Institite of Health Services Research, Peninsula Medical School, University of Exeter, Exeter EX2 4SG, UK.
BMC Fam Pract. 2011 Jun 20;12:53. doi: 10.1186/1471-2296-12-53.
Self-care is a key component of current policies to manage long term conditions. Although most people with long-term health problems care for themselves within lay networks, consultation rates for long-term undifferentiated illness remain high. Promotion of self-care in these individuals requires an understanding of their own self-care practices and needs to be understood in the context of health care pluralism. The aim was to investigate the extent and nature of self-care practices in patients experiencing long term health problems, sources of information used for self-care, and use of other forms of health care (conventional health care and complementary and alternative medicine).
The study involved a cross-sectional community-based survey set in three general practices in South West England: two in urban areas, one in a rural area. Data were collected using a postal questionnaire sent to a random sample of 3,060 registered adult patients. Respondents were asked to indicate which of six long term health problems they were experiencing, and to complete the questionnaire in reference to a single (most bothersome) problem only.
Of the 1,347 (45% unadjusted response rate) who responded, 583 reported having one or more of the six long term health problems and 572 completed the survey questionnaire. Use of self-care was notably more prevalent than other forms of health care. Nearly all respondents reported using self-care (mean of four self-care practices each). Predictors of high self-care reported in regression analysis included the reported number of health problems, bothersomeness of the health problem and having received a diagnosis. Although GPs were the most frequently used and trusted source of information, their advice was not associated with greater use of self-care.
This study reveals both the high level and wide range of self-care practices undertaken by this population. It also highlights the importance of GPs as a source of trusted information and advice. Our findings suggest that in order to increase self-care without increasing consultation rates, GPs and other health care providers may need more resources to help them to endorse appropriate self-care practices and signpost patients to trusted sources of self-care support.
自我护理是当前管理长期疾病政策的关键组成部分。尽管大多数患有长期健康问题的人在非专业网络中照顾自己，但长期未分化疾病的就诊率仍然很高。在这些人中推广自我护理需要了解他们自己的自我护理实践，并需要在医疗多元化的背景下理解。目的是调查患有长期健康问题的患者自我护理实践的程度和性质、用于自我护理的信息来源以及其他形式的医疗保健（常规医疗保健和补充和替代医学）的使用情况。
该研究涉及在英格兰西南部的三个普通诊所进行的横断面社区调查：两个在城市地区，一个在农村地区。使用邮寄问卷收集数据，随机抽取了 3060 名注册成年患者作为样本。受访者被要求指出他们正在经历的六种长期健康问题中的一种或多种，并仅针对一个（最麻烦）问题完成问卷。
在 1347 名（未调整的 45%应答率）回应者中，583 名报告患有六种长期健康问题中的一种或多种，572 名完成了调查问卷。自我护理的使用明显多于其他形式的医疗保健。几乎所有受访者都报告使用了自我护理（平均每人使用四种自我护理措施）。回归分析中的高自我护理预测因素包括报告的健康问题数量、健康问题的困扰程度和已获得诊断。尽管全科医生是最常使用和最信任的信息来源，但他们的建议与更多地使用自我护理无关。
这项研究揭示了该人群所进行的高水平和广泛的自我护理实践。它还强调了全科医生作为值得信赖的信息和建议来源的重要性。我们的研究结果表明，为了在不增加就诊率的情况下增加自我护理，全科医生和其他医疗保健提供者可能需要更多的资源来帮助他们认可适当的自我护理实践，并为患者提供值得信赖的自我护理支持来源。
