The emotional context of self-management in chronic illness: A qualitative study of the role of health professional support in the self-management of type 2 diabetes
The emotional context of self-management in chronic illness: A qualitative study of the role of health professional support in the self-management of type 2 diabetes
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DOI：
10.1186/1472-6963-8-214
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发表时间：
2008-10-17
影响因子：
2.8
通讯作者：
Young, Doris
中科院分区：
文献类型：
--
作者：
Furler, John;Walker, Christine;Young, Doris
背景：支持患者自我管理是卫生专业人员公认的角色。关于卫生专业人员在实现最佳自我管理结果方面的作用，几乎没有适当的证据。本研究探讨了2型糖尿病患者对自我管理策略的看法，以及与健康专业人员的关系如何支持这一点。方法：对2型糖尿病患者进行4个焦点小组：2个英语组，1个土耳其语组和1个阿拉伯语组。根据基础解释学和解释性描述分析小组的转录本。结果：我们根据自我管理的情感背景、自我管理的主要方法和卫生专业人员对自我管理的支持，描述了焦点小组中三个概念相关的文本类别。所有小组都描述了与糖尿病生活和自我管理的重要情感环境，这些与他们如何处理糖尿病管理以及他们从健康专业人员那里寻求的东西密切相关。文化似乎是形成这些联系的重要影响因素。结论：我们的研究结果表明，人们构建自己的个人自我管理和自我保健计划，源于一个重要的情感基础。这部分是由文化形成的，反过来又决定了每个人在追求自我管理战略方面的目标以及他们向保健专业人员提供支持的作用。如果卫生专业人员探究每个人的社会、情感和文化环境，他们对自我保健策略的支持将更符合患者的期望，追求改善的健康结果可能需要在支持和帮助改变围绕糖尿病患者生活的情感结构之间取得谨慎的平衡。
Background: Support for patient self-management is an accepted role for health professionals. Little evidence exists on the appropriate basis for the role of health professionals in achieving optimum self-management outcomes. This study explores the perceptions of people with type 2 diabetes about their self-management strategies and how relationships with health professionals may support this.Methods: Four focus groups were conducted with people with type 2 diabetes: two with English-speaking and one each with Turkish and Arabic-speaking. Transcripts from the groups were analysed drawing on grounded hermeneutics and interpretive description.Results: We describe three conceptually linked categories of text from the focus groups based on emotional context of self management, dominant approaches to self management and support from health professionals for self management. All groups described important emotional contexts to living with and self-managing diabetes and these linked closely with how they approached their diabetes management and what they looked for from health professionals. Culture seemed an important influence in shaping these linkages.Conclusion: Our findings suggest people construct their own individual self-management and self-care program, springing from an important emotional base. This is shaped in part by culture and in turn determines the aims each person has in pursuing self-management strategies and the role they make available to health professionals to support them. While health professionals' support for self-care strategies will be more congruent with patients' expectations if they explore each person's social, emotional and cultural circumstances, pursuit of improved health outcomes may involve a careful balance between supporting as well as helping shift the emotional constructs surrounding a patient life with diabetes.