慢性病患者的患者激活测量与自感健康之间的关系。
Relationship between patient activation measurement and self-rated health in patients with chronic diseases.
机构信息
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.
出版信息
BMC Fam Pract. 2020 Nov 4;21(1):225. doi: 10.1186/s12875-020-01301-y.
BACKGROUND
In the aging population, chronic diseases and multimorbidity are common. Therefore, it is important to engage patients in their self-care. The aim of this study was to analyze the relationship between activity in self-care and self-rated health among primary care patients with chronic diseases.
METHODS
The data of the present study were derived from a research project on the Participatory Patient Care Planning in Primary Care (4PHC). A total of 605 patients were recruited in the Siilinjärvi Health Center from those patients who were being monitored due to the treatment of hypertension, ischemic heart disease or diabetes. We evaluated the level of patient's activity in self-care with the Patient Activation Measurement (PAM). Self-rated health (SRH) was measured with the 5-item Likert scale. An adjusted hypothesis of linearity across categories of PAM and self-rated health was estimated using analysis of covariance (ANCOVA).
RESULTS
It was found that 76 patients had low activity, 185 had moderate while 336 patients had high activity as measured with PAM. Patients with the highest activity were younger, less depressed, had a lower body mass index and a higher level of physical activity than those with the lower activity. Correspondingly, good SRH was perceived by 29, 45 and 67% of the patients in these three PAM groups adjusted with sex, age, depressive symptoms (BDI) and number of diseases. There was a significant linear trend (adjusted with age, number of diseases and depressive symptoms) between SRH and PAM, p < 0.001.
CONCLUSIONS
Activity in self-care had an independent, linear relationship with the self-rated health. The present findings suggest that Patient Activation Measurement has the potential to categorize the patients according to their perceived health and their needs related to their disease management and self-care. The present results warrant longitudinal studies on the impact of promoting patient activation levels.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02992431 . Registered 14 December 2016 https://clinicaltrials.gov/ct2/show/NCT02992431.
背景
在老龄化人口中，慢性病和多种疾病较为常见。因此，让患者参与自我护理非常重要。本研究的目的是分析初级保健慢性病患者自我护理活动与自我报告健康之间的关系。
方法
本研究的数据来自初级保健参与式患者护理计划（4PHC）研究项目。从因高血压、缺血性心脏病或糖尿病治疗而接受监测的患者中，共在 Siilinjärvi 健康中心招募了 605 名患者。我们使用患者激活测量（PAM）评估患者自我护理活动的水平。自我报告健康（SRH）使用 5 项李克特量表进行测量。使用协方差分析（ANCOVA）对 PAM 和自我报告健康的类别之间的线性假设进行调整。
结果
结果发现，根据 PAM 测量，76 名患者的活动水平低，185 名患者的活动水平中等，336 名患者的活动水平高。与活动水平较低的患者相比，活动水平最高的患者年龄较小、抑郁程度较低、身体质量指数较低、身体活动水平较高。相应地，在这些三个 PAM 组中，有 29%、45%和 67%的患者自我报告的健康状况良好，调整后的因素为性别、年龄、抑郁症状（BDI）和疾病数量。在 SRH 和 PAM 之间存在显著的线性趋势（调整了年龄、疾病数量和抑郁症状），p<0.001。
结论
自我护理活动与自我报告的健康状况之间存在独立的线性关系。本研究结果表明，患者激活测量具有根据患者感知的健康状况以及他们与疾病管理和自我护理相关的需求对患者进行分类的潜力。本研究结果支持关于提高患者激活水平的影响的纵向研究。
试验注册
ClinicalTrials.gov 标识符：NCT02992431。于 2016 年 12 月 14 日注册，https://clinicaltrials.gov/ct2/show/NCT02992431。
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