University of Cardiff, Cardiff, United Kingdom.
Patient Educ Couns. 2010 Aug;80(2):219-26. doi: 10.1016/j.pec.2009.11.007. Epub 2009 Dec 16.
To explore the way that patient-centred care is realised within a tele-carer behavioural change intervention.
In-depth, semi-structured interviews undertaken at years 1 and 3 with a purposively selected sample from the intervention group within a 3-year randomised controlled trial (RCT) of a telephone-based education and support for persons with type 2 diabetes, and interviews with the non-medically trained tele-carers and supervising diabetes specialist nurse.
A four-phased flow of the patient-centred interactions was identified, which evolved over the process of the intervention. Initially, attention centred on building a picture for and of the patient and assessing their knowledge base. Later, focus moved towards understanding diabetes from the patient's perspective and advice-giving became more individualised. Throughout, the interaction dynamics varied for patients.
This study provides insight into the development of patient-centred behaviours over time and the influence of patients on tele-carer communication styles.
When adopting a patient-centred approach, tele-carers need to be flexible and recognise that patients vary in their knowledge, skills and psychological adaption to diabetes. Continuity of care and consistent contact is pivotal to patients being able to move through the various phases of their illness trajectory and make the transition towards improved self-care management.
探索以患者为中心的护理在远程护理行为改变干预中的实现方式。
在一项为期 3 年的 2 型糖尿病电话教育和支持的随机对照试验（RCT）中，对干预组进行了深入的、半结构式访谈，时间分别为第 1 年和第 3 年，并对非医学培训的远程护理人员和监督糖尿病专科护士进行了访谈。
确定了以患者为中心的互动的四个阶段流程，这一流程在干预过程中不断发展。最初，重点是了解患者的情况和评估他们的知识基础。后来，重点转移到从患者的角度了解糖尿病，提供的建议变得更加个性化。整个过程中，患者之间的互动动态各不相同。
本研究深入了解了以患者为中心的行为随时间的发展以及患者对远程护理人员沟通方式的影响。
当采用以患者为中心的方法时，远程护理人员需要灵活，并认识到患者在知识、技能和对糖尿病的心理适应方面存在差异。护理的连续性和持续联系对于患者能够经历疾病轨迹的各个阶段并过渡到改善自我护理管理至关重要。
