Xiao Yue
The Center for Health Policy Evaluation and Technology Assessment, The China National Health Development Research Center, Beijing 100910, China.
Chronic Dis Transl Med. 2015 Sep 4;1(3):145-151. doi: 10.1016/j.cdtm.2015.08.001. eCollection 2015 Sep.
This paper seeks to explore the relevance between the Western "expert patient" rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective. It firstly sets up a conceptual framework of the "expert patient" or the patient self-management approach, showing the rhetoric of the initiative in the developed countries. Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the "expert patient" approach in these countries. Kober and Van Damme's study on the relevance of the "expert patient" for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries' rhetoric of the "expert patient" approach for the reality of developing countries. In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient self-management programs. Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.
本文旨在从健康社会学角度探讨西方“专家型患者”言论与中低收入环境下非传染性疾病（NCDs）控制和管理现实之间的相关性。它首先建立了“专家型患者”或患者自我管理方法的概念框架，展示了发达国家这种倡议的言论。然后通过考察低收入环境下非传染性疾病控制和管理的情况，本文试图评估在这些国家实施“专家型患者”方法的可能性。对科伯和范达姆关于“专家型患者”与低收入环境下艾滋病项目相关性的研究进行批判性研究，以表明发达国家“专家型患者”方法的言论与发展中国家现实的相关性。此外，分析了莫波乔糖尿病同伴教育项目，以展示低收入国家在实施患者自我管理项目时面临的挑战。最后，还讨论了“专家型患者”方法在中国的应用，以提醒我们将其引入农村地区可能存在的困难。
