IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France.
Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France.
Health Expect. 2022 Jun;25(3):947-958. doi: 10.1111/hex.13430. Epub 2022 Jan 10.
The Chronic Disease Self-Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles.
This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation.
We conducted a qualitative phenomenological semio-pragmatic study based on 37 in-depth interviews with 20 patients (20 before/17 after CDSMP).
By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person. By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education.
Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient-centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient.
Patients provided the data that were collected through in-depth interviews, and their experiences before and after the programme were analysed.
慢性疾病自我管理计划(CDSMP)已改善患者的健康结果。然而,研究主要集中在患有慢性疾病的患者身上,并未广泛探索针对具有特定脆弱性特征的个体的预防计划。
本研究旨在根据 EFFICHRONIC 项目中纳入的脆弱患者的需求和期望,了解 CDSMP 对他们生活体验的影响。
我们进行了一项基于半语用现象学的定性研究,对 20 名患者(20 名参加前/17 名参加后)进行了 37 次深入访谈。
慢性疾病通过改变存在维度(身份、与他人的关系和身体体验),产生了脆弱个体的新需求。通过与参与者的期望和需求产生共鸣,CDSMP 激发了动机和归属感,成为同行社区的一员。它使参与者能够在赋权之前成为自己健康的参与者。尽管报告了一些局限性,但该计划激发了参与者更好地照顾自己健康的愿望,并发展了个人技能,一些人希望参与健康教育。
我们的现象学方法强调了计划(其设计和实施)与患者生活体验之间的共鸣,这是赋权的有效因素。这需要培训协调员以引出患者的生活体验。此外,由于需要采用以患者为中心的方法,协调员需要学习如何根据患者的独特性调整计划的设计。
患者提供了通过深入访谈收集的数据,并分析了他们参加该计划前后的经验。