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一项针对慢性病患者自我管理项目的评估。

An evaluation of a self-management program for patients with long-term conditions.

作者信息

Turner Andrew, Anderson Joanna K, Wallace Louise M, Bourne Claire

机构信息

Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK.

Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK.

出版信息

Patient Educ Couns. 2015 Feb;98(2):213-9. doi: 10.1016/j.pec.2014.08.022. Epub 2014 Oct 22.

Abstract

OBJECTIVE

To evaluate a group-based self-management program (SMP) delivered as part of a quality improvement program, Co-Creating Health, for patients living with one of four long-term conditions (LTCs): chronic obstructive pulmonary disease, depression, diabetes, and musculoskeletal pain.

METHODS

The 7 week SMP was co-delivered by lay and health professional tutors. Patients completed self-reported outcome measures at pre-course and 6 months follow-up.

RESULTS

486 patients completed (attended ≥5 sessions) the SMP and returned pre-course and 6 months follow up data. Patients reported significant improvements in patient activation (ES 0.65, p<0.001), with 53.9% of all patients reporting a meaningful ≥4 point improvement. Health-related quality of life (ES 0.06, p=0.04), and health status (ES 0.33, p<0.001) were also significantly improved. Patients' anxiety (ES 0.37, p<0.001) and depression (ES 0.31, p<0.001) significantly improved. Patients also reported significant improvements in their self-management skills (p values from p<0.001 to p=0.028).

CONCLUSION

Attending the SMP led to improvements in a range of outcomes. Improvement in patient activation is important, as activated patients are more likely to perform self-care activities.

PRACTICE IMPLICATIONS

Co-delivered SMPs provide meaningful improvements in activation for >50% of those who complete and are a useful addition to self-management support provision.

摘要

目的

评估作为质量改进项目“共同创造健康”一部分实施的基于小组的自我管理项目(SMP),该项目针对患有慢性阻塞性肺疾病、抑郁症、糖尿病和肌肉骨骼疼痛这四种慢性病之一的患者。

方法

为期7周的SMP由非专业和健康专业导师共同授课。患者在课程开始前和随访6个月时完成自我报告的结局指标。

结果

486名患者完成(参加≥5次课程)了SMP并返回了课程开始前和随访6个月的数据。患者报告患者激活方面有显著改善(效应量0.65,p<0.001),所有患者中有53.9%报告有意义的≥4分改善。健康相关生活质量(效应量0.06,p=0.04)和健康状况(效应量0.33,p<0.001)也有显著改善。患者的焦虑(效应量0.37,p<0.001)和抑郁(效应量0.31,p<0.001)显著改善。患者还报告自我管理技能有显著改善(p值从p<0.001到p=0.028)。

结论

参加SMP导致一系列结局得到改善。患者激活的改善很重要,因为被激活的患者更有可能进行自我护理活动。

实践意义

共同授课的SMP对超过50%完成项目的患者的激活有显著改善,是自我管理支持提供的有益补充。

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