Öberg Ulrika, Orre Carl Johan, Hörnsten Åsa, Jutterström Lena, Isaksson Ulf
Department of Nursing Umeå University Umeå Sweden.
Department of Computer Science and Media Technology DVMT, Malmö University Malmö Sweden.
JMIR Nurs. 2020 Sep 15;3(1):e16318. doi: 10.2196/16318. eCollection 2020 Jan-Dec.
Globally, most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of digital tools to tackle health care challenges established views on traditional nursing, based on face-to-face meetings. Self-management is considered a key component of chronic care and can be defined as management of the day-to-day impact of a condition, something that is often a lifelong task. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. However, research on self-management screening instruments is sparse, and no research on nurses' experiences using a digitalized scale for measuring patients' needs for self-management support in primary health care settings has been found.
This paper describes diabetes specialist nurses' (DSNs) experiences of a pilot implementation of the SMASc instrument as the basis for person-centered digital self-management support.
This qualitative study is based on observations and interviews analyzed using qualitative content analysis.
From the perspectives of DSNs, the SMASc instrument offers insights that contribute to strengthened self-management support for people with type 2 diabetes by providing a new way of thinking and acting on the patient's term. Furthermore, the SMASc was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, DSNs and patients, to develop together through collaboration.
Person-centered care is advocated as a model for good clinical practice; however, this is not always complied with. Screening instruments, such as the SMASc, may empower both nurses and patients with type 2 diabetes with more personalized care. Using a screening instrument in a patient meeting may also contribute to a role change in the work and practice of DSNs.
在全球范围内，大多数国家在向以人群为基础的结构转变过程中面临着共同的挑战，即患有慢性疾病（如2型糖尿病）的老年人数量不断增加。这给医疗保健服务带来了相当大的负担。利用数字工具应对医疗保健挑战，对基于面对面会议的传统护理观念提出了新的看法。自我管理被认为是慢性病护理的关键组成部分，可定义为对某种疾病日常影响的管理，而这通常是一项终身任务。使用诸如自我管理评估量表（SMASc）之类的筛查工具，有可能引导初级保健护士提供以患者为中心的自我管理支持，进而帮助人们增强其自主能力和自我管理能力。然而，关于自我管理筛查工具的研究很少，且尚未发现有关于在初级保健环境中护士使用数字化量表测量患者自我管理支持需求的经验的研究。
本文描述了糖尿病专科护士（DSNs）对SMASc工具试点实施的经验，作为以患者为中心的数字自我管理支持的基础。
本定性研究基于观察和访谈，采用定性内容分析法进行分析。
从糖尿病专科护士的角度来看，SMASc工具通过提供一种基于患者视角的新思维和行动方式，为加强2型糖尿病患者的自我管理支持提供了见解。此外，SMASc被视为一种具有良好潜力的筛查工具，其涵盖的内容不止医疗问题；它有助于加强以患者为中心的自我管理支持，并且该工具被认为能促使双方，即糖尿病专科护士和患者，通过合作共同发展。
以患者为中心的护理被倡导为良好临床实践的模式；然而，并非总是能做到这一点。诸如SMASc之类的筛查工具可能使2型糖尿病患者和护士都能获得更个性化的护理。在患者会诊中使用筛查工具也可能促使糖尿病专科护士的工作和实践发生角色转变。
