Grohmann Barbara, Espin Sherry, Gucciardi Enza
Dietitian at Idlewyld Manor in Hamilton, Ont.
Associate Professor in the Daphne Cockwell School of Nursing at Ryerson University in Toronto, Ont.
Can Fam Physician. 2017 Feb;63(2):e128-e136.
To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care.
Qualitative study using semistructured, one-on-one interviews.
Three diabetes education programs operating in 11 primary care sites in one region of Ontario.
Twenty-three patients with diabetes.
Purposeful sampling was used to recruit participants from each site for interviews. Educator teams invited patients with whom they had met at least once to participate in semistructured interviews. Data were analyzed using thematic analysis with NVivo 11 software.
The diabetes education teams integrated into primary care exhibited many of the principles of person-centred care, as evidenced by the 2 overarching themes. The first is personalized care, with the subthemes care environment, shared decision making, and patient preference for one-on-one care. Participants described feeling included in partnerships with their health care providers, as they collaborated with physicians and diabetes educators to develop knowledge and set goals in the convenience and comfort of their usual primary care settings. Many participants also expressed a preference for one-on-one sessions. The second theme is patient-provider relationship, with the subthemes respect, supportive interaction, and facilitating patient engagement. Supportive environments created by the educators built trusting relationships, where patients expressed enhanced motivation to improve their self-care.
Diabetes educators integrated into primary care can serve to enrich the experience of patients, provide key education to improve patient understanding, and support primary care physicians in providing timely and comprehensive clinical care. Diabetes patients appear to benefit from convenient access to interprofessional teams of educators in primary care to support diabetes self-management.
探讨患者对融入初级保健的糖尿病教育团队（一名注册护士和一名注册营养师）所提供护理的看法。
采用半结构化一对一访谈的定性研究。
安大略省一个地区11个初级保健机构开展的三个糖尿病教育项目。
23名糖尿病患者。
采用目的抽样法从每个机构招募参与者进行访谈。教育团队邀请至少见过一次面的患者参加半结构化访谈。使用NVivo 11软件进行主题分析来分析数据。
融入初级保健的糖尿病教育团队展现出许多以患者为中心的护理原则，这在两个总体主题中得到体现。第一个是个性化护理，其亚主题包括护理环境、共同决策以及患者对一对一护理的偏好。参与者表示在与医疗服务提供者的合作关系中感到被接纳，因为他们与医生和糖尿病教育者协作，在熟悉的初级保健环境的便利与舒适氛围中增长知识并设定目标。许多参与者还表达了对一对一课程的偏好。第二个主题是患者与提供者的关系，其亚主题包括尊重、支持性互动以及促进患者参与。教育者营造的支持性环境建立了信任关系，患者在其中表达了增强自我护理的动力。
融入初级保健的糖尿病教育者可丰富患者体验，提供关键教育以增进患者理解，并支持初级保健医生提供及时、全面的临床护理。糖尿病患者似乎受益于在初级保健中便捷地获得跨专业教育团队的支持，以进行糖尿病自我管理。
