Ruiz-Azarola Ainhoa, Perestelo-Pérez Lilisbeth
Escuela Andaluza de Salud Pública, Granada, España.
Gac Sanit. 2012 Mar;26 Suppl 1:158-61. doi: 10.1016/j.gaceta.2011.10.005. Epub 2012 Jan 23.
In recent decades, citizen's participation has become increasingly important in the field of public health, with the new role of the patient as an active agent, manager and producer of his or her own health, and the paradigm of patient-centered care. These changes have represented some of the most important milestones in the continuous improvement of healthcare. The involvement of patients is a new way of understanding the relationship between patients, health professionals and health systems, not only in terms of knowledge management and patients' control of their own health, individually or collectively, but also in terms of the influence that patients may have in health policy planning. Increased life expectancy and the consequent rise in the prevalence of chronic diseases, which already account for 80% of primary care consultations, is one of the key factors changing the role of patients. The place traditionally occupied by professional consultations given any symptoms or signs of alarm is beginning to be occupied by self-care and information and health education resources within the reach of patients and citizens. Internet access is an inexhaustible source of health information resources aimed at patients and provides participation tools. Social networks are places to exchange information and practical advice among patients, families and health professionals. Patients may be experts in their own illnesses and may thus take a more active role in decisions about their health, such as in shared decision making, as part of initiatives, and as part of evaluation of public health activities and health services.
近几十年来，公民参与在公共卫生领域变得越来越重要，患者成为自身健康的积极推动者、管理者和创造者，以及以患者为中心的护理模式也应运而生。这些变化是医疗保健持续改善过程中一些最重要的里程碑。患者的参与是理解患者、卫生专业人员和卫生系统之间关系的一种新方式，不仅体现在知识管理以及患者对自身健康的个体或集体掌控方面，还体现在患者对卫生政策规划可能产生的影响方面。预期寿命的增加以及随之而来的慢性病患病率上升，慢性病已占初级保健咨询的80%，这是改变患者角色的关键因素之一。传统上因任何警示症状或体征而进行专业咨询的场所，正开始被患者和公民能够获取的自我护理以及信息和健康教育资源所占据。互联网接入是面向患者的取之不尽的健康信息资源来源，并提供参与工具。社交网络是患者、家庭和卫生专业人员之间交流信息和实用建议的场所。患者可能是自身疾病的专家，因此可能在有关自身健康的决策中发挥更积极的作用，例如在共同决策中，作为倡议的一部分，以及作为公共卫生活动和卫生服务评估的一部分。
