事对有关患者参与的文献进行了绘制，揭示了促进患者参与的几个新挑战。其他作者提出了促进特定患者群体自我管理的干预措施，包括 Hellström 及其同事针对患有长期疾病的儿童，以在他们进入学校时实现健康过渡； J. Yang 为韩国慢性乙型肝炎患者； BL Faett 及其同事针对慢性下肢水肿患者进行了研究。也许并不奇怪，因为该主题的复杂性，许多被选中发表的原始研究报告都依赖于定性探究，包括现象学、扎根理论、定性描述、
As a nursing professional you are no doubt aware of the growing prevalence of people with chronic conditions and the problems they face interacting and getting support from health care systems that are designed to deal with acute problems. Chronic diseases, such as heart disease, stroke, cancer, respiratory diseases and diabetes, are by far the leading cause of morbidity and mortality in the world [1]. Furthermore, more than half of individuals with one chronic condition have multiple chronic conditions, increasing the complexity and burden of managing their health. Chronic conditions require a life-long care perspective. Support for patient’s self-management is an essential component in the care of the chronically ill in order to guarantee favorable outcomes. Self-management has been defined as the individual’s ability to manage symptoms, treatment, physical and psychosocial consequences and lifestyle changes inherent in living with a chronic condition [2]. Patients and families are often on the front-line managing chronic illness between formal contacts with their healthcare providers. Effective self-management of chronic conditions requires patients and families to be engaged in their care in the face of dynamic changes in disease condition, complexity, symptoms, burdens, support and coping resources. Certain events and points of transition arise over the course of illness and make patients and families more vulnerable when their ability to perform self-management and maintain their quality of life is threatened. Due to the dynamic nature of chronic illness, patients’ and families’ needs for skills, information and support vary at different points in time, environments and situations. Because of the dynamic realities of living with a chronic condition, they need a repertoire of self-management skills to deal with the unpredictable and sudden variations. All of the papers in this special issue inform the science of self-management. Several authors employed integrated review and meta-analytic techniques, including Altman Klein and colleagues whose review identified the need for more responsive and dynamic education interventions for selfmanagement of diabetes; GS Rasmussen and colleagues’ integrative review of the problems and vulnerability associated with having psoriasis during adolescence; the study conducted by E. Kendall and colleagues points to the need for a more ecological model for the management of illness that actively engages consumers in social relationships and addresses the context within which their lives (and illnesses) are enacted; and the mapping of the literature regarding patient engagement conducted by S. Barello and colleagues which revealed several emerging challenges to promoting patient engagement.Other authors presented interventions to promote selfmanagement in specific patient populations, including Hellström and colleagues for children with long-term illness to make a healthy transition as they enter school; J. Yang for Korean Patients with Chronic Hepatitis B; and BL Faett and colleagues for persons with chronic lower limb edema. Perhaps not surprisingly because of the complexity of the topic, many of the original research reports that were selected for publication relied on qualitative inquiry, including phenomenography, grounded theory, qualitative description,