SELF-CARE AND COMPLIANCE OF CHRONICALLY ILL AGED

本研究的主要目的是检查医生的影响， 干预方式和患者对疾病经历的感知 患者对其治疗计划的理解和依从性 长期病患者、中年人及长者的健康保险计划。 在这种情况下，顺从被视为一种疾病行为， 与自我护理或自我治疗相比。第二个目的是比较 这些男女之间的关系这项研究是基于一个 概念模型，结合了对慢性病的认识， 经验，健康信念模型中的因素，已被发现是 一致的疾病行为和方面的预测， 医患关系 初步随机抽样调查了2000名45岁和 老年人将从一个大型健康机构的活跃成员中抽取 维修组织（HMO）在中西部，工业SMSA和 筛选出关节炎、糖尿病或高血压患者， 最终样本约为800个。这样的样本适合于此 因为获得医疗保健的机会和质量都没有因种族而异 或性别在健康维护组织，这种情况在一般人群中没有发现。 虽然结果的普遍性会受到某些性质的限制 在样本中，差异接入的潜在混淆效应 在确保获得医疗记录的同时，消除了获得医疗保健的机会。 将从三个来源收集数据。面对面采访 抽样成员将提供患者对医生的看法的数据， 干预方式、慢性病经历、对慢性病的认识、 遵守治疗计划和自我护理行为。临床 将获得关于这些治疗计划和临床结果的信息， 医疗记录审查。此外，受访者的初级保健 医生将接受自填问卷调查， 评估他们对自己的互动风格的看法。 合规和自我照顾的联合检查以及增加 医患互动和慢性疾病的经验， 健康信念模式是本研究特色。

The major aim of this study is to examine the impacts of physicians' interactional styles and patients' perceptions of their disease experiences on patients' understandings of their treatment plans and compliance with those plans among chronically ill, middle aged and elderly persons. Compliance is viewed in this context as one form of illness behavior in contrast to self-care or self-treatment. The secondary aim is to compare these relationships between women and men. This research is based on a conceptual model that combines the perception of the chronic disease experience, factors in the health belief model that have been found to be consistent predictors of illness behaviors and aspects of the physician-patient relationship. An initial random sample of 2000 non-institutionalized persons aged 45 and older will be drawn from the active membership of a large health maintenance organization (HMO) in a midwestern, industrial SMSA and screened to select those with arthritis, diabetes or hypertension, to yield a final sample of approximately 800. Such a sample is appropriate for this study because neither access to nor quality of health care varies by race or gender in the HMO, a situation not found in the general population. Although generalizability of results will be somewhat limited by the nature of the sample, the potentially confounding effects of differential access to health care are eliminated while access to medical records is assured. Data will be collected from three sources. Face-to-face interviews with sample members will provide data on patients' perceptions of physicians' interactional styles, the chronic disease experience, understanding of and compliance with treatment plans and self-care behaviors. Clinical information on these treatment plans and clinical outcomes will be obtained from medical record reviews. In addition, the respondents' primary care physicians will be surveyed with self-administered questionnaires, to assess their own perceptions of their interactional styles. The joint examination of compliance and self-care and the addition of physician-patient interactions and the chronic disease experience to the health belief model are unique features of this study.