Pelicand Julie, Fournier Cécile, Le Rhun Anne, Aujoulat Isabelle
Pediatric Diabetology, Hospital Necker-Enfants Malades, Paris, France.
Health Expect. 2015 Jun;18(3):303-11. doi: 10.1111/hex.12041. Epub 2013 Jan 14.
This study examines how the term 'self-care' imported from health promotion has been used in the context of patient education interventions for paediatric patients with type 1 diabetes.
Thirty articles over the last decade were analysed, using a qualitative method of thematic coding and categorizing.
The term 'self-care' has been mainly used as a synonym for self-management of one's condition and treatment. Indeed, the activities performed by paediatric patients independently or with the help of their parents under the term 'self-care' fail to explicitly take into account the general health and life dimensions of self-care, as defined in health promotion. Although such dimensions are implicitly present when it comes to define the parents' and health-care providers' roles in supporting the children's emerging self-care capacity, their importance is acknowledged as a way of strengthening the children's and their families' capacity to respond to illness demands, rather than in relation to their general well-being.
The discourse on self-care in the field of paediatric diabetes therefore appears to be oriented more towards disease and prevention, rather than health promotion. The psychosocial dimension of self-care should be particularly investigated, as young patients need to be supported in their efforts to gain autonomy not only in relation to the management of their condition, but in their lives in general.
本研究探讨了从健康促进领域引入的“自我护理”一词在1型糖尿病儿科患者的患者教育干预背景下是如何使用的。
采用主题编码和分类的定性方法,对过去十年的30篇文章进行了分析。
“自我护理”一词主要被用作病情和治疗自我管理的同义词。事实上,儿科患者在“自我护理”这一术语下独立或在父母帮助下进行的活动,并未明确考虑到健康促进中所定义的自我护理的总体健康和生活维度。尽管在界定父母和医疗保健提供者在支持儿童新兴自我护理能力方面的作用时,这些维度隐含其中,但人们认识到其重要性是为了增强儿童及其家庭应对疾病需求的能力,而非关乎他们的总体幸福感。
因此,儿科糖尿病领域中关于自我护理的论述似乎更侧重于疾病和预防,而非健康促进。自我护理的心理社会维度应得到特别研究,因为年轻患者不仅在病情管理方面,而且在总体生活中努力获得自主权时都需要得到支持。