Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
Clin Rehabil. 2021 May;35(5):629-638. doi: 10.1177/0269215520975327. Epub 2020 Nov 23.
In this paper, we aim to provide a comprehensive description of the multicomponent self-management intervention for adults with epilepsy, ZMILE.
Acquiring self-management skills has been shown to play a vital role in enabling patients with epilepsy overcoming (health-related) struggles in daily life and coping with limitations their condition poses on them. ZMILE is a course consisting of education (to increase concordance to treatment), goal-setting (proactive coping), and self-monitoring.
The course is guided by two nurse practitioners and each patient is allowed to bring one family member or friend. Self-monitoring plays an important role and can be done through e-Health tools or written diaries.
During and after the course, patients are required to work toward a personally defined goal using a five-step approach by means of pro-active coping. Moreover, patients are expected to use self-monitoring tools to reflect on their own behavior and identify ways to optimize medication intake when required.
ZMILE is provided in an outpatient setting over five weekly group sessions and one booster session. From the start, patients are encouraged to set individual goals. Each group session will have a different theme but part of every session is reflecting on personal goals and to learn from eachother.
The ZMILE-intervention has been evaluated and may be a promising intervention in terms of effectiveness and feasibility for adults with epilepsy, relatives, and professionals. We present the adapted version which can be implemented in clinical practice.
本文旨在全面描述针对成人癫痫患者的多组分自我管理干预措施 ZMILE。
已证实,掌握自我管理技能对于帮助癫痫患者克服日常生活中的(健康相关)困难以及应对其病情带来的限制至关重要。ZMILE 课程包括教育(提高治疗依从性)、目标设定(积极应对)和自我监测。
该课程由两名护士从业者指导,每位患者可带一名家属或朋友参加。自我监测起着重要作用,可以通过电子健康工具或书面日记进行。
在课程期间和之后,患者需要使用积极应对的五步方法朝着个人定义的目标努力。此外,患者应使用自我监测工具来反思自己的行为,并在需要时确定优化药物摄入的方法。
ZMILE 在门诊环境中进行,共五周的小组会议和一次强化会议。从一开始,就鼓励患者设定个人目标。每个小组会议都有不同的主题,但部分会议内容是反思个人目标并相互学习。
ZMILE 干预措施已经过评估,对于癫痫患者、家属和专业人员来说,在有效性和可行性方面可能是一种很有前途的干预措施。我们介绍了经过改编的版本,可在临床实践中实施。