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我们是否正在向以患者为中心的自我管理支持实践转变?挪威一家风湿病门诊护士的探索性案例研究。

Are We Transitioning Toward Person-centered Practice on Self-management Support? An Explorative Case Study Among Rheumatology Outpatient Clinic Nurses in Norway.

作者信息

Fischer Heike, Grønning Kjersti

机构信息

Trondheim Municipality, Trondheim, Norway.

Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

出版信息

SAGE Open Nurs. 2021 Oct 6;7:23779608211037494. doi: 10.1177/23779608211037494. eCollection 2021 Jan-Dec.

Abstract

INTRODUCTION

There are only a few studies investigating nurses' views on self-management in the care of patients with rheumatic diseases.

OBJECTIVE

The aim of this study is to explore how Norwegian rheumatology outpatient nurses describe their ways of supporting patients' self-management focusing on the core dimensions of person-centered self-management support.

METHODS

Ten individual semistructured interviews with rheumatology outpatient nurses were conducted in Norway from March to September 2017. The interviews were audiorecorded and transcribed verbatim. NVIVO was used to support a systematic analysis of themes and patterns.

RESULTS

Nurses' views on self-management support fell into three approaches; (1) narrowly biomedically orientated, (2) biomedically and holistic, and (3) person-centered. The nurse's views of self-management support varied and did not fully align with the core dimensions of person-centered practice.

CONCLUSION

The findings indicate that the biomedical paradigm continues to influence Norwegian rheumatology outpatient clinic nurses' approach to self-management support. If person-centered principles of self-management support are to be translated into standard nursing practice, including identifying and supporting patient-defined self-management goals and processes, there is a need to challenge established structures in health care systems.

摘要

引言

仅有少数研究调查了护士对风湿性疾病患者护理中自我管理的看法。

目的

本研究旨在探讨挪威风湿病门诊护士如何描述他们支持患者自我管理的方式,重点关注以患者为中心的自我管理支持的核心维度。

方法

2017年3月至9月在挪威对10名风湿病门诊护士进行了个人半结构式访谈。访谈进行了录音并逐字转录。使用NVIVO软件辅助对主题和模式进行系统分析。

结果

护士对自我管理支持的看法分为三种方式:(1)狭义的生物医学导向型,(2)生物医学与整体相结合型,(3)以患者为中心型。护士对自我管理支持的看法各不相同,且与以患者为中心的实践的核心维度不完全一致。

结论

研究结果表明,生物医学范式继续影响挪威风湿病门诊护士对自我管理支持的方法。如果要将以患者为中心的自我管理支持原则转化为标准护理实践,包括识别和支持患者确定的自我管理目标及过程,就需要挑战医疗保健系统中的既定结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ec/8642106/e69cdf739cec/10.1177_23779608211037494-fig1.jpg

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