General Internal Medicine, Boston Medical Center, Boston, MA, USA.
Boston University School of Medicine, Boston, MA, USA.
J Gen Intern Med. 2018 Oct;33(10):1692-1699. doi: 10.1007/s11606-018-4557-9. Epub 2018 Jul 10.
A patient's self-management of chronic disease is influenced in part by their explanatory model of illness (EMI) and daily lived experiences (DLE). Unfortunately, assessing patient's EMI and using this information to engage patients in chronic illness self-management continues to be a challenge.
"Health mind mapping" (HMM) is a novel process that captures a patient's EMI and DLE through the use of a graphic representation of ideas. We aimed to explore patient's experiences using HMM.
Qualitative study utilizing semi-structured interviews.
Adult patients with uncontrolled type 2 diabetes from a primary care clinic.
A facilitator guided 20 participants through the process of developing a health mind map. Subsequently, each participant completed a semi-structured interview about their experience with the process and perceptions about how their maps could be used. The process and interviews were video and audio recorded. We conducted a content analysis of the maps and a thematic analysis, using an inductive approach, of the interview data.
Participants explored a wide range of EMs and DLEs in their HMM process. Participants reported that the HMM process (1) helped to develop insight about self and illness; (2) was a catalyst for wanting to take actions to improve illness; and (3) represented an opportunity to actively share illness experiences. They reported potential uses of the map: (1) to communicate about their illness to others in their social network; (2) to communicate about their illness to providers; (3) to help others with diabetes manage their illness; and (4) to encourage ongoing engagement in diabetes self-care.
Participants reported that HMM helped them develop new insight about their illness and was a catalyst for encouraging them to take control of their illness. HMM has the potential to facilitate communication with providers and engage patients in collaborative goal setting to improve self-care in chronic illness.
患者对慢性病的自我管理在一定程度上受到其疾病解释模型（EMI）和日常生活体验（DLE）的影响。不幸的是，评估患者的 EMI 并利用这些信息来促使患者参与慢性病自我管理仍然是一个挑战。
“健康思维导图”（HMM）是一种新颖的过程，通过使用思想的图形表示来捕获患者的 EMI 和 DLE。我们旨在探索患者使用 HMM 的体验。
利用半结构化访谈进行定性研究。
来自初级保健诊所的未控制 2 型糖尿病成年患者。
由一名协调员引导 20 名参与者完成健康思维导图的制作过程。随后，每位参与者都完成了一项关于他们对该过程的体验以及对其地图如何使用的看法的半结构化访谈。该过程和访谈均进行了视频和音频记录。我们对思维导图进行了内容分析，并采用归纳法对访谈数据进行了主题分析。
参与者在 HMM 过程中探索了广泛的 EMI 和 DLE。参与者报告称，HMM 过程（1）有助于深入了解自我和疾病；（2）激发了改善疾病的行动意愿；（3）代表了积极分享疾病经验的机会。他们报告了地图的潜在用途：（1）与社交网络中的其他人交流有关疾病的信息；（2）与提供者交流有关疾病的信息；（3）帮助其他糖尿病患者管理疾病；（4）鼓励持续参与糖尿病自我保健。
参与者报告称，HMM 帮助他们深入了解自己的疾病，并激发他们控制疾病的意愿。HMM 有可能促进与提供者的沟通，并促使患者参与协作性目标设定，以改善慢性病的自我保健。
