Moser Albine, van der Bruggen Harry, Widdershoven Guy
Faculty of Health Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Int J Nurs Stud. 2006 May;43(4):417-27. doi: 10.1016/j.ijnurstu.2005.06.003. Epub 2005 Aug 22.
In the Netherlands diabetes specialist nurses play an important role in specialized, long-term care for the chronically ill. One of the goals of nurse-led, shared care is to encourage chronically ill people to participate actively in selecting the organisation and interventions of care. This paper reports the findings of a study to determine which concepts of autonomy people with type 2 diabetes use in a nurse-led, shared-care setting.
The aim of this article was to portray how people with type 2 diabetes mellitus who are being cared for by diabetes specialist nurses in a shared-care unit view autonomy.
This qualitative study used in-depth interviews and was carried out in a nurse-led, shared-care unit in the Netherlands.
The study population consisted of 15 people who were enrolled for at least 1 year at the nurse-led, shared-care unit and who lived independently at home.
Data were analysed with a grounded-theory-like method.
The core category, 'competency in shaping one's life', described how people with diabetes exercise their autonomy. Seven categories that emerged were considered dimensions of autonomy. The dimensions were: identification, self-management, welcomed paternalism, self-determination, shared decision-making, planned surveillance, and responsive relationship.
Autonomy is a multi-dimensional, dynamic and complex construct. Further research is needed to investigate which decision-making processes patients with type 2 diabetes use in a nurse-led, shared-care setting.
在荷兰，糖尿病专科护士在慢性病的专科长期护理中发挥着重要作用。由护士主导的共享护理的目标之一是鼓励慢性病患者积极参与护理组织和干预措施的选择。本文报告了一项研究的结果，该研究旨在确定2型糖尿病患者在护士主导的共享护理环境中使用的自主概念。
本文旨在描绘在共享护理单元中由糖尿病专科护士护理的2型糖尿病患者如何看待自主性。
这项定性研究采用了深度访谈，在荷兰一个由护士主导的共享护理单元中进行。
研究人群包括15名在护士主导的共享护理单元登记至少1年且独立居住在家的人。
采用类似扎根理论的方法分析数据。
核心类别“塑造生活的能力”描述了糖尿病患者如何行使其自主性。出现的七个类别被视为自主性的维度。这些维度是：认同、自我管理、可接受的家长式作风、自我决定、共同决策、计划监督和响应性关系。
自主性是一个多维、动态且复杂的概念。需要进一步研究以调查2型糖尿病患者在护士主导的共享护理环境中使用哪些决策过程。
