Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
BMC Health Serv Res. 2013 Jul 3;13:251. doi: 10.1186/1472-6963-13-251.
The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health system. This paper aims to increase understanding of the challenges faced by chronically ill patients and family carers in relation to their experiences with the health care system and health service providers.
We interviewed patients, carers and health care professionals (HCPs) about the challenges faced by people living with complicated diabetes, chronic heart failure or chronic obstructive pulmonary disease.
Patients indicated that they had a range of concerns related to the quality of health care encounters with health care professionals (HCPs), with these concerns being expressed as needs or wants. These included: 1) the need for improved communication and information delivery on the part of HCPs; 2) well organised health services and reduced waiting times to see HCPs; 3) help with self care; 4) greater recognition among professionals of the need for holistic and continuing care; and 5) inclusion of patients and carers in the decision making processes.
In order to address the challenges faced by people with chronic illness, health policy must be more closely aligned with the identified needs and wants of people affected by chronic illness than is currently the case.
Wagner 模型提供了一个框架，可以帮助促进医疗体系向以慢性病护理为导向的模式转变。借鉴该框架的元素以及与以患者为中心的护理相关的卫生政策，我们描述了慢性病患者的健康需求，并将这些需求与理想情况下应由以患者为中心的卫生系统提供的服务进行了比较。本文旨在提高对慢性病患者及其家庭照顾者在与医疗保健系统和卫生服务提供者互动时所面临挑战的理解。
我们采访了患有复杂糖尿病、慢性心力衰竭或慢性阻塞性肺疾病的患者、照顾者和卫生保健专业人员（HCP），了解他们所面临的挑战。
患者表示，他们对与卫生保健专业人员（HCP）的医疗保健接触质量存在一系列担忧，这些担忧表现为需求或愿望。其中包括：1）HCP 需要改善沟通和信息传递；2）组织良好的卫生服务和减少等待 HCP 的时间；3）自我护理方面的帮助；4）专业人员更认识到需要全面和持续的护理；5）让患者和照顾者参与决策过程。
为了应对慢性病患者所面临的挑战，卫生政策必须与受慢性病影响的人群的已确定需求和愿望更加紧密地结合，而不是像现在这样。
