Joshu Corinne E, Rangel Lourdes, Garcia Otila, Brownson Carol A, O'Toole Mary L
The Department of Community Health, Prevention Research Center, Saint Louis University School of Public Health, St Louis, Missouri (Ms Joshu)
Gateway Community Health Center, Laredo, Texas (Ms Rangel and Ms Garcia)
Diabetes Educ. 2007 Jun;33 Suppl 6:151S-158S. doi: 10.1177/0145721707304076.
The purpose of this article is to describe the integration of a promotora-led self-management component into a system of care and assess the influence of this program on indicators of metabolic control over time.
Gateway Community Health Center is a federally qualified health center in Laredo, Texas, that serves a predominantly Hispanic population. Gateway integrated self-management support into care for people with diabetes by incorporating promotora-led self-management services into the clinic structure, operations, and patient visits. The self-management program included education, goal setting, depression screening with symptom follow-up, and support groups after course end. Indicators of metabolic control, HbA1c, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were compared at baseline and at 12 months.
The integration of promotora-led self-management services into the system of care allowed for continual improvements of self-management services in response to patient needs. Patients enrolled in the self-management course showed improved indicators of metabolic control that were sustained over time, and they reported a high level of goal achievement.
The integration of the promotora-led self-management program into diabetes care at Gateway generated a system of referral, follow-up, feedback, and documentation that produced consistently high-quality clinical care.
本文旨在描述将由健康促进员主导的自我管理组件整合到护理系统中，并评估该项目随时间推移对代谢控制指标的影响。
盖特威社区健康中心是德克萨斯州拉雷多市一家获得联邦资质的健康中心，主要服务西班牙裔人群。盖特威通过将由健康促进员主导的自我管理服务纳入诊所结构、运营和患者就诊流程，将自我管理支持整合到糖尿病患者的护理中。自我管理项目包括教育、目标设定、伴有症状随访的抑郁筛查以及课程结束后的支持小组。在基线和12个月时比较代谢控制指标、糖化血红蛋白、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯。
将由健康促进员主导的自我管理服务整合到护理系统中，能够根据患者需求不断改进自我管理服务。参加自我管理课程的患者代谢控制指标有所改善，且随着时间推移得以维持，他们报告目标达成率很高。
将由健康促进员主导的自我管理项目整合到盖特威的糖尿病护理中，产生了一个转诊、随访、反馈和记录系统，该系统提供始终如一的高质量临床护理。
