使用 PACIC 评估糖尿病患者的慢性病护理。
Diabetic patient assessment of chronic illness care using PACIC.
机构信息
Department of Nursing, University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece.
General Public Hospital of Volos "Achillopouleio", Athanasaki 3, TK 38222, Volos, Greece.
出版信息
BMC Health Serv Res. 2020 Jun 16;20(1):543. doi: 10.1186/s12913-020-05400-5.
BACKGROUND
The Patient Assessment of Chronic Illness Care plus is used in order to assess whether provided care is congruent with the Chronic Care Model, according to patients. The purpose of this study was to correlate PACIC+ and the revised 5As "ask, advise, agree, assist and arrange" scoring of a sample of DM patients, with their QoL, depressive symptomatology, demographic and disease characteristics, self-management behaviours of healthy eating and physical activity.
METHODS
This is a cross-sectional study where data were collected between January and April 2018 by using three questionnaires (PACIC+, SF-36, CES-D) from a sample of 90 DM patients treated at a Public General Hospital of Central Greece. Anonymous self-completed questionnaires were used to collect the data. Data was processed in the Statistical Package for the Social Sciences (SPSS).
RESULTS
The mean age of the participants with DM was 52.8 years (SD = 21.2 years), with cardiovascular disease and arterial hypertension scoring as the most frequently reporting chronic comorbidities. The healthcare received by DM patients has been correlated with their QoL. More specifically SF - 36 and PACIC+ scale scores showed a positive and low correlation in several subscales. The total score of PACIC+ scale as well as the Patient activation score were increased in higher scores of vitality (p = 0.034 & p = 0.028 respectively), hence both scores correlate significantly with latter. In addition, Delivery System / Practice Design score was increased in higher scores of mental health (p = 0.01) and MCS (p = 0.03).
CONCLUSIONS
The shift from hospital care focusing on the disease to a more patient-oriented approach puts forward a dynamic holistic approach to chronic diseases and the reduction of their impact. Finding evidence-based and effective strategies to promote health, prevent and manage chronic diseases such as diabetes mellitus is deemed to be crucial and necessary. PACIC+, which is a tool of a patient-level assessment of CCM implementation, can be used by countries which intend to apply changes in the way their health systems provide chronic care and specifically wish to improve the quality of chronic disease care and the QoL of their patients.
背景
根据患者的评估，慢性疾病关怀加是用来评估所提供的护理是否符合慢性护理模式。本研究的目的是将 PACIC+与修订后的 5A“询问、建议、同意、协助和安排”评分与 DM 患者样本的生活质量、抑郁症状、人口统计学和疾病特征、健康饮食和身体活动的自我管理行为进行相关分析。
方法
这是一项横断面研究，于 2018 年 1 月至 4 月期间，从希腊中部一家公立综合医院接受治疗的 90 名 DM 患者中使用三个问卷（PACIC+、SF-36、CES-D）收集数据。匿名自填问卷用于收集数据。数据在社会科学统计软件包（SPSS）中进行处理。
结果
DM 患者的平均年龄为 52.8 岁（标准差=21.2 岁），心血管疾病和动脉高血压是最常见的慢性合并症。DM 患者接受的医疗保健与他们的生活质量相关。更具体地说，SF-36 和 PACIC+量表评分在几个子量表中呈正相关且相关性较低。PACIC+量表的总分以及患者激活评分在活力得分较高时增加（p=0.034 和 p=0.028 分别），因此两者与后者呈显著相关。此外，在心理健康（p=0.01）和 MCS（p=0.03）得分较高时，交付系统/实践设计评分增加。
结论
从以疾病为中心的医院护理向更以患者为中心的方法转变，提出了一种针对慢性疾病及其影响的动态整体方法。寻找基于证据的有效策略来促进健康，预防和管理糖尿病等慢性疾病被认为是至关重要和必要的。PACIC+是评估 CCM 实施情况的患者水平评估工具，希望改善慢性病护理质量和患者生活质量的国家可以使用它来改变其卫生系统提供慢性病护理的方式。
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