Using self- determination theory to understand the social prescribing process: a qualitative study
Using self- determination theory to understand the social prescribing process: a qualitative study
复制标题
DOI：
10.3399/bjgpo.2020.0153
复制
发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Cole, Donald C.
中科院分区：
文献类型：
--
作者：
Bhatti, Sara;Rayner, Jennifer;Cole, Donald C.
背景：社会处方（SP）帮助患者参与社会活动，并连接到社区支持作为整体方法的一部分，以初级保健。Rx：社区是一个SP项目，在加拿大安大略省各地的11个社区保健中心实施。目的：探讨SP作为一个过程如何促进患者的积极结果。设计与设定：采用定性方法。18个焦点小组在CHCs或通过视频会议进行，涉及88名患者。此外，还进行了八次深入的电话访问。方法：采用基于自我决定理论（SDT）的理论框架对访谈和焦点小组进行逐字记录，并进行主题分析。结果：接受社会处方的被试将SP描述为一个尊重其需求和利益的共情过程。SP促进了患者在护理中的声音，帮助患者发展解决对他们重要需求的技能，并培养了与工作人员和其他参与者的信任关系。患者报告说，他们的社会支持网络扩大了，他们的心理健康和自我管理慢性病的能力得到了改善。作为自愿“健康捍卫者”参与SP的患者报告说，这是一种积极的经历，他们通过以对自己有意义的方式回馈社区，获得了一种目标感。结论：SP对患者产生了积极的结果，它很适合社区卫生中心的初级保健模式。今后的研究应审查对健康结果的影响，并审查制定和执行特别服务方案的投资回报。
Background: Social prescribing (SP) assists patients to engage in social activities and connect to community supports as part of a holistic approach to primary care. Rx: Community was a SP project, which was implemented within 11 community health centres (CHCs) situated across Ontario, Canada.Aim: To explore how SP as a process facilitates positive outcomes for patients.Design & setting: Qualitative methods were used. Eighteen focus groups were conducted at CHCs or by video-conferencing, and involved 88 patients. In addition, eight in -depth telephone interviews were undertaken.Method: Interviews and focus groups were transcribed verbatim, and analysed thematically using a theoretical framework based on self-determination theory (SDT).Results: Participants who had received social prescriptions described SP as an empathetic process that respects their needs and interests. SP facilitated the patient's voice in their care, helped patients to develop skills in addressing needs important to them, and fostered trusting relationships with staff and other participants. Patients reported their social support networks were expanded, and they had improved mental health and ability in selfmanagement of chronic conditions. Patients who became involved in SP as voluntary 'health champions' reported this was a positive experience and they gained a sense of purpose by giving back to their communities in ways that felt meaningful for them.Conclusion: SP produced positive outcomes for patients, and it fits well within the community health centre model of primary care. Future research should examine the impact on health outcomes and examine the return on investment of developing and implementing SP programmes.