Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities.
Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities.
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DOI：
10.1016/j.pec.2021.04.038
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发表时间：
2022-01
影响因子：
3.5
通讯作者：
Iturralde E
中科院分区：
文献类型：
--
作者：
Fang A;Abdelgadir D;Gopalan A;Ross T;Uratsu CS;Sterling SA;Grant RW;Iturralde E
心血管疾病(CVD)仍然是美国发病率的主要原因。管理心血管疾病的风险因素，如糖尿病或高血压，对许多人来说可能是具有挑战性的。我们调查了那些一直在努力达到他们的心血管危险因素控制目标的患者所经历的障碍。这项定性研究考察了患者、临床医生和研究人员对个人在慢性病管理计划中的经验的观察。所有参与者(n=332)都参加了一项临床试验，测试旨在提高医疗参与度的基于技能的团体干预。数据通过一般归纳法进行分析，结果主题沿着能力-机会-动机-行为框架进行构建。分析确定的关爱参与障碍与参与者的沟通技能和激活、关爱团队关系过程和情感因素有关。尽管大多数参与者报告从技能培训中受益，但持续存在的障碍包括对提供者的不信任，对健康挑战的羞愧，以及对护理团队互动的不满，这些互动被描述为客观或反应迟钝。支持参与心血管疾病风险因素管理计划的努力应考虑患者及其护理团队是否具有必要的技能、机会和信心，以主动沟通健康需求，并参与目标设定、和谐共处和共同决策的非评判性互动。
Cardiovascular disease (CVD) continues to be a leading cause of morbidity in the U.S. Managing CVD risk factors, such as diabetes or hypertension, can be challenging for many individuals. We investigated the barriers experienced by patients who persistently struggled to reach their CVD risk factor control goals. This qualitative study examined patient, clinician, and researcher observations of individuals’ experiences in a chronic disease management program. All participants (n=332) were enrolled in a clinical trial testing a skills-based group intervention seeking to improve healthcare engagement. Data were analyzed through a general inductive approach and resulting themes were structured along the Capability-Opportunity-Motivation-Behavior framework. Analyses identified care engagement barriers related to participants’ communication skills and activation, care team relationship processes, and emotional factors. Although most participants reported benefitting from skills training, persistent barriers included distrust of their providers, shame about health challenges, and dissatisfaction with care team interactions that were described as impersonal or unresponsive. Efforts to support engagement in CVD risk factor management programs should address whether patients and their care team have the necessary skills, opportunities and confidence to proactively communicate health needs and engage in non-judgmental interactions for goal-setting, rapport-building, and shared decision-making.
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影响因子：
2.9
作者：
Browne JL;Ventura A;Mosely K;Speight J
通讯作者：
Speight J
影响因子：
3.5
作者：
Brom L;Hopmans W;Pasman HR;Timmermans DR;Widdershoven GA;Onwuteaka-Philipsen BD
通讯作者：
Onwuteaka-Philipsen BD
DOI：
10.1186/1748-5908-6-42
发表时间：
2011-04-23
期刊：
Implementation science : IS
影响因子：
--
作者：
Michie S;van Stralen MM;West R
通讯作者：
West R
影响因子：
16.2
作者：
Grant, RW;Cagliero, E;Meigs, JB
通讯作者：
Meigs, JB
影响因子：
3.9
作者：
Denzin, Norman K.
通讯作者：
Denzin, Norman K.