Carryer Jenny, Budge Claire, Hansen Chiquita, Gibbs Katherine
School of Health and Social Services, Massey University, PB 11222 Palmerston North, New Zealand.
J Prim Health Care. 2010 Jun;2(2):124-9.
Providing care for people with chronic illness is a major issue for health practitioners around the world, especially as populations age. Encouraging self-management is beneficial in terms of relieving the burden on the health system and promoting better health and adherence to medication and advice amongst this group.
To measure the level of self-management support being provided to and received by people living with chronic illness in a District Health Board (DHB) region.
Self-report questionnaires (PACIC) were completed by 341 people living with chronic illness to measure the self-management support they receive from general practitioners and nurses. A modified version of the PACIC was used with 12 GPs and 77 primary health nurses in the same region to assess the provision of self-management support.
Patients' assessments suggest that they are receiving intermittent self-management support for their chronic illness. A comparison of ratings of different health practitioners revealed that nurses were reported to be providing support more consistently than GPs. The health practitioners rated themselves as providing self-management support more often than the patients reported receiving it. Many clinicians also suggested that not all forms of support are appropriate for everyone, suggesting the need to tailor support to the individual.
Chronic illness support needs to be considered within the context ofthe individual and to be embedded in an ongoing relationship between the person and the provider. Findings highlightthe benefits of a multidisciplinaryteam approach to self-management support and education in chronic illness care.
为慢性病患者提供护理是全球医疗从业者面临的一个重大问题,尤其是在人口老龄化的情况下。鼓励自我管理在减轻卫生系统负担以及促进这一群体的健康改善、药物依从性和遵循医嘱方面具有益处。
衡量在一个地区卫生委员会(DHB)区域内,慢性病患者所获得的以及提供给他们的自我管理支持水平。
341名慢性病患者填写了自我报告问卷(PACIC),以衡量他们从全科医生和护士那里获得的自我管理支持。同一区域的12名全科医生和77名初级保健护士使用了经过修改的PACIC版本,以评估自我管理支持的提供情况。
患者的评估表明,他们在慢性病方面获得的是间歇性的自我管理支持。对不同医疗从业者评分的比较显示,据报告护士提供支持的持续性高于全科医生。医疗从业者对自己提供自我管理支持的评分高于患者报告的接受支持的评分。许多临床医生还表示,并非所有形式的支持都适合每个人,这表明需要针对个人量身定制支持。
慢性病支持需要在个体背景下加以考虑,并融入个人与提供者之间持续的关系中。研究结果凸显了多学科团队方法在慢性病护理的自我管理支持和教育方面的益处。