Département de Médecine de Famille, Université de Sherbrooke, Quebec, Canada.
Patient Educ Couns. 2012 Aug;88(2):170-6. doi: 10.1016/j.pec.2012.01.009. Epub 2012 Feb 22.
The objective was to provide a synthesis of the results of the research and discourse lines on main dimensions of patient-centered care in the context of chronic disease management in family medicine, building on Stewart et al.'s model.
We developed search strategies for the Medline, Embase, and Cochrane databases, from 1980 to April 2009. All articles addressing patient-centered care in the context of chronic disease management in family medicine were included. A thematic analysis was performed using mixed codification, based on Stewart's model of patient-centered care.
Thirty-two articles were included. Six major themes emerged: (1) starting from the patient's situation; (2) legitimizing the illness experience; (3) acknowledging the patient's expertise; (4) offering realistic hope; (5) developing an ongoing partnership; (6) providing advocacy for the patient in the health care system.
The context of chronic disease management brings forward new dimensions of patient-centered care such as legitimizing the illness experience, acknowledging patient expertise, offering hope and providing advocacy.
Chronic disease management calls for the adaptation of the family physician's role to patients' fluctuating needs. Literature also suggests the involvement of the family physician in care transitions as a component of patient-centered care.
在家庭医学慢性病管理背景下，基于斯图尔特等人的模式，对患者为中心的关怀的研究结果和论述线索的主要维度进行综合。
我们制定了从 1980 年到 2009 年 4 月间在 Medline、Embase 和 Cochrane 数据库中的搜索策略。所有在家庭医学慢性病管理背景下涉及以患者为中心的关怀的文章都被纳入。采用混合编码的方法，基于斯图尔特的以患者为中心的关怀模式进行主题分析。
共纳入 32 篇文章。出现了六个主要主题：（1）从患者的情况出发；（2）使疾病体验合法化；（3）承认患者的专业知识；（4）提供现实的希望；（5）发展持续的伙伴关系；（6）在医疗保健系统中为患者提供支持。
慢性病管理提出了以患者为中心的关怀的新维度，如使疾病体验合法化、承认患者专业知识、提供希望和提供支持。
慢性病管理要求家庭医生的角色适应患者不断变化的需求。文献还建议家庭医生参与护理过渡，作为以患者为中心的关怀的一个组成部分。
