Thorne S E, Paterson B L
University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Patient Educ Couns. 2001 Jan;42(1):81-90. doi: 10.1016/s0738-3991(00)00095-1.
While it has long been recognized that health care professionals play an important role in supporting self-care management in chronic illness, the nature of that support is not well understood. This paper represents an analysis of findings drawn from qualitative research into the development of self-care decision-making expertise in adults with longstanding Type I diabetes, specifically addressing ways in which health professionals' interactions support or fail to support such processes. These findings highlight issues associated with the disease trajectory, the assumptions about intended outcome, and the complex contexts in which individuals live with chronic disease, illustrating the manner in which varying kinds of support may be required at different points within the learning process. They further challenge notions of standardized communication and informational strategies, demonstrating the complexities inherent in the support needs of chronically ill persons as they change over time and context.
长期以来，人们一直认识到医疗保健专业人员在支持慢性病自我护理管理方面发挥着重要作用，但这种支持的性质却并未得到充分理解。本文对一项定性研究的结果进行了分析，该研究针对长期患I型糖尿病的成年人自我护理决策专业技能的发展情况，特别探讨了医疗保健专业人员的互动在哪些方面支持或未能支持此类过程。这些研究结果突出了与疾病轨迹、对预期结果的假设以及慢性病患者生活的复杂环境相关的问题，说明了在学习过程的不同阶段可能需要不同类型支持的方式。它们还对标准化沟通和信息策略的观念提出了挑战，表明慢性病患者的支持需求会随着时间和环境的变化而变化，其中存在着固有的复杂性。
