Davis Kia L, O'Toole Mary L, Brownson Carol A, Llanos Patricia, Fisher Edwin B
The Health Communication Research Laboratory, St Louis University School of Public Health, St Louis, Missouri (Ms Davis)
Division of Health Behavior Research, Washington University School of Medicine, St Louis, Missouri (Dr O’Toole, Ms Brownson)
Diabetes Educ. 2007 Jun;33 Suppl 6:208S-215S. doi: 10.1177/0145721707304133.
The purpose of this study is to describe ways in which community health workers (CHWs) are used in various clinic and community settings to support diabetes self-management.
Descriptive quantitative data were collected from logs completed by CHWs. Logs described mode, place, type, duration, and focus of individual contact between the CHW and the patient. Qualitative data were collected from semistructured interviews with patients. Interviews were conducted on site from June to August 2006. Interviewees included a purposeful sample of 47 patients who perceived being helped by CHWs.
CHWs reported providing assistance and teaching or practicing skills as the focus of most of the 1859 individual contacts. The assistance CHWs reported providing was most often in the form of encouragement/motivation. During interviews, patients shared that CHWs were helpful in demonstrating how to incorporate diabetes self-management (DSM) into their daily lives. The information patients shared also provided insight into what they perceived as encouragement/motivation from the CHWs. Quotes from interviews provide specific examples of how support from CHWs was different from that received from family and health care team members.
Both CHWs and patients perceived assistance being provided in similar ways, with consistent emphasis on encouragement/motivation. Interviews with the patients revealed that a personal connection along with availability and provision of key resources and supports for self-management made the CHW-patient interaction successful for DSM. Examples provide insight into the valuable contributions of CHWs to DSM. This insight should encourage guidelines that make CHWs a routine, standard part of the diabetes care team.
本研究旨在描述社区卫生工作者（CHWs）在各种诊所和社区环境中用于支持糖尿病自我管理的方式。
从CHWs填写的日志中收集描述性定量数据。日志描述了CHW与患者之间个人接触的方式、地点、类型、持续时间和重点。从对患者的半结构化访谈中收集定性数据。访谈于2006年6月至8月在现场进行。受访者包括47名认为得到CHWs帮助的有目的抽样患者。
CHWs报告称，在1859次个人接触中，大部分接触的重点是提供帮助以及教授或练习技能。CHWs报告提供的帮助最常采取鼓励/激励的形式。在访谈中，患者表示CHWs有助于示范如何将糖尿病自我管理（DSM）融入他们的日常生活。患者分享的信息也提供了关于他们所认为的CHWs的鼓励/激励的见解。访谈中的引述提供了CHWs的支持与家人和医疗团队成员的支持有何不同的具体例子。
CHWs和患者都认为提供帮助的方式相似，都一致强调鼓励/激励。对患者的访谈显示，个人联系以及关键资源的可用性和自我管理支持使得CHW与患者的互动在DSM方面取得成功。这些例子提供了关于CHWs对DSM的宝贵贡献的见解。这种见解应促使制定指南，使CHWs成为糖尿病护理团队的常规、标准组成部分。
