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在初级保健中促进健康生活方式:患者作为共同生产者

Implementation of healthy lifestyle promotion in primary care: patients as coproducers.

作者信息

Thomas Kristin, Bendtsen Preben, Krevers Barbro

机构信息

Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, 58183 Linköping, Sweden.

Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, 58183 Linköping, Sweden; Department of Medical Specialist and Department of Medical and Health Sciences, Linköping University, Motala, Sweden.

出版信息

Patient Educ Couns. 2014 Nov;97(2):283-90. doi: 10.1016/j.pec.2014.07.033. Epub 2014 Aug 11.

Abstract

OBJECTIVES

To explore and theorize how patients perceive, interpret, and reactin healthy lifestyle promotion situations in primary care and to investigate patients' role in implementation of lifestyle promotion illustrated by typologies.

METHODS

Grounded theory was used to assess qualitative interview data from 22 patients with varied experience of healthy lifestyle promotion. Data were analyzed by constant comparative analysis.

RESULTS

A substantive theory of being healthy emerged from the data. The theory highlights the processes that are important for implementation before, during, and after lifestyle promotion. Three interconnected categories emerged from the data: conditions for being healthy, managing being healthy, and interactions about being healthy; these formed the core category: being healthy. A typology proposed four patient trajectories on being healthy: resigned, receivers, coworkers, and leaders.

CONCLUSION

Patients coproduced the implementation of lifestyle promotion through the degree of transparency, which was a result of patients' expectations and situation appraisals.

PRACTICE IMPLICATIONS

Different approaches are needed during lifestyle promotion depending on a variety of patient-related factors. The typology could guide practitioners in their lifestyle promotion practice.

摘要

目的

探讨并从理论上分析患者在初级保健中对健康生活方式促进情况的认知、理解及反应方式,并通过类型学研究患者在生活方式促进实施过程中的作用。

方法

运用扎根理论对22名有不同健康生活方式促进经历的患者的定性访谈数据进行评估。通过持续比较分析对数据进行分析。

结果

从数据中得出了一个关于保持健康的实质性理论。该理论强调了在生活方式促进之前、期间和之后对实施过程至关重要的各个环节。数据中出现了三个相互关联的类别:保持健康的条件、管理健康以及关于健康的互动;这些构成了核心类别:保持健康。一种类型学提出了四种关于保持健康的患者轨迹:顺从者、接受者、协作者和领导者。

结论

患者通过透明度的高低共同参与了生活方式促进的实施,而透明度是患者期望和情境评估的结果。

实践意义

在生活方式促进过程中,根据各种与患者相关的因素需要采用不同的方法。这种类型学可以指导从业者进行生活方式促进实践。

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