Steno Diabetes Center, Gentofte, Denmark.
Qual Health Res. 2012 Jan;22(1):103-18. doi: 10.1177/1049732311420735. Epub 2011 Aug 29.
Although health professionals advocate empowerment in patient care, they often fail to realize it in practice. Through grounded theories we previously explained why barriers to empowerment were seldom overcome in diabetes care. Zoffmann used these theories as a basis for developing a decision-making and problem-solving method called guided self-determination (GSD). To realize empowerment, health professionals need detailed knowledge of the barriers, their own roles in these barriers, ways to overcome them, and recognizable evidence of having succeeded. Through theory-driven, qualitative evaluation, the previously developed grounded theories helped us recognize changes consistent with empowerment in dyads of nurses and patients with poorly controlled type 1 diabetes. By completing GSD reflection, patients remarkably improved their ability to identify, express, and share unique and unexpected difficulties related to living with diabetes. As signs of empowerment, patients and health professionals accomplished shared decision making, resolved life-disease conflicts, and established meaningful and effective relationships.
尽管医疗专业人员提倡在患者护理中赋予患者权力，但他们在实践中往往未能实现这一点。通过我们之前解释的扎根理论，我们了解到为什么在糖尿病护理中很少能够克服赋予患者权力的障碍。Zoffmann 医生将这些理论作为开发一种称为引导自主决策（GSD）的决策和解决问题方法的基础。为了实现赋权，医疗专业人员需要详细了解障碍、他们在这些障碍中的角色、克服障碍的方法以及成功的可识别证据。通过理论驱动的定性评估，我们之前开发的扎根理论帮助我们识别出与 1 型糖尿病控制不佳的护士和患者二人组中赋权一致的变化。通过完成 GSD 反思，患者显著提高了他们识别、表达和分享与糖尿病生活相关的独特和意外困难的能力。作为赋权的标志，患者和医疗专业人员共同做出决策，解决了生活与疾病的冲突，并建立了有意义和有效的关系。
