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将慢性病预防和管理服务整合到基层医疗保健中(PR1MaC):一项嵌入式定性研究的结果。

Integration of chronic disease prevention and management services into primary care (PR1MaC): findings from an embedded qualitative study.

机构信息

Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Sherbrooke 3001, 12e avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.

Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Chicoutimi, 305, Saint-Vallier, Chicoutimi, Quebec, G7H 5H6, Canada.

出版信息

BMC Fam Pract. 2019 Jan 9;20(1):7. doi: 10.1186/s12875-018-0898-z.

Abstract

BACKGROUND

The PR1MaC study was conducted to evaluate the integration of Chronic Disease Prevention and Management services into primary care practices and was reported effective. The aim of this study was to further explore the effects of the PR1MaC intervention on patients and their family.

METHODS

We conducted a qualitative study embedded in a randomized controlled trial. The trial was implemented in eight primary health care practices in the Saguenay region, Quebec, Canada. The interdisciplinary patient-centred team-based intervention included self-management support and a motivational approach. We conducted focus groups and semi-directed individual interviews with patients, family members and healthcare professionals.

RESULTS

Perceived positive effects can be grouped into six major themes: awareness, improved knowledge, improved motivation and empowerment, adoption of healthy behaviours, improvement of health status and improvement of quality of life. On the negative side, some participants reported lack of sustainability of newly acquired benefits in the months following the intervention.

CONCLUSIONS

Integrating chronic disease prevention and management services into primary care settings had impacts on patients and their family members. These findings are consistent with findings that were reported in the quantitative study. Further studies should address longterm sustainabilility in terms of benefits for the patients.

TRIAL REGISTRATION

ClinicalTrials.gov, no.: NCT01319656 .

摘要

背景

PR1MaC 研究旨在评估将慢性病预防和管理服务整合到初级保健实践中的效果,结果表明该干预措施是有效的。本研究旨在进一步探讨 PR1MaC 干预对患者及其家属的影响。

方法

我们进行了一项定性研究,嵌入在一项随机对照试验中。该试验在加拿大魁北克省萨格奈地区的 8 个初级保健实践中实施。跨学科的以患者为中心的团队为基础的干预措施包括自我管理支持和动机方法。我们对患者、家庭成员和医疗保健专业人员进行了焦点小组和半结构化个人访谈。

结果

感知到的积极影响可归纳为六个主要主题:意识、知识提高、动机和赋权增强、健康行为的采用、健康状况的改善和生活质量的提高。另一方面,一些参与者报告说,在干预结束后的几个月里,新获得的益处缺乏可持续性。

结论

将慢性病预防和管理服务整合到初级保健环境中对患者及其家属产生了影响。这些发现与定量研究中报告的结果一致。进一步的研究应该解决患者受益的长期可持续性问题。

试验注册

ClinicalTrials.gov,编号:NCT01319656。

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