Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA.
Behav Med. 2013;39(1):1-6. doi: 10.1080/08964289.2012.708682.
The aim of this study was to examine whether patients who received a multicondition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy was positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention that combined self-management support and collaborative care management. At 6 and 12 month outcomes the intervention group showed significant improvements over the usual care group in confidence in ability to follow through with medical regimens important to managing their conditions and to maintain lifestyle changes even during times of stress. Improvements in self care-efficacy were significantly related to improvements in depression, and early improvements in confidence to maintain lifestyle changes even during times of stress explained part of the observed subsequent improvements in depression.
本研究旨在探讨接受多条件合作护理干预的慢性病和抑郁症患者在自我护理知识和效能方面是否有更大的改善，以及更大的知识和自我效能是否与改善目标结果呈正相关。一项针对 214 名患有合并抑郁症和糖尿病及/或冠心病且控制不佳的患者的随机对照试验测试了一项为期 12 个月的基于团队的干预措施，该措施结合了自我管理支持和合作护理管理。在 6 个月和 12 个月的结果中，干预组在对自己有信心方面表现出显著改善，他们有能力坚持执行对管理病情很重要的医疗方案，并在压力时期保持生活方式的改变。自我护理效能的提高与抑郁的改善显著相关，即使在压力时期也能保持生活方式改变的信心的早期提高，解释了观察到的抑郁后续改善的部分原因。
