School of Population Health, The University of Queensland, Herston, QLD 4006, Australia.
Patient Educ Couns. 2011 May;83(2):217-21. doi: 10.1016/j.pec.2010.05.031. Epub 2010 Jul 3.
This study explores a range of relevant socio-demographic, physical and psychological factors in a unique examination of the risk factors for frequent attendance at primary care. The impact of patient activation for self-management on health service utilisation is of particular interest.
A population-based sample of people with chronic disease from Queensland, Australia, was interviewed using computer assisted telephone surveying. Data were collected from a random sample of 1470 people with either diabetes or a cardiovascular condition.
As participants became more activated they were less likely to frequently attend their main health care provider for assistance with their chronic condition. For both conditions the association was graduated and for participants with a cardiovascular condition this association remained statistically significant even after controlling for other potentially influential factors such as disease severity, length of time since diagnosis, and psychological distress.
Characteristics of the individual, including patient activation and psychological functioning, as well as disease factors contribute to primary care consulting patterns among people with chronic illness.
Efforts to improve patient activation for self-management should remain a central element of chronic care.
本研究在独特的角度下探讨了一系列相关的社会人口学、身体和心理因素,以研究频繁到初级保健就诊的风险因素。特别关注患者自我管理的积极性对卫生服务利用的影响。
本研究采用计算机辅助电话调查,对来自澳大利亚昆士兰州的慢性病患者进行了基于人群的抽样调查。数据来自于随机抽取的 1470 名糖尿病或心血管疾病患者。
随着参与者的积极性提高,他们不太可能频繁地到主要医疗保健提供者处寻求帮助来管理他们的慢性病。对于这两种疾病,这种关联是渐进的,即使在控制了其他潜在的影响因素,如疾病严重程度、诊断后时间长度和心理困扰后,心血管疾病患者的这种关联仍然具有统计学意义。
个体特征,包括患者的自我管理积极性和心理功能,以及疾病因素,都有助于慢性病患者的初级保健就诊模式。
努力提高患者的自我管理积极性应仍然是慢性病管理的核心要素。